Study quality: 
Low
LowReason for the rating: This study received a low study quality rating because the implementation of the randomized controlled trial was compromised and it does not adjust estimated impacts for potentially important differences between the intervention and comparison groups.
Services provided:
Treatment or recovery services for substance use disorder
Setting: Urban only
Study design
Design:
Randomized controlled trial
Study group formation:
Once potential participants completed drug and alcohol detoxification, research staff administered a baseline assessment to determine eligibility for the study. Participants (known to be experiencing homelessness and to 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 their eligibility was confirmed, participants were randomly assigned to one of three study groups. The comparison condition reviewed here was provided throughout the study duration. Due to implementation challenges with the initial intervention condition that provided housing assistance without peer support, however, the intervention group condition as reviewed here was not introduced until eight months after the first participant was randomly assigned. At that point, research staff made the decision to only assign females (approximately 13 percent of the study sample) to one of two study conditions (the first of which is reviewed here as the comparison condition, and the second of which is 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.
Time period of study:
April 1991 to December 1993
Pathways only reports results from studies with a study quality rating of high or moderate.
Sample characteristics
Age
| Mean age | 37 years |
Sex
| Female | 13% |
| Male | 87% |
Participant race and ethnicity
| White, not Hispanic |
41%
|
| Hispanic or Latino of any race |
31%
|
| American Indian or Alaska Native |
18%
|
| Unknown, not reported, or other |
10%
|
The race and ethnicity categories may sum to more than 100 percent if the authors reported race and ethnicity separately; in these cases, we report the category White, rather than White, not Hispanic.
Participant employment and public benefit status
| Were employed | 50% |
| Were unemployed | 50% |
Specific employment barriers
| Had a substance abuse disorder | 100% |
| Were experiencing homelessness | 100% |
Intervention implementation
Implementing organization:
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)
Intervention services:
The intervention condition of referrals to substance use treatment and transportation assistance provided low-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. Participants could not have serious disabilities or dependent children. Comparison participants were referred to local and statewide alcohol treatment services, were paid bus fare to these facilities, and were paid to provide data on their use of health services at biweekly check-ins with program staff. The comparison condition began operating in December 1991, about eight months after the first study participant was randomized. This replaced a housed comparison condition that was terminated due to implementation issues and limitations in the unsupervised service delivery model.
Mandatory services:
None
Comparison services:
The comparison condition of case management, substance use counseling, plus housing with a peer support group provides high-intensity intervention services to adults who were experiencing homelessness and also had alcohol use disorders. Comparison group members must have lived in or near Albuquerque, NM, for three months or more. Participants in this comparison condition could not have serious disabilities or dependent children. All comparison group participants successfully completed a detoxification from alcohol at a residential treatment facility 2 to 10 days before beginning services. Services were subsequently provided in two phases, each lasting two months. In the first phase, comparison 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 comparison condition 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, comparison group participants primarily received case management designed to encourage participants to search for employment and to develop other soft skills, including those in social and domestic settings. During this phase, individual counseling was continued, and participants met with case managers as often as needed. Comparison group participants received free housing along with peer support from residence managers who were also recently in recovery from alcohol dependence.
Study publications
Lapham, Sandra, Marge Hall, and Betty Skipper (1996). Homelessness and substance use among alcohol abusers following participation in Project H&ART, Journal of Addictive Diseases (14): 41-55. Available at https://www.tandfonline.com/doi/abs/10.1300/J069v14n04_03.
Lapham, Sandra, Marge Hall, Marsha McMurray-Avila, and Harry Beaman (1993). Albuquerque's community-based housing and support services demonstration program for homeless alcohol abusers, Alcoholism Treatment Quarterly (10): 139-154. Available at https://www.tandfonline.com/doi/abs/10.1300/J020V10N03_12.
View the glossary for more information about these and other terms used on this page.
The Pathways Clearinghouse refers to interventions by the names used in study reports or manuscripts. Some intervention names may use language that is not consistent with our style guide, preferences, or the terminology we use to describe populations.
28567.03R-Study of Project Hou