Homeless mothers with young children in their care contend with high rates of substance use, HIV risk, physical and mental health problems and parenting stress. These struggles are in addition to homelessness and meeting the basic needs of themselves and their children. However, a very limited number of studies have examined mother and child outcomes associated with housing and supportive services. Even with increased focus on those experiencing homelessness, the number of homeless families continues to rise, with the demand for temporary shelter so high that many cities are unable to meet the needs of these families. A comprehensive intervention that can be offered outside the shelter setting may offer greater reach to those experiencing homelessness who do not make it in to the shelter system, and for those communities that do not have shelters available. Among the young homeless, those under age 25, research documents that the majority (70%) have never used shelter services. Research attention towards identifying efficacious interventions for this population which address the multiple needs of these families is thus considered an important focus. The proposed intervention (Ecologically-Based Treatment, EBT) includes housing and supportive services and utilizes an ecological systems approach as the theoretical base. It was rigorously developed in a Stage 1 treatment development study with substance use disordered homeless mothers who were engaged through a crisis shelter. EBT showed several outcomes superior to shelter services and is therefore considered a good fit for a population who avoids the shelter but is in great need of housing and support services. Two hundred forty (N = 240) substance use disordered homeless young women between the ages of 18 to 24 years with a biological child under the age of 6 years in their care will be randomly assigned to one of three conditions: (1) housing and support services (EBT) + Treatment as Usual (TAU) (N = 80), (2) housing only (HO) + TAU (N = 80), or (3) TAU only (N=80). EBT includes 6 months of supportive services (case management, HIV prevention and the Community Reinforcement Approach) in addition to 3 months of rental assistance. HO includes 3 months of rental assistance, but without supportive services. TAU is usual services offered by a homeless youth drop-in center. Participants will be re-assessed at 3, 6, 9 and 12 months post-baseline. Theoretically derived mediators of change as well as a formal economic evaluation will offer important policy implications. Since homeless substance use disordered mothers and their children are at increased risk for a variety of adverse outcomes, the intervention may produce substantial health-care benefits to their families and society at large.

Public Health Relevance

A dearth of information is available regarding how best to intervene with substance use disordered homeless mothers and their young children. This proposal follows from the promising findings of a rigorously developed ecologically based treatment that offers a comprehensive intervention for the multiple needs of this vulnerable population. Such research attention is needed in order to effectively intervene in the substance use, HIV risk, mental/physical health and homeless trajectory of these women and their young children. Further, if successful, this intervention may be transportable to communities without crisis shelters and to homeless mothers who do not access shelter or residential treatment services.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA023908-09
Application #
9604322
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Anderson, Ann
Project Start
2007-10-01
Project End
2019-11-30
Budget Start
2018-12-01
Budget End
2019-11-30
Support Year
9
Fiscal Year
2019
Total Cost
Indirect Cost
Name
Ohio State University
Department
Other Health Professions
Type
Schools of Education
DUNS #
832127323
City
Columbus
State
OH
Country
United States
Zip Code
43210
Wu, Qiong; Slesnick, Natasha; Murnan, Aaron (2018) UNDERSTANDING PARENTING STRESS AND CHILDREN'S BEHAVIOR PROBLEMS AMONG HOMELESS, SUBSTANCE-ABUSING MOTHERS. Infant Ment Health J 39:423-431
Guo, Xiamei; Slesnick, Natasha; Feng, Xin (2016) Housing and Support Services with Homeless Mothers: Benefits to the Mother and Her Children. Community Ment Health J 52:73-83
Slesnick, Natasha; Guo, Xiamei (2013) Treatment desires and symptomatology among substance-abusing homeless mothers: what I want versus what I need. J Behav Health Serv Res 40:156-68
Slesnick, Natasha; Erdem, Gizem (2013) Efficacy of ecologically-based treatment with substance-abusing homeless mothers: substance use and housing outcomes. J Subst Abuse Treat 45:416-25
Slesnick, Natasha; Erdem, Gizem (2012) Intervention for homeless, substance abusing mothers: findings from a non-randomized pilot. Behav Med 38:36-48
Dashora, Pushpanjali; Slesnick, Natasha; Erdem, Gizem (2012) ""Understand My Side, My Situation, and My Story:"" Insights into the Service Needs Among Substance-Abusing Homeless Mothers. J Community Psychol 40:938-950
Slesnick, Natasha; Glassman, Michael; Katafiasz, Heather et al. (2012) Experiences associated with intervening with homeless, substance-abusing mothers: the importance of success. Soc Work 57:343-52
Sznajder-Murray, Brittany; Slesnick, Natasha (2011) 'Don't Leave Me Hanging': Homeless Mothers' Perceptions of Service Providers. J Soc Serv Res 37:457-468