# Revision to the HOME Trial: Suicide Treatment Education and Prevention (HOME + STEP)

> **NIH NIH UH3** · OHIO STATE UNIVERSITY · 2020 · $708,132

## Abstract

Project Summary/Abstract
Notice of Special Interest: HEAL Supplements to Improve the Treatment and Management of Common Co-
Occurring Conditions and Suicide Risk in People Affected by the Opioid Crisis. Homeless youth have high
rates of alcohol and illicit drug use, comorbid mental health conditions, and are at high risk for suicide.
However, few preventive interventions have been proven for reducing substance use or addressing suicide
among homeless youth. Resolution of youth homelessness through housing and prevention services, often
referred to as “Housing First” (HF), as proposed in the parent HOME study has great potential to reduce opioid
use and progression to opioid use disorder (OUD). This Competitive Revision (CR), “HOME + Suicide
Treatment Education and Prevention (STEP),” proposes to collect additional measures of suicide risk and
evaluate the secondary benefits of HF combined with preventive interventions to reduce suicidal ideation (SI)
and related outcomes over time. Given the anticipated severity of suicide risk in our sample, we will add
“STEP” to the parent study’s preventive interventions targeting opioid use, including additional screening
procedures and Cognitive Therapy for Suicide Prevention (CTSP) for those at high risk for suicide. In our prior
trial among homeless youth with severe SI, those who received CTSP has a significantly faster decline in SI
compared to youth receiving treatment as usual. The Primary Aim of the CR is to determine the effectiveness
of HF + STEP, compared to STEP alone, for reducing primary (suicidal ideation) and related (depression
symptoms, suicide attempts) outcomes over time. Secondary aims will test whether outcomes differ among
those at high risk at baseline (eligible for CTSP), and whether they are mediated through hypothesized primary
(housing stability and substance use) and secondary (hopelessness, stress coping) pathways; and will explore
CTSP implementation determinants and outcomes (acceptability, appropriateness, feasibility, fidelity, and
cost). Methods. The CR will use the parent study’s sample of youth who do not meet criteria for OUD at
baseline (n=240). The parent study will deliver manualized preventive interventions to all youth to address
opioid use, and 6 months of housing to a random sample (n=120). With the CR, additional screening and
CTSP will be delivered to youth in both study groups. CTSP will be delivered to high risk youth via one-on-one
therapy sessions with a trained research therapist over 6 months. Primary and secondary outcome measures
will be collected at 3-, 6-, 9-, and 12 months. Analyses of aims will be conducted via intention-to-treat and will
use latent growth models (LGM) to estimate trajectories of change across assessment points (baseline, 3, 6, 9,
and 12 months follow-up). A series of path analysis will test hypothesized mediators and assess
implementation context in a Hybrid Type I implementation study. Impact. Identifying effective strategies to
del...

## Key facts

- **NIH application ID:** 10141532
- **Project number:** 3UH3DA050174-02S1
- **Recipient organization:** OHIO STATE UNIVERSITY
- **Principal Investigator:** Kelly J Kelleher
- **Activity code:** UH3 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $708,132
- **Award type:** 3
- **Project period:** 2019-09-01 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10141532

## Citation

> US National Institutes of Health, RePORTER application 10141532, Revision to the HOME Trial: Suicide Treatment Education and Prevention (HOME + STEP) (3UH3DA050174-02S1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10141532. Licensed CC0.

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