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Subgroups
Once potential participants completed drug and alcohol detoxification, they received a baseline assessment by research staff to determine their eligibility for the study. Participants (known to be experiencing homelessness and have substance use disorders at intake) were deemed eligible if they had lived in or near Albuquerque, NM, for three months or more, did not have serious disabilities, and had no dependent children. Once they were determined eligible, participants were randomly assigned to one of three study groups. Both the intervention and comparison conditions reviewed here were provided throughout the study duration. Due to implementation challenges, however, a third study condition that provided housing assistance without peer support was discontinued about eight months after the first participant was randomly assigned, and research staff replaced it with referrals to substance use treatment and transportation assistance without residential housing. At this point, the decision was made to only assign females (approximately 13 percent of the study sample) to one of the two study conditions reviewed here to ensure they received housing. The analyses do not further adjust for differing probabilities of random assignment to the study conditions over time and by gender.
April 1991 to December 1993
The Lovelace Medical Foundation in collaboration with Albuquerque's Health Care for the Homeless (HCH) Clinic in partnership with St. Martin's Hospitality Center (SMC)
The intervention condition of case management, substance use counseling, plus housing with peer support provided high-intensity intervention services to adults who were experiencing homelessness and had alcohol use disorders. Participants must have lived in or near Albuquerque, NM, for three months or more. Participants could not have serious disabilities or dependent children. All intervention group participants successfully completed a detoxification from alcohol at a residential treatment facility between 2 and 10 days before beginning services. Services were subsequently provided in two phases, each lasting two months. In the first phase, participants housed in Project H&ART residences received group- and individual-level therapy (one to two sessions per week), art therapy, psychodrama, and group education classes in a nearby office building. The intervention also provided recreational events weekly. These intensive activities were scheduled from 9 a.m. to 3 p.m., five days per week. Intervention participants were also required to attend Alcoholics Anonymous or Narcotics Anonymous meetings once a day. In the second two-month phase, intervention group participants primarily received case management designed to encourage them to search for employment and develop other soft skills, including those used in social and domestic settings. During this phase, individual counseling was continued, and participants met with case managers as often as needed. Intervention group participants received free housing along with peer support from residence managers who were also recently recovering from alcohol dependencies.
The comparison condition of housing with peer support provided medium-intensity services to adults who were experiencing homelessness and had alcohol use disorders. Participants must have lived in or near Albuquerque, NM, for three months or more. They could not have serious disabilities or dependent children. All participants successfully completed a detoxification from alcohol at a residential treatment facility between 2 and 10 days before beginning services. Comparison group participants received free housing from Project H&ART in a substance-free living environment alongside support from residence managers who were also recently recovering from alcohol dependence. Residence managers encouraged comparison group participants to set personal goals and build peer support networks, but these outcomes were not enforced. Comparison group participants were only required to (1) remain alcohol and drug free (as determined by random drug tests), (2) attend weekly community meetings, and (3) inform residence managers twice weekly about any other community services received.
None
Project H&ART took place in Albuquerque, NM. Study participants were housed in study-provided apartments, and most program activities took place in a nearby office building.
Alcohol use; Housing stability