# Prevention of OUD: The HOME (Housing, Opportunities, Motivation and Engagement) Randomized Trial

> **NIH NIH UH3** · OHIO STATE UNIVERSITY · 2020 · $4,922,920

## Abstract

Abstract
While opioid use in the general population has received significant media and scholarly attention in recent
years, very little research exists on opioid use among homeless or street-involved youth. Homeless youth
have a much higher rate of substance use than non-homeless peers with evidence suggesting that homeless
youth have the highest rates of opioid use among youth subgroups in the country (Brands et al., 2005); heroin
using homeless youth also appear to have the highest rates of IV drug use and HIV (Rhoades et al., 2014).
Given the high rates of opioid use, exposure to violence, mental and physical health challenges, and high
rates of mortality in homeless youth, it is surprising that no study to date utilizes a randomized controlled
design to test prevention of opioid and other drug use among this vulnerable population. Even among those
receiving risk reduction interventions, lack of stable housing appears to be a barrier to reducing risk behaviors
(DesJarlais et al., 2007). Resolution of youth homelessness through housing and prevention services, often
referred to as “Housing First”, as proposed in the current study, has great potential to reduce the likelihood for
the development of an opioid use disorder as well as other problem behaviors associated with living on the
streets. However, only 20-30% of homeless youth samples report ever having stayed at a crisis shelter, 9%
report having ever accessed mental health services, and 15% report ever having received substance use
treatment (Ray, 2006) indicating a need to reach and engage youth in services that are feasible and
acceptable. This study will provide essential information for researchers and providers on the efficacy of
housing + opioid and related risk prevention services in an RCT on opioid use, how moderators affect the
response, and mechanisms underlying change. Our intervention and hypotheses are guided by our
conceptual model incorporating the biopsychosocial model (Fordyce et al., 1973) with social ecological
systems theory (Bronfenbrenner, 1979) and Bandura’s Social-Cognitive Theory (1977; 1986). Interview,
physiological, and self-report methods will be used for data gathering. Phase I (UG3) of the study includes a
pilot study with 21 youth to assess initial efficacy, feasibility of recruitment and acceptability of the manualized
housing + opioid and related risk prevention services. Upon meeting transition milestones, 240 youth will then
be recruited for a larger randomized clinical trial testing housing + opioid and related risk prevention services
versus opioid and related risk prevention services alone (Phase II, UH3). Follow-up will be conducted at 3, 6,
9 and 12-months post-baseline. The economic cost of each intervention will be determined to inform future
providers and their funders. This project utilizes existing efficacious models of prevention to generate valuable
new information critical to prevention services delivery for a special population of highly ...

## Key facts

- **NIH application ID:** 10168176
- **Project number:** 4UH3DA050174-02
- **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:** $4,922,920
- **Award type:** 4N
- **Project period:** 2019-09-30 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10168176

## Citation

> US National Institutes of Health, RePORTER application 10168176, Prevention of OUD: The HOME (Housing, Opportunities, Motivation and Engagement) Randomized Trial (4UH3DA050174-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10168176. Licensed CC0.

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