Study Details | Pathways to Work

28567.04-Housing with Peer Support Compared with Housing Assistance Without Peer Support

Study quality: Low

Low

Reason 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.

Intervention: Project Housing and Alcohol Research Team (Project H&ART)—Housing with Peer Support (as compared with Housing Without Peer Support)

Population and employment barriers:

Specific employment barriers (Homelessness, Substance use disorder)

Services provided:

Case management, Health services (Substance use disorder treatment and mental health services), Soft skills training, Supportive services

Setting: Urban only

Study design

Design:

Randomized controlled trial

Study group formation:

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 without residential housing (replacement not reviewed here). At this point, research staff made the decision to only assign females (approximately 12 percent of the study sample) to one of the first two intervention conditions (the first of the conditions 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

Sex

Female	12%
Male	88%

Participant race and ethnicity

White, not Hispanic	42%
Another race	10%
American Indian or Alaska Native	17%
Hispanic or Latino of any race	31%

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.

Family status

Parents

Participant employment and public benefit status

Were employed	51%
Were unemployed	49%

Specific employment barriers

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 housing with peer support provided medium-intensity services to adults experiencing homelessness who also had problems with alcohol. Participants had to have lived in or near Albuquerque, NM, for three months or more. (Participants 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 cost-free housing from Project H&ART in a substance-free living environment accompanied by support from residence managers who were also recently in recovery 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 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.

Mandatory services:

None

Comparison services:

The comparison condition of housing assistance without peer support provided low-intensity services to adults who were experiencing homelessness and had problems with alcohol. They had to have lived in or near Albuquerque, NM, for three months or more. (Participants could not have serious disabilities or dependent children.) Comparison participants received community-based housing (apartment or motel based) 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 per 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.

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.

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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.

Study of Housing with Peer Support versus Housing Assistance Without Peer Support