Can you help improve literature review conclusions? Prompt instructions 2 pages at end of writing...

By Leon Pikor

Public Administration, California State University Northridge

Research Proposal People experiencing homelessness (PEH) and Substance abuse (SA)

Prof. E. Maggioni

Mar 15, 2023

Contents

In Barman-Adhikari et al.'s (2017) article, "Descriptive and Injunctive Network Norms Associated With Nonmedical Use of Prescription Drugs (NMUPD) Among Homeless Youth," the research shows how addictive critical components youth experiencing homelessness (YEH). Additionally, it is revealed that harmful habits of the misuse of drugs can become regular behaviors until treatments work. YEH practices NMUPD as a temporary escape from issues that they endure. The method of this research includes1,046 YEH, from three drop-in centers. The participants of this study were interviewed, which discussedtheir personal and social life.

Although Barman-Adhikari et al.'s (2017) research is useful,the methods are limited as bias occurs in data that is self-reported through surveys. The confidential questionnaire has a self-interview impression of social management related to changing YEH' perceptions of social norms: "assessing their perceptions of their network members' reduced the confusion noted above"(Barman-Adhikari et al., 2017, p. 76).

Coreability of designs in collection of data and cause for YEH substance abuse (SA) perceptions are peer related.Research improves what can be seen to understand why YEH use of NMUPD and the gap of doctor's limits to connect services to commit to treatment services for the YEH. "Longitudinal investigations of how the causal pathways through which network attributes facilitate the formation of substance use norms"(Barman-Adhikari et al., 2017, p.76).

Confidential data and choices SA and YEH did not enter theneeds to identify the prescription drug. "Our findings help further our understanding of the relationship between perceived norms of NMUPD and self-reported NMUPD"(Barman-Adhikari, 2017, p 76).YEH may start NMUPD to cope with their peers' use. The benefits of network interventions that specifically target prevention of NMUPD among YEH.

Brubaker et al.,'s (2013) article, "Barriers and Supports to substance abuse (SA) Service Use Among Homeless Adults" SA barriers are measured in perceptions for societal individuals for PEH. Survey methods with time intervals to help with treatment plan analysis and have shown progress. The study "measures 49 barriers identified within the literature, each of which are statement form and rated on a 5-point Likert scale from strongly agree to strongly disagree" (Brubaker et al., 2013). The survey clarifies societal PEH patients' individual perceptions of barriers to housing. "For many who are living on the streets or in other precarious situations, family members may be less able to provide support because of their own economic limitations or for reasons directly related to the effects of addiction on a family" (Brubaker et al., 2013). Practitioners providing services are designing methods for improvement with a small accountable sample of SA, PEH with financial and societal issues. "For the current study, the three subscales of the [Barriers to Treatment Inventory] BTI (Social/Financial, Programmatic, and Individual) " (Brubaker et al., 2013). An interview with open-ended questions in an open ended manner is more likely to gather rich data."In addition, an open-ended question was added to the BTI to inquire about barriers that were encountered that may not have been covered in the 49 items. " (Brubaker et al., 2013, p. 87). PEH's addictions and excessive drinking and societal counseling programs to improve the quality of life. "Four limitations related to the study design were as follows: (a) convenience sampling methods, (b) the use of less sophisticated procedures for missing data, (c) the use of self-reported data, and (d) instrumentation" (Brubaker et al., 2013, p. 87). Samples to improve data results and accuracy with methods of self reporting and survey approach limitation from one area of history.

DiGuiseppi et al., 's (2020) article, "Polysubstance use among youth experiencing homelessness (YEH): The role of trauma, and social network composition" and behavioral experiences interviews over a period of time assess YEH and SA show: "test whether (a) traumatic experiences, or (b) social network composition, are better predictors of heterogeneity in polysubstance use among YEH"(DiGuiseppi et al., 2020, p. 12).The researchers made assessments of the profiles and designed a model to address and plan to help improve YEH to become drug free and have housing with case management.

"Data collection occurred in four waves from October 2011 to June 2013, allowing for sufficient recruitment of new individuals accessing drop-in services. Individuals aged 14-25 were approached to participate in the study"(DiGuiseppi et al., 2020, p. 21) The YEH on drugs will take practice of research tools and specific measures to help overcome the issue of SA and YEH."In conclusion, previous traumatic experiences, suicidality, and social network composition are associated with emergent polysubstance use classes among YEH" (DiGuiseppi et al., 2020, p. 42). Focus groups contributed with interviews of the YEH and can determine SA patterns with a better heartfelt understanding.

Ibabe et al.,'s (2014) article "Predictors of Substance abuse (SA) treatment participation among homeless adults" Environmental and psychological issues that contribute to PEH who have SA that research models for psychosocial health improvement. "Psychosocial factors play an influential role in health."(Ibabe et al p. 376) SA assessment and treatment models predict behavioral plans to lower stress. "The rates of SA are considerably high among PEH (50 % or more), and those who are dependent on alcohol or drugs are less likely to be out of homelessness" (Ibabe et al, p. 376). Mental illness increases the risk for victimization for PEH. "Although there is important empirical evidence about the factors (child abuse and drug abuse) that increase the probability of becoming homeless, there are few studies that have attempted to integrate these factors into a model, explain the relations among these factors, and to analyze their associations with treatment engagement and current participation in SA."(Ibabe et al p. 376) PEH do not complete most SA treatment program model solutions. "Statistical analysis helps. to elucidate the directional relationships among a large set of variables, and represents an improvement over the multiple regression techniques more commonly used in the substance" (Ibabe et al p. 376) Trauma history missing necessities, food and shelter housing in a communities' integration management helps. Thus, stable housing may provide interventions to help addiction.

Problems overcome the barriers to treatment by improvement of trust and success with completion of programs with solid models to believe in social and physical improvement with access to a good treatment plan.

PEH needs meaningful care programs for SA custom outreach to overcome taking action in starting services. " training of nurses, social workers, psychologists, physicians and other professionals who are in contact with homeless people will be the key to break these barriers."(Ibabe et al p. 379) Finding methods to design programs to lessen emotional stress like interview-based research to review distress with SA among PEH and treatment fortrauma history.

Awareness of resources and availability is important for reducing overdoses which could directly affect overdoses and deaths among PEH. A research study by Dr. Kinnard et al. (2021) found, "People who Inject Drugs (PWID) may have multiple opioid overdoses over time, especially with the emergence of fentanyl, which requires more frequent use due to shorter duration of effect" (Kinnard et al., 2021, p. 6-7). This data about homeless drug abuse and stability measures proves many limitations are responsible for the high number of deathsdue to overdose.

Milby, J. B., et al, article "To House or Not to House: The Effects of Providing Housing to Homeless SArs in Treatment." Shows that housing matters in treatment of homeless individuals that are on drugs, but it is not the first step to provide housing during treatment until drug tests reveal that monitoring methods for SA conditions are completed. "196 cocaine-dependent participants who received day treatment and no housing (NH), housing contingent on drug abstinence (ACH), or housing not contingent on abstinence" (NACH). Milby 2005 p. 1259) The results showed that "The ACH group had a higher prevalence of drug abstinence than the NACH group (after control for treatment attendance), which in turn had a higher prevalence than the NH group" (Milby 2005 p. 1259) All the groups had made progress and the programs to measure outcomes reviewed. "Proportion (SE) of Participants Who Were Abstinent During Phases 1 and 2 of Treatment: Results of Generalized Estimating Equation Model Prevalence" (Milby p 1262) The design models are increasing help to effectively improve treatment of PEH and SA.

The Nicholas et al. (2021) article is about PEH deaths of other homeless as a peer support monitoring implementation. The point is to lessen deaths from historical data by measuring whether the medical examiner/coroner (MEC) were allowing for clarity about the cause of deaths. "This matching also allowed for homeless deaths investigated by the MEC to be distinguished from those identified solely from death certificate addresses" (Nicholas et al., 2021, p. 2214). Accountability and understanding of the causes help to identify key issues leading to solutions. "Public health strategies for reducing mortality in the general population are guided by trends in mortality rates that use mid-year target point estimates as proxies for person-years of exposure to mortality risk" (Nicholas et al., 2021, p. 2212). Issues are overwhelming to the PEH and data is not sufficient to track the number of overdoses to better inform prevention programs to lessen the deaths.

Nelson, et al.,article "Early implementation evaluation of a multi-site housing first intervention for homeless people". A path for housing for PEH and SA using Interviews and surveys. Getting to the why with understanding the reasons for SAis difficult. Nelson et al. (2014) evaluated with a mixed methods approach, the multisite Housing First intervention to provide a compassionate life. They found limitations in the coordination between shelter caregivers with lessening SA.

Housing first in action for PEH) to discover the descriptions of science related to understanding SA and lack of rapid response custom treatment plans to help, includingstable housing for PEH. Housing helps in creating recovery first in residential treatment with a linear path to help with SA abstinence. Current support systems include problems that show that systematic failures occur in design effectiveness models for supporting PEH. Inclusion and exclusion acceptance conditions are a barrier to provide the needed help to PEH (Nelson et al., 2014).

Nelson et al. (2014) continued that housing first is one commonly successful support for reducing overdoses among PEH finding temporary housing for those with SA issues and case workers have been provided to evaluate and address homeless people's needs. This allows for an appropriate level of treatment in a program that is custom for PEH on drugs will need to get a long-term housing plan. PEH improve their situation with housing and drug treatment programs that are tested and work.

Current data support measures to impact the lives of PEH and society on the whole. For example, SA services to help homeless individuals transition successfully to more permanent housing(Nelson et al., 2014). By understanding the root causes of homelessness and mapping the best careful solutions. First, it is important to understand that SA service methods are eligible for benefits but are simply not receiving their fair share, or do not have a clear understanding or may not speak English. Teaching PEH to engage in self-determination for education and resources for their health. The collaboration of many people allows for improvement for those PEH and SA in need.

North, et al. article., "The role of organizational characteristics in determining patterns of utilization of services for substance abuse (SA), shelter by homeless people" surveys are completed, however, many PEH with SA did not complete program treatments. The shelter management of survey data size, staffing and funding access platform are needed. "12-month interval following these individuals' index interviews (North,et al., 2005, p. 577). Technology is an important factor in accountability of data from contractors hired to perform the design model. "The service use data were obtained from the few organizations not participating in the city's centralized intake, referral, and case management network by manual review of organizational rosters and sign-up sheets by project" (North,et al., 2005, p.578). Inpatient programs gave the service from purchase data or Medicaid sectors of health care in SA, PEH for 12-months. Management of organized data as an independent variable in historical data to research, practice and improve services to PEH and SA.

Padgett et al., article, "Life Course Adversity in the Lives of Formerly Homeless Persons with Serious Mental Illness", furthermore the "38 formerly PEH, SA negative history accounted for in surveys showing the traumas listed below inventoried in checklist. "Participants averaged 8.8 adverse events, with approximately one-third having experienced incarceration (37%), suicidality (32%), abandonment by one or both parents (30%), and death of their mother (34%)" Padget2012 p. 421-422). The results show causes of stress of estrangement, trauma and death among those with SA and PEH. "Recovery movement should address prior adverse experiences beyond comorbid diagnoses in this population. Padget 2012 p. 421-422)

"Co-occurring SA and mental health problems among homeless", written by Polcin (2016), shows that there is a wealth of literature regarding the problem of SA among PEH. Polcin (2016) explains, "to improve the evidence base for systems of care for homeless persons with substance use disorders there needs to be closer attention to measurement of the characteristicsofhomelesspersons, specificationof inclusion and exclusion criteria that help focus studies on specific problems, and assessment of the types of services participants receive within different models" (p. 8 ). Causality of the problems is important to determine to improve with understanding designs to improve access to service that PEH need, such as many broad peer SA experts to close the gap of service missing to solve the critical issues faced by SA rehabilitation limitations of impact assessments and fast treatments or service (Polcin, 2016).PEH and SA need to overcome barriers to helping them quit and understand the causes then predict a permanent solution. (Kinnard et al., 2021; Polcin, 2016). Causes include stress caused by poverty, mental illness, including depression and trauma, and the stress caused by homelessness, itself (Polcin, 2016).

Sophia Lee, H., & Petersen, S. R., article "Demarginalizing the marginalized in substance abuse (SA) treatment: Stories of homeless, active substance users in an urban harm reduction based drop-in center," the research shows that improvement is accomplished to lessen the feeling of powerlessness and trauma among people experiencing homelessness (PEH) and SA addiction and enable the program treatment to improve its potential. The trauma of being dehumanized leaves PEH and SA a bad method in the process of improvement with respect works better (Sophia-Lee & Peterson, 2009, p.622-623). As stated by the researchers: "this shift in receptivity is significant given that the vast majority of participants held negative perceptions of their past treatment experience" (Sophia Lee, H.,& Peterson, 2009 p 622-623). Quitting addictions are part of the process to achieve sobriety and address history of bad causes leading to PEH and SA.

Sosin et al.'s (2003)article "The Individual and Beyond: A Socio-Rational Choice Model of Service Participation Among Homeless Adults with Substance abuse (SA) Problems" explains that many societal theories will rationalize model selections based on perspectives. "One of our simple hypotheses is that homeless clients will more fully participate in substance-user treatment if they hear an inviting recruitment pitch" (Sosin et al., 2003, p. 523). Research including historical perception taking action to succeed on a path that they had lost before on getting help and now have a urgent need to take action. "When considering poor clients, a state administrator told us the initial rate of treatment participation in his SA programs can move from 20 to 80% with the addition of an unusually effective recruiter" (Sosin et al., 2003, p. 523). PEH do not believe in or are not clearly informed about the care and benefits of treatment programs. "Two more complex argumentsoverlooked in most of the empirical work on service participation among this population" (Sosin et al., 2003, p. 523). Historical data helps to model the flow of data.

Rhoades et al.' s (2018) article "Social networks and substance use after transitioning into permanent supportive housing" Social networks to others in a community or with similar users and found a high incidence of binge drinking. Rhoades et al. (2018) concluded that permanent supportive housing (PSH) can worsen drug usage because PEH use substances to cope with change (Rhoades et al., 2018, p. 67). This study findings of cross-sectional networks of SA in PEH shows longitudinal connections. "These ndings aimed at integration and pro-social relationships and improving the social ecological context (Rhoades et al., 2018, p. 68)

Improvements in SA lower the PEH desire for social networks and help strategies to quit. "Despite the use of the term abstinence with regard to illicit drugs compatible with the principles of harm reduction; programs aimed at reducing substance use in the social environment (Rhoades, 2018, p. 68). Changes need to be made to continue on research to lower chances of relapse and address the majority of PEH with SA diagnosis.

In observation of training methods to help the SA recovery among Injection drug users (IDUs) PEH were paid for providing survey data to better understand the issues that they face. "Trained interviewers administered the surveys with demographic information including age, ethnicity, housing status, drug use behavior, and treatment were collected at baseline and 3-month follow-up" (Wagner et al., 2010,p. 187). PEH, IDUs that overdose need quick help to recover by those with proper training. The intention of lessening death designed with follow up surveys to measure variables since learning about drug abuse solutions.

"The majority (53%) reported that their drug use had decreased. In support of this observation, an increased proportion reported enrollment in drug treatment, from23% to 36% (p = 0.07) (Wagner, et al. 2010,p. 189). Observing the overdoses follow-up end surveys showed PEH with IDUs the following results occurred: "Most of the victims were strangers (40%), associates/acquaintances (31%), and friends (17%)" (Wagner et al., 2010,p. 189).

Learn from the designs to lessen the overdose death amounts. "One participant provided data about her own overdose, during which her friend injected her with her own naloxone" (Wagner et al., 2010,p. 189). The contribution of prevention with follow updesign program plans and experts in reversing and helping with housing will lessen drug overdose.

Interviews

Quantitaive data: Jones, smith and Land show good improvement Qualitative data: Interviews show 123 at 300 surveys with 91 percent response positiveImportant assessment for custom a

Typical components of a research proposal Assessment of material costs Time 400 hours

Materials $7500.00. Staffing 5. Reporting strategy Interviews and surveys every 3 Months.

Written report, public presentation, Attention to the target population Federal Government.

References

Barman-Adhikari, A., Al Tayyib, A., Begun, S., Bowen, E., & Rice, E. (2017). Descriptive and injunctive network norms associated with nonmedical use of prescription drugs among homeless youth.Addictive Behaviors, 64,70-77.https://doi.org/10.1016/j.addbeh.2016.08.015

Brubaker, M. D., Amatea, E. A., Torres-Rivera, E., Miller, M. D., & Nabors, L. (2013). Barriers and Supports to SA Service Use Among Homeless Adults.Journal of Addictions & Offender Counseling,34(2), 81-98.https://doi.org/10.1002/j.2161-1874.2013.00017.x

DiGuiseppi, G. T., Davis, J. P., Christie, N. C., & Rice, E. (2020). Polysubstance use

among youth experiencing homelessness: The role of trauma, mental health, and social network composition.Drug and Alcohol Dependence, 216, 108228-108228.https://doi.org/10.1016/j.drugalcdep.2020.108228

Ibabe, I., Stein, J. A., Nyamathi, A., & Bentler, P. M. (2014). Predictors of SA treatment participation among homeless adults.Journal of SA Treatment,46(3), 374-381.https://doi.org/10.1016/j.jsat.2013.10.008

Kinnard, E. N., Bluthenthal, R. N., Kral, A. H., Wenger, L. D., & Lambdin, B. H. (2021). The naloxone delivery cascade: Identifying disparities in access to naloxone among people who inject drugs in Los Angeles and San Francisco, CA.Drug and Alcohol Dependence, 225, 108759-108759.https://doi.org/10.1016/j.drugalcdep.2021.108759

Milby, J. B., Schumacher, J. E., Wallace, D., Freedman, M. J., & Vuchinich, R. E. (2005). To house or not to house: The effects of providing housing to homeless SArs in treatment.American Journal of Public Health (1971), 95(7), 1259-1265.https://doi.org/10.2105/AJPH.2004.039743

Nelson, G., Stefancic, A., Rae, J., Townley, G., Tsemberis, S., Macnaughton, E., Aubry, T.,

Distasio, J., Hurtubise, R., Patterson, M., Stergiopoulos, V., Piat, M., & Goering, P. (2014). Early implementation evaluation of a multi-site housing first intervention for homeless people with mental illness: A mixed methods approach.Evaluation and program planning, 43, 16-26.https://doi.org/10.1016/j.evalprogplan.2013.10.004

Nicholas, W., Greenwell, L., Henwood, B. F., & Simon, P. (2021). Using point-in-time homeless counts to monitor mortality trends among PEH in Los Angeles County, California, 20152019.American Journal of Public Health (1971),111(12), 2212-2222.https://doi.org/10.2105/AJPH.2021.306502

North, C. S., Pollio, D. E., Perron, B., Eyrich, K. M., & Spitznagel, E. L. (2005). The role of organizational characteristics in determining patterns of utilization of services for SA, mental health, and shelter by homeless people.Journal of Drug Issues,35(3), 575-591.https://doi.org/10.1177/002204260503500309

Padgett, D. K., Smith, B. T., Henwood, B. F., & Tiderington, E. (2012). Life Course Adversity in the Lives of Formerly Homeless Persons With Serious Mental Illness: Context and Meaning. American Journal of Orthopsychiatry, 82(3), 421-430. https://doi.org/10.1111/j.1939-0025.2012.01159.x

Polcin, D. L. (2016). Co-occurring SA and mental health problems among homeless persons: Suggestions for research and practice.Journal of social distress and homeless, 25(1), 1-10.https://doi.org/10.1179/1573658X15Y.0000000004

Rhoades, H., La Motte-Kerr, W., Duan, L., Woo, D., Rice, E., Henwood, B., Harris, T., & Wenzel, S. L. (2018). Social networks and substance use after transitioning into permanent supportive housing.Drug and Alcohol Dependence,191, 63-69.https://doi.org/10.1016/j.drugalcdep.2018.06.027

Sophia Lee, H., & Petersen, S. R. (2009). Demarginalizing the marginalized in substance abuse treatment: Stories of homeless, active substance users in an urban harm reduction based drop-in center. Addiction Research & Theory, 17(6), 622-636. https://doi.org/10.3109/16066350802168613

Sosin, M. R., & Grossman, S. F. (2003). The Individual and Beyond: A Socio-Rational Choice Model of Service Participation Among Homeless Adults with SA Problems.Substance Use & Misuse,38(3-6), 503-549.https://doi.org/10.1081/JA-120017384

Wagner, K. D., Valente, T. W., Casanova, M., Partovi, S. M., Mendenhall, B. M., Hundley, J. H., Gonzalez, M., & Unger, J. B. (2010). Evaluation of an overdose prevention and response training programme for injection drug users in the Skid Row area of Los Angeles, CA.The International Journal of Drug Policy, 21(3), 186-193.https://doi.org/10.1016/j.drugpo.2009.01.003

Prompt 2 pages instructions for assignment: This deliverable supports all 3 learning objectives of this class:

• Acquire basic analytical skills allowing you to present a structured research design (proposal) on the topic of your choice. (L.O. 1)
• Develop your abilities to speak and write about the research methods applicable to the field of public administration. (L.O. 2)
• Develop reflexivity, critical thinking as well as problem-solving capacities. (L.O. 3)

Purpose:

The final assignment is for students to prepare a research proposal.

Instructions:

Project proposal's components:

• A "problem statement" description of the chosen topic and its justification (pertinence).
• A short literature review explaining the core component of the research problem and the limitations in existing research (that is a section with your critique and analysis of the literature's shortcomings).
• A specific problem (gap).
• A statement regarding what is the specific research question and specific research aim.
• A description of the research methodology: research's approach, design, dimensions, and strategies.
• Specification of dimensions, variables, and hypothesis (if applicable).
• Description of data collection methods and analytical methods (projected).
• A discussion of ethical considerations.
• A discussion about the methodological limitations: reliability, validity (both internal and external), credibility, robustness, transferability and generalizability.
• The mention of some research benefits, merits, and/or possible outcomes.
• Your list of references: only include references that you cite in-text (include a minimum of 12 references, including a min. of 10 peer-reviewed sources).

Additional guidelines for the production of the Research proposal are posted on canvas in a file named "Directives - Deliverable #4".

Grading Criteria:

1. Clarity
2. Feasibility
3. Credibility
4. Originality
5. Design validity
6. Transferability