Motivation to change and treatment attendance as predictors of alcohol-use outcomes among project-based Housing First residents

Collins et al. (2012) indicated that time spent in a project-based Housing First (HF) intervention was associated with improved two-year alcohol-use trajectories among chronically homeless individuals with alcohol problems. To explore potential correlates of these findings, we tested the relative prediction of alcohol-use outcomes by motivation to change (MTC) and substance abuse treatment attendance. Participants (N=95) were chronically homeless individuals with alcohol problems receiving a project-based HF intervention in the context of a larger nonrandomized controlled trial (Larimer et al., 2009). Participants were interviewed regularly over the two-year follow-up. Treatment attendance and MTC were measured using items from the Addiction Severity Index and the SOCRATES, respectively. Alcohol-use outcomes included alcohol quantity, problems and dependence. Generalized estimating equation modeling indicated that MTC variables and not treatment attendance consistently predicted alcohol-use outcomes over the two-year follow-up. Findings suggest that the importance of motivation to change may outweigh treatment attendance in supporting alcohol behavior change in this population. (C) 2012 Elsevier Ltd. All rights reserved.