# A cluster-randomized controlled trial testing the effectiveness of the Life Enhancing Alcohol-management Program (LEAP) for Housing First residents

> **NIH NIH R01** · UNIVERSITY OF WASHINGTON · 2021 · $612,255

## Abstract

PROJECT SUMMARY/ABSTRACT
 People experiencing chronic homelessness comprise a small yet high-morbidity, high-cost subset of the
larger homeless population and are disproportionately impacted by alcohol-related harm. Unfortunately,
traditional abstinence-based treatment does not adequately reach or engage this population, and both
firsthand (problems stemming from one’s own alcohol use) and secondhand (problems stemming from others’
alcohol use) alcohol-related harm persists even after housing attainment. There have therefore been calls for
more flexible and client-centered approaches tailored to this population’s needs. Housing First, which entails
the provision of immediate, permanent, low-barrier, nonabstinence-based housing, is a response to this call.
Research has shown that Housing First is associated with decreased alcohol use, alcohol-related harm, and
publicly funded service utilization. Nonetheless, Housing First residents continue to experience both first- and
secondhand alcohol-related harm. Thus, further community-based interventions are necessary. To this end,
a pilot project was conducted in which researchers as well as Housing First residents, staff and management
codeveloped, implemented, and initially evaluated the Life Enhancing Alcohol-management Program (LEAP).
The LEAP entails low-barrier, community-level, house-wide resident programming—including leadership
opportunities, activities, and pathways to recovery. At the 6-month follow up, LEAP participants reported
significantly more engagement in meaningful activities than control participants (p < .001). Moreover, high
levels of LEAP program engagement (>2 activities per month) predicted significant reductions in alcohol use
and alcohol-related harm (ps < .01). To build on these promising findings, we propose a larger, cluster-
randomized controlled trial of LEAP (N=500) as an innovative, community-based, and client-driven adjunct
to Housing First. In the proposed project, 10 Housing First sites will be optimally matched and block
randomized on a rolling basis to either LEAP or services-as-usual control conditions. At LEAP sites, research
staff will work with housing staff and residents to conduct a needs assessment, form a community advisory
board, and develop and implement this community-level intervention. Participants in the LEAP evaluation will
meet criteria for at-risk drinking and will be assessed at baseline, 3-, 6-, and 12-month follow-ups. Analyses
will test LEAP effectiveness in increasing engagement in meaningful activities, decreasing alcohol use,
ameliorating both first- and secondhand alcohol-related harm, and improving quality of life. Engagement in
meaningful activities will also be tested as a mediator of the LEAP effect on alcohol and quality-of-life
outcomes. Finally, we will assess whether LEAP is associated with reduced costs stemming from participants’
use of emergency health-care and criminal justice services.

## Key facts

- **NIH application ID:** 10116236
- **Project number:** 5R01AA026593-03
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Seema Lisa Clifasefi
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $612,255
- **Award type:** 5
- **Project period:** 2019-05-20 → 2024-02-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10116236

## Citation

> US National Institutes of Health, RePORTER application 10116236, A cluster-randomized controlled trial testing the effectiveness of the Life Enhancing Alcohol-management Program (LEAP) for Housing First residents (5R01AA026593-03). Retrieved via AI Analytics 2026-06-11 from https://api.ai-analytics.org/grant/nih/10116236. Licensed CC0.

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