Project RENEWAL: Research and Evaluation of a NEW model of Alcohol treatment for homeless women

Studies over the last 30 years that have examined rates of alcohol and drug use in women have consistently shown that homeless women have higher rates of risky substance use and significant mental and physical co-morbidity, whether compared to housed poor women or the general population of women. Health Care for the Homeless primary care clinics see over 200,000 homeless women yearly and rank integration of substance abuse and mental health treatment as a high priority to improve their patients' quality of care. Primary care clinicians, however, rarely systematically screen their patients for problem drinking, even though there is evidence in the general primary care population that brief alcohol interventions can have lasting effects in reductions of drinking levels of patients. Additionally, primary care can be an effective setting to identify substance abuse issues and motivate homeless women to participate in treatment. We will report the design and implementation of a brief primary care alcohol intervention combined with a specialized care manager to reduce homeless women's risky alcohol use. The NIAAA-sponsored study was conducted in a large Health Care for the Homeless primary care clinic. Over 400 women were screened for alcohol use, resulting in 36% meeting criteria for risky drinking; 60% of those who drank met criteria for abuse or dependence. The study enrolled 82 women in a small RCT comparing usual care to Project Renewal. Outcomes, including motivation for, and engagement in, alcohol treatment, and health and mental health over a six month follow up will be presented.