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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. The intervention condition reviewed here was provided throughout the study duration. Due to implementation challenges, however, the comparison group 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 but without residential housing (with this condition not reviewed here). At this point, the decision was made to only assign females (approximately 13 percent of the study sample) to one of the other two study conditions (the intervention condition or the second condition not 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 who had alcohol use disorders. Participants must have lived in or near Albuquerque, NM, for three months or more. Participants in the intervention condition 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 in social and domestic settings. During this phase, individual counseling 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 assistance without peer support provided low-intensity services to adults who were experiencing homelessness and had alcohol use disorders. They had to have lived in or near Albuquerque, NM, for three months or more. They could not have serious disabilities or dependent children. Comparison participants received community-based housing in an apartment or motel, and random alcohol and drug testing. Participants were also required to monitor their use of substance abuse and rehabilitation services-and other services received in the community-twice a week. All comparison condition services were generally unsupervised. The comparison condition was terminated in December 1991, after 92 participants were randomly assigned to this condition, due to implementation issues and limitations in unsupervised design of services.
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