title: Perceptions of twelve-step mutual-help groups and their associations with motivation, treatment attendance and alcohol outcomes among chronically homeless individuals with alcohol problems.
abstract: BACKGROUND
  Twelve-step mutual-help groups (TMGs) are among the most available forms of support for homeless individuals with alcohol problems. Qualitative research, however, has suggested that this population often has negative perceptions of these groups, which has been shown to be associated with low TMG attendance. It is important to understand this population's perceptions of TMGs and their association with alcohol outcomes to provide more appropriate and better tailored programming for this multiply affected population. The aims of this cross-sectional study were to (a) qualitatively examine perception of TMGs in this population and (b) quantitatively evaluate its association with motivation, treatment attendance and alcohol outcomes.
  
  
  METHODS
  Participants (N=62) were chronically homeless individuals with alcohol problems who received single-site Housing First within a larger evaluation study. Perceptions of TMGs were captured using an open-ended item. Quantitative outcome variables were created from assessments of motivation, treatment attendance and alcohol outcomes.
  
  
  RESULTS
  Findings indicated that perceptions of TMGs were primarily negative followed by positive and neutral perceptions, respectively. There were significant, positive associations between perceptions of TMGs and motivation and treatment attendance, whereas no association was found for alcohol outcomes.
  
  
  CONCLUSIONS
  Although some individuals view TMGs positively, alternative forms of help are needed to engage the majority of chronically homeless individuals with alcohol problems.
authors.affiliation: Department of Community Medicine and Health, Lausanne University Hospital, Switzerland; University of Washington, Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors (CSHRB), 1100 NE 45th, Suite 300, Box 354944, Seattle, WA 98105, United States.
authors.forename: Véronique S
authors.initials: VS
authors.lastname: Grazioli
authors.affiliation: University of Washington-Harborview Medical Center, 325 Ninth Avenue, Box 359911, Seattle, WA 98195, United States. Electronic address: collinss@uw.edu.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Collins
authors.affiliation: Department of Community Medicine and Health, Lausanne University Hospital, Switzerland.
authors.forename: Jean-Bernard
authors.initials: JB
authors.lastname: Daeppen
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors (CSHRB), 1100 NE 45th, Suite 300, Box 354944, Seattle, WA 98105, United States.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Larimer
mesh_terms: D000437:Alcoholism / Q000523:psychology / Q000628:therapy*; D001294:Attitude to Health; D005260:Female; D006703:Ill-Housed Persons / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data; D012657:Self-Help Groups / Q000706:statistics & numerical data
keywords: Alcohol use; Homelessness; Motivation; Qualitative analysis; Treatment attendance; Twelve-step mutual-help groups