Stefan G. Kertesz, M.D. is an academic physician in general internal medicine with five years of clinical experience caring for homeless persons addicted to drugs and alcohol, and drug abuse research training experience. As part of his K23 career development award, he will seek to identify factors associated with addiction treatment utilization and addiction outcomes among homeless persons who abuse drugs and/or alcohol (Aim 1). Given the heterogeneity of the homeless population, in particular the ways in which the duration of homelessness can vary from a few nights to many years, the proposed research also seeks to determine whether factors associated with addiction treatment utilization differ according to the persistence of homelessness (Aim 2). The research program will use two existing datasets to address these aims. In Part 1, data from the 1996 National Survey of Homeless Assistance Providers and Clients will permit evaluation of factors associated with treatment utilization in a nationally representative cross-sectional survey of homeless persons. In Part 2, data from a completed 2-year prospective follow-up study of 470 homeless and housed persons addicted to drugs and/or alcohol will permit evaluation of factors associated with sustained treatment utilization, and evaluation of the relationship between treatment utilization and addiction outcomes. The value of treatment itself has been documented in the context of clinical trials. The importance of this proposed research lies in its potential to assist policymakers and treatment planners who wish to understand how to improve actual treatment access and treatment utilization by homeless persons who are addicted to drugs and/or alcohol. ? ? Career development activities for this career development award include the research itself, mentoring by individuals with extensive research experience in addiction and homelessness, and coursework to develop methodological expertise pertinent to the use of large and complex datasets, content expertise in the areas of addiction, addiction treatment theory, housing policy and homeless sociology, and research ethics. Completion of the proposed work will prepare Dr. Kertesz to independently investigate the treatment of drug and alcohol abuse in the homeless.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23DA015487-05
Application #
6941786
Study Section
Human Development Research Subcommittee (NIDA)
Program Officer
Jones, Dionne
Project Start
2002-12-03
Project End
2007-08-31
Budget Start
2005-09-01
Budget End
2006-08-31
Support Year
5
Fiscal Year
2005
Total Cost
$169,161
Indirect Cost
Name
University of Alabama Birmingham
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
063690705
City
Birmingham
State
AL
Country
United States
Zip Code
35294
Kertesz, Stefan G; Crouch, Kimberly; Milby, Jesse B et al. (2009) Housing first for homeless persons with active addiction: are we overreaching? Milbank Q 87:495-534
Kertesz, Stefan G; Hwang, Stephen W; Irwin, Jay et al. (2009) Rising inability to obtain needed health care among homeless persons in Birmingham, Alabama (1995-2005). J Gen Intern Med 24:841-7
Kertesz, Stefan G; Posner, Michael A; O'Connell, James J et al. (2009) Post-hospital medical respite care and hospital readmission of homeless persons. J Prev Interv Community 37:129-42
Pletcher, Mark J; Kertesz, Stefan G; Kohn, Michael A et al. (2008) Trends in opioid prescribing by race/ethnicity for patients seeking care in US emergency departments. JAMA 299:70-8
Kertesz, Stefan G; Pletcher, Mark J; Safford, Monika et al. (2007) Illicit drug use in young adults and subsequent decline in general health: the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Drug Alcohol Depend 88:224-33
Kertesz, Stefan G; Mullins, Ashley N; Schumacher, Joseph E et al. (2007) Long-term housing and work outcomes among treated cocaine-dependent homeless persons. J Behav Health Serv Res 34:17-33
Schumacher, Joseph E; Milby, Jesse B; Wallace, Dennis et al. (2007) Meta-analysis of day treatment and contingency-management dismantling research: Birmingham Homeless Cocaine Studies (1990-2006). J Consult Clin Psychol 75:823-8
Pletcher, Mark J; Kertesz, Stefan G; Sidney, Stephen et al. (2006) Incidence and antecedents of nonmedical prescription opioid use in four US communities. The Coronary Artery Risk Development in Young Adults (CARDIA) prospective cohort study. Drug Alcohol Depend 85:171-6
Kim, Theresa W; Kertesz, Stefan G; Horton, Nicholas J et al. (2006) Episodic homelessness and health care utilization in a prospective cohort of HIV-infected persons with alcohol problems. BMC Health Serv Res 6:19