title: A randomized control trial of a chronic care intervention for homeless women with alcohol use problems.
abstract: A clinician-randomized trial was conducted using the chronic care model for disease management for alcohol use problems among n = 82 women served in a health care for the homeless clinic. Women with problem alcohol use received either usual care or an intervention consisting of a primary care provider (PCP) brief intervention, referral to addiction services, and on-going support from a care manager (CM) for 6 months. Both groups significantly reduced their alcohol consumption, with a small effect size favoring intervention at 3 months, but there were no significant differences between groups in reductions in drinking or in housing stability, or mental or physical health. However, intervention women had significantly more frequent participation in substance use treatment services. Baseline differences and small sample size limit generalizability, although substantial reductions in drinking for both groups suggest that screening and PCP brief treatment are promising interventions for homeless women with alcohol use problems.
authors.affiliation: Department of Family Medicine and Community Health, University of Massachusetts Medical School. Electronic address: carole.upshur@umassmed.edu.
authors.forename: Carole
authors.initials: C
authors.lastname: Upshur
authors.affiliation: Department of Family Medicine and Community Health, University of Massachusetts Medical School.
authors.forename: Linda
authors.initials: L
authors.lastname: Weinreb
authors.affiliation: Departments of Medicine, Boston University Medical Center and Massachusetts General Hospital, Boston Health Care for the Homeless Program.
authors.forename: Monica
authors.initials: M
authors.lastname: Bharel
authors.affiliation: Department of Quantitative Health Sciences, University of Massachusetts Medical School.
authors.forename: George
authors.initials: G
authors.lastname: Reed
authors.affiliation: Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School.
authors.forename: Christine
authors.initials: C
authors.lastname: Frisard
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000517:prevention & control*; D019973:Alcohol-Related Disorders / Q000534:rehabilitation*; D005260:Female; D006703:Ill-Housed Persons; D006801:Humans; D008875:Middle Aged; D010865:Pilot Projects; D011320:Primary Health Care / Q000379:methods*; D011614:Psychotherapy, Brief / Q000379:methods; D012017:Referral and Consultation; D013997:Time Factors
keywords: Alcohol abuse; Chronic care model; Homeless women; Primary care; Randomized trial