R01DA054976

Implementation of Overdose Prevention Practices in Permanent Supportive Housing - Project Summary

Permanent Supportive Housing (PSH), the gold standard intervention for ending chronic homelessness, has expanded rapidly across the U.S. in recent years and is likely to continue expanding as homelessness increases in the wake of the COVID-19 pandemic.

Due to a confluence of individual and environmental risk factors, PSH tenants face heightened risk for overdose (OD). While evidence-based practices (EBPs) to prevent OD exist, they have not been broadly implemented in PSH settings.

We propose to address this significant research-to-practice gap by tailoring a set of evidence-based OD prevention practices for PSH settings, then studying their implementation in 20 PSH buildings in New York. We will test a package of implementation strategies that includes an implementation toolkit, tenant-staff implementation champion dyads, limited practice facilitation, and learning collaboratives.

The project will be conducted in partnership with the Corporation for Supportive Housing, a national organization that advances solutions to improve PSH through education, practice, and policy.

Aim 1 is to adapt evidence-based OD prevention practices for PSH, using key stakeholder focus groups, and develop a PSH OD prevention toolkit to guide implementation. In this preparation phase, we will adapt an existing package of EBPs in consideration of the unique environmental characteristics of PSH and will prepare for implementation.

Aim 2 is to evaluate implementation of evidence-based OD prevention practices across diverse PSH buildings and effectiveness on PSH tenant outcomes in a stepped wedge trial. In this hybrid type 3 effectiveness-implementation study, the primary implementation outcome is PSH building adoption of the OD prevention EBPs. We will additionally examine secondary implementation outcomes, tenant clinical outcomes, and implementation sustainment.

Aim 3 is to explore multilevel factors influencing implementation—including barriers and facilitators—and refine dissemination and implementation frameworks for housing settings, using qualitative interviews with PSH staff. The research draws from the EPIS (Exploration, Preparation, Implementation, Sustainment) implementation framework and Rhodes' Risk Environment Framework. The research will inform implementation frameworks and strategies by examining the application of EPIS for PSH and testing novel housing-relevant implementation strategies, including staff-tenant implementation champion dyads.

Findings from this PSH-focused research are expected to be more broadly applicable to other types of housing and settings serving people experiencing homelessness. The multidisciplinary investigator team will work with a stakeholder advisory board to maximize the impact of the research, which has been designed to inform local and national programmatic and policy interventions.

Changes in the epidemiology of the U.S. OD crisis highlight the need for concerted efforts to reduce the disparate burden of ODs faced by particularly marginalized populations.

New York University

TO SUPPORT BASIC AND CLINICAL NEUROSCIENCE, BIOMEDICAL, BEHAVIORAL AND SOCIAL SCIENCE, EPIDEMIOLOGIC, HEALTH SERVICES AND HEALTH DISPARITY RESEARCH. TO DEVELOP NEW KNOWLEDGE AND APPROACHES RELATED TO THE PREVENTION, DIAGNOSIS, TREATMENT, ETIOLOGY, AND CONSEQUENCES OF DRUG ABUSE AND ADDICTION, INCLUDING HIV/AIDS. TO SUPPORT RESEARCH TRAINING AND RESEARCH SCIENTIST DEVELOPMENT. TO SUPPORT DISSEMINATION OF RESEARCH FINDINGS. SMALL BUSINESS INNOVATION RESEARCH (SBIR) LEGISLATION IS INTENDED TO EXPAND AND IMPROVE THE SBIR PROGRAMS TO EMPHASIZE AND INCREASE PRIVATE SECTOR COMMERCIALIZATION OF TECHNOLOGY DEVELOPED THROUGH FEDERAL SBIR RESEARCH AND DEVELOPMENT, INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT, AND FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN THE SBIR PROGRAM. THE LEGISLATION INTENDS THAT THE SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM STIMULATE AND FOSTER SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, FOSTER TECHNOLOGY TRANSFER BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, AND FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION.

93.279 - Drug Abuse and Addiction Research Programs

National Institute on Drug Abuse (NIDA) [HHS - NIH]

New York, New York 100168203 United States

Single Zip Code

Dissemination and Implementation Research in Health (R01 Clinical Trial Optional) (PAR-19-274)

Amendment Since initial award the total obligations have increased 291% from $794,541 to $3,104,337.