Within-Subjects Analyses of 2-Year Alcohol Trajectories
RESEARCH AND PRACTICE Project-Based Housing First for Chronically Homeless Individuals With Alcohol Problems: Within-Subjects Analyses of 2-Year Alcohol Trajectories Susan E. Collins, PhD, Daniel K. Malone, MPH, Seema L. Clifasefi, PhD, Joshua A. Ginzler, PhD, Michelle D. Garner, MSW, PhD, Bonnie Burlingham, MPH, Heather S. Lonczak, PhD, Elizabeth A. Dana, MA, Megan Kirouac, BS, Kenneth Tanzer, BA, William G. Hobson, MA, G. Alan Marlatt, PhD, and Mary E. Larimer, PhD A review of 29 studies conducted worldwide Objectives. Two-year alcohol use trajectories were documented among estimated an alcohol dependence prevalence of residents in a project-based Housing First program. Project-based Housing First 1 37.9% among homeless populations. Among provides immediate, low-barrier, nonabstinence-based, permanent supportive chronically homeless individuals (i.e., people with housing to chronically homeless individuals within a single housing project. The long-term, often-repeated episodes of homeless- study aim was to address concerns that nonabstinence-based housing may ness2), the prevalence of alcohol dependence enable alcohol use. is even higher.3 Alcohol dependence is associ- Methods. A 2-year, within-subjects analysis was conducted among 95 chron- ated with greater levels of alcohol problems, ically homeless individuals with alcohol problems who were allocated to project- resulting from acute intoxication or long-term based Housing First. Alcohol variables were assessed through self-report. Data on intervention exposure were extracted from agency records. alcoholuse,aswellasincreasedriskforalcohol- Results. Multilevel growth models indicated significant within-subjects de- related deaths.4 --- 7 creases across alcohol use outcomes over the study period. Intervention Unfortunately, traditional housing infra- exposure, represented by months spent in housing, consistently predicted structures designed to serve chronically additional decreases in alcohol use outcomes.
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