Trial Outcomes & Findings for Community Wise: An Innovative Multi-level Intervention to Reduce Alcohol and Illegal Drug Use (NCT NCT02951455)

Last Updated: 2022-12-23

Results Overview

The primary outcome was the percentage of ASM (i.e., the percentage of days each substance was used in the past month) as operationalized by the Global Assessment of Individual needs. At each time point (baseline, five follow-ups), percentage ASM was calculated by dividing the reported number of days in the past month that participants used cannabis, heroin, alcohol, opioids, or cocaine by the number of days in the month (data were collected with the Timeline Follow-Back measure), multiplied by 100. Next, mean ASM frequency per month during 5 months of follow-up was calculated by adding the percentages for each substance and dividing by 5.31 We conducted correlations for self-reported ASM in the past 30 days with toxicology urine screens to assess validity of self-reported data.

Recruitment status

COMPLETED

Study phase

Target enrollment

602 participants

Primary outcome timeframe

5 months

Results posted on

2022-12-23

Participant Flow

Participant milestones

Participant milestones
Measure	CD-LC Group behavioral intervention with 9 weekly sessions lasting 2 hours. Critical Dialogue (CD), Licensed Clinician (LC). Critical Dialogue: Prompted by thematic images, aims to help participants develop a deeper understanding of how marginalizing processes (e.g., systematic stigma; feelings of rage as victims of discrimination) impact participants' lives and behavior. LC: Whether the intervention is delivered by a licensed clinician.	CBP- LC Group community mobilizing intervention with 9 weekly sessions spread in 15 weeks. Capacity Building Project (CBP), Licensed Clinician (LC) Capacity Building Project: Designed to create collaborative efforts to overcome and dismantle marginalizing processes by building positive social and organizational relationships and community capacity through the development and implementation of community projects aiming to address social determinants of health. LC: Whether the intervention is delivered by a licensed clinician.	QLW- LC Group intervention where participants learn to develop and implement personal goals that are measurable, attainable, realistic, and time bound. Intervention includes 9 sessions. Quality of Life Wheel, Licensed Clinician (LC) Quality of Life Wheel: Aims to increase self-efficacy and help participants develop a vision for their future, breaking this vision down into small, feasible, measureable goals they can implement on a weekly basis (e.g. quitting smoking, improving relationships with family members, paying down debt). LC: Whether the intervention is delivered by a licensed clinician.	CD & CBP- LC Combination of group behavioral intervention and community mobilization intervention including 15 weekly sessions.Licensed Clinician (LC) Critical Dialogue: Prompted by thematic images, aims to help participants develop a deeper understanding of how marginalizing processes (e.g., systematic stigma; feelings of rage as victims of discrimination) impact participants' lives and behavior. Capacity Building Project: Designed to create collaborative efforts to overcome and dismantle marginalizing processes by building positive social and organizational relationships and community capacity through the development and implementation of community projects aiming to address social determinants of health. LC: Whether the intervention is delivered by a licensed clinician.	CD & QLW- LC Combination of group behavioral intervention and community mobilization intervention including 15 weekly sessions.Licensed Clinician (LC) Critical Dialogue: Prompted by thematic images, aims to help participants develop a deeper understanding of how marginalizing processes (e.g., systematic stigma; feelings of rage as victims of discrimination) impact participants' lives and behavior. Quality of Life Wheel: Aims to increase self-efficacy and help participants develop a vision for their future, breaking this vision down into small, feasible, measureable goals they can implement on a weekly basis (e.g. quitting smoking, improving relationships with family members, paying down debt). LC: Whether the intervention is delivered by a licensed clinician.	QLW & Capacity Building ProjectCBP- LC Combination of goal development and implementation with community mobilization intervention including 9 weekly sessions spread across 15 weeks. Licensed Clinician (LC) Capacity Building Project: Designed to create collaborative efforts to overcome and dismantle marginalizing processes by building positive social and organizational relationships and community capacity through the development and implementation of community projects aiming to address social determinants of health. Quality of Life Wheel: Aims to increase self-efficacy and help participants develop a vision for their future, breaking this vision down into small, feasible, measureable goals they can implement on a weekly basis (e.g. quitting smoking, improving relationships with family members, paying down debt). LC: Whether the intervention is delivered by a licensed clinician.	QLW & CD & CBP-LC Combination of group behavioral intervention, goal development and implementation, and community mobilization intervention including 15 weekly sessions.Licensed Clinician (LC) Critical Dialogue: Prompted by thematic images, aims to help participants develop a deeper understanding of how marginalizing processes (e.g., systematic stigma; feelings of rage as victims of discrimination) impact participants' lives and behavior. Capacity Building Project: Designed to create collaborative efforts to overcome and dismantle marginalizing processes by building positive social and organizational relationships and community capacity through the development and implementation of community projects aiming to address social determinants of health. Quality of Life Wheel: Aims to increase self-efficacy and help participants develop a vision for their future, breaking this vision down into small, feasible, measureable goals they can implement on a weekly basis (e.g. quitting smoking, improving relationships with family members, paying down debt). LC: Whether the intervention is delivered by a licensed clinician.	Core LC This condition will include 3 core sessions that are not a part of the components being tested. These are support sessions to the components being tested and is hypothesized to have the smallest impact on substance use outcomes.Licensed Clinician (LC) LC: Whether the intervention is delivered by a licensed clinician.	CD- PF Group behavioral intervention with 9 weekly sessions lasting 2 hours. Critical Dialogue (CD), Peer Facilitator (PF) Critical Dialogue: Prompted by thematic images, aims to help participants develop a deeper understanding of how marginalizing processes (e.g., systematic stigma; feelings of rage as victims of discrimination) impact participants' lives and behavior. PF: Whether the intervention is delivered by a peer facilitator.	CBP- PF Group community mobilizing intervention with 9 weekly sessions spread in 15 weeks. Capacity Building Project (CBP), Peer Facilitator (PF) Capacity Building Project: Designed to create collaborative efforts to overcome and dismantle marginalizing processes by building positive social and organizational relationships and community capacity through the development and implementation of community projects aiming to address social determinants of health. PF: Whether the intervention is delivered by a peer facilitator.	QLW-PF Group intervention where participants learn to develop and implement personal goals that are measurable, attainable, realistic, and time bound. Intervention includes 9 sessions. Quality of Life wheel, Peer Facilitator (PF) Quality of Life Wheel: Aims to increase self-efficacy and help participants develop a vision for their future, breaking this vision down into small, feasible, measureable goals they can implement on a weekly basis (e.g. quitting smoking, improving relationships with family members, paying down debt). PF: Whether the intervention is delivered by a peer facilitator.	CD & CBP- PF Combination of group behavioral intervention and community mobilization intervention including 15 weekly sessions. Peer Facilitator (PF) Critical Dialogue: Prompted by thematic images, aims to help participants develop a deeper understanding of how marginalizing processes (e.g., systematic stigma; feelings of rage as victims of discrimination) impact participants' lives and behavior. Capacity Building Project: Designed to create collaborative efforts to overcome and dismantle marginalizing processes by building positive social and organizational relationships and community capacity through the development and implementation of community projects aiming to address social determinants of health. PF: Whether the intervention is delivered by a peer facilitator.	CD & QLW- PF Combination of group behavioral intervention and community mobilization intervention including 15 weekly sessions.Peer Facilitator (PF) Critical Dialogue: Prompted by thematic images, aims to help participants develop a deeper understanding of how marginalizing processes (e.g., systematic stigma; feelings of rage as victims of discrimination) impact participants' lives and behavior. Quality of Life Wheel: Aims to increase self-efficacy and help participants develop a vision for their future, breaking this vision down into small, feasible, measureable goals they can implement on a weekly basis (e.g. quitting smoking, improving relationships with family members, paying down debt). PF: Whether the intervention is delivered by a peer facilitator.	QLW & CBP- PF Combination of goal development and implementation with community mobilization intervention including 9 weekly sessions spread across 15 weeks.Peer Facilitator (PF) Capacity Building Project: Designed to create collaborative efforts to overcome and dismantle marginalizing processes by building positive social and organizational relationships and community capacity through the development and implementation of community projects aiming to address social determinants of health. Quality of Life Wheel: Aims to increase self-efficacy and help participants develop a vision for their future, breaking this vision down into small, feasible, measureable goals they can implement on a weekly basis (e.g. quitting smoking, improving relationships with family members, paying down debt). PF: Whether the intervention is delivered by a peer facilitator.	CD & QLW & CBP- PF Combination of group behavioral intervention, goal development and implementation, and community mobilization intervention including 15 weekly sessions.Peer Facilitator (PF) Critical Dialogue: Prompted by thematic images, aims to help participants develop a deeper understanding of how marginalizing processes (e.g., systematic stigma; feelings of rage as victims of discrimination) impact participants' lives and behavior. Capacity Building Project: Designed to create collaborative efforts to overcome and dismantle marginalizing processes by building positive social and organizational relationships and community capacity through the development and implementation of community projects aiming to address social determinants of health. Quality of Life Wheel: Aims to increase self-efficacy and help participants develop a vision for their future, breaking this vision down into small, feasible, measureable goals they can implement on a weekly basis (e.g. quitting smoking, improving relationships with family members, paying down debt). PF: Whether the intervention is delivered by a peer facilitator.	Core PF This condition will include 3 core sessions that are not a part of the components being tested. These are support sessions to the components being tested and is hypothesized to have the smallest impact on substance use outcomes. Peer Facilitator (PF) PF: Whether the intervention is delivered by a peer facilitator.
Overall Study STARTED	37	37	39	39	36	37	39	37	39	37	37	39	37	37	39	36
Overall Study COMPLETED	14	24	27	32	26	17	30	30	26	26	26	30	25	29	35	28
Overall Study NOT COMPLETED	23	13	12	7	10	20	9	7	13	11	11	9	12	8	4	8

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Community Wise: An Innovative Multi-level Intervention to Reduce Alcohol and Illegal Drug Use

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure	CD-LC n=37 Participants Group behavioral intervention with 9 weekly sessions lasting 2 hours. Critical Dialogue (CD), Licensed Clinician (LC). Critical Dialogue: Prompted by thematic images, aims to help participants develop a deeper understanding of how marginalizing processes (e.g., systematic stigma; feelings of rage as victims of discrimination) impact participants' lives and behavior. LC: Whether the intervention is delivered by a licensed clinician.	CBP- LC n=37 Participants Group community mobilizing intervention with 9 weekly sessions spread in 15 weeks. Capacity Building Project (CBP), Licensed Clinician (LC) Capacity Building Project: Designed to create collaborative efforts to overcome and dismantle marginalizing processes by building positive social and organizational relationships and community capacity through the development and implementation of community projects aiming to address social determinants of health. LC: Whether the intervention is delivered by a licensed clinician.	QLW- LC n=39 Participants Group intervention where participants learn to develop and implement personal goals that are measurable, attainable, realistic, and time bound. Intervention includes 9 sessions. Quality of Life Wheel, Licensed Clinician (LC) Quality of Life Wheel: Aims to increase self-efficacy and help participants develop a vision for their future, breaking this vision down into small, feasible, measureable goals they can implement on a weekly basis (e.g. quitting smoking, improving relationships with family members, paying down debt). LC: Whether the intervention is delivered by a licensed clinician.	CD & CBP- LC n=39 Participants Combination of group behavioral intervention and community mobilization intervention including 15 weekly sessions.Licensed Clinician (LC) Critical Dialogue: Prompted by thematic images, aims to help participants develop a deeper understanding of how marginalizing processes (e.g., systematic stigma; feelings of rage as victims of discrimination) impact participants' lives and behavior. Capacity Building Project: Designed to create collaborative efforts to overcome and dismantle marginalizing processes by building positive social and organizational relationships and community capacity through the development and implementation of community projects aiming to address social determinants of health. LC: Whether the intervention is delivered by a licensed clinician.	CD & QLW- LC n=36 Participants Combination of group behavioral intervention and community mobilization intervention including 15 weekly sessions.Licensed Clinician (LC) Critical Dialogue: Prompted by thematic images, aims to help participants develop a deeper understanding of how marginalizing processes (e.g., systematic stigma; feelings of rage as victims of discrimination) impact participants' lives and behavior. Quality of Life Wheel: Aims to increase self-efficacy and help participants develop a vision for their future, breaking this vision down into small, feasible, measureable goals they can implement on a weekly basis (e.g. quitting smoking, improving relationships with family members, paying down debt). LC: Whether the intervention is delivered by a licensed clinician.	QLW & Capacity Building ProjectCBP- LC n=37 Participants Combination of goal development and implementation with community mobilization intervention including 9 weekly sessions spread across 15 weeks. Licensed Clinician (LC) Capacity Building Project: Designed to create collaborative efforts to overcome and dismantle marginalizing processes by building positive social and organizational relationships and community capacity through the development and implementation of community projects aiming to address social determinants of health. Quality of Life Wheel: Aims to increase self-efficacy and help participants develop a vision for their future, breaking this vision down into small, feasible, measureable goals they can implement on a weekly basis (e.g. quitting smoking, improving relationships with family members, paying down debt). LC: Whether the intervention is delivered by a licensed clinician.	QLW & CD & CBP-LC n=39 Participants Combination of group behavioral intervention, goal development and implementation, and community mobilization intervention including 15 weekly sessions.Licensed Clinician (LC) Critical Dialogue: Prompted by thematic images, aims to help participants develop a deeper understanding of how marginalizing processes (e.g., systematic stigma; feelings of rage as victims of discrimination) impact participants' lives and behavior. Capacity Building Project: Designed to create collaborative efforts to overcome and dismantle marginalizing processes by building positive social and organizational relationships and community capacity through the development and implementation of community projects aiming to address social determinants of health. Quality of Life Wheel: Aims to increase self-efficacy and help participants develop a vision for their future, breaking this vision down into small, feasible, measureable goals they can implement on a weekly basis (e.g. quitting smoking, improving relationships with family members, paying down debt). LC: Whether the intervention is delivered by a licensed clinician.	Core LC n=37 Participants This condition will include 3 core sessions that are not a part of the components being tested. These are support sessions to the components being tested and is hypothesized to have the smallest impact on substance use outcomes.Licensed Clinician (LC) LC: Whether the intervention is delivered by a licensed clinician.	CD- PF n=39 Participants Group behavioral intervention with 9 weekly sessions lasting 2 hours. Critical Dialogue (CD), Peer Facilitator (PF) Critical Dialogue: Prompted by thematic images, aims to help participants develop a deeper understanding of how marginalizing processes (e.g., systematic stigma; feelings of rage as victims of discrimination) impact participants' lives and behavior. PF: Whether the intervention is delivered by a peer facilitator.	CBP- PF n=37 Participants Group community mobilizing intervention with 9 weekly sessions spread in 15 weeks. Capacity Building Project (CBP), Peer Facilitator (PF) Capacity Building Project: Designed to create collaborative efforts to overcome and dismantle marginalizing processes by building positive social and organizational relationships and community capacity through the development and implementation of community projects aiming to address social determinants of health. PF: Whether the intervention is delivered by a peer facilitator.	QLW-PF n=37 Participants Group intervention where participants learn to develop and implement personal goals that are measurable, attainable, realistic, and time bound. Intervention includes 9 sessions. Quality of Life wheel, Peer Facilitator (PF) Quality of Life Wheel: Aims to increase self-efficacy and help participants develop a vision for their future, breaking this vision down into small, feasible, measureable goals they can implement on a weekly basis (e.g. quitting smoking, improving relationships with family members, paying down debt). PF: Whether the intervention is delivered by a peer facilitator.	CD & CBP- PF n=39 Participants Combination of group behavioral intervention and community mobilization intervention including 15 weekly sessions. Peer Facilitator (PF) Critical Dialogue: Prompted by thematic images, aims to help participants develop a deeper understanding of how marginalizing processes (e.g., systematic stigma; feelings of rage as victims of discrimination) impact participants' lives and behavior. Capacity Building Project: Designed to create collaborative efforts to overcome and dismantle marginalizing processes by building positive social and organizational relationships and community capacity through the development and implementation of community projects aiming to address social determinants of health. PF: Whether the intervention is delivered by a peer facilitator.	CD & QLW- PF n=37 Participants Combination of group behavioral intervention and community mobilization intervention including 15 weekly sessions.Peer Facilitator (PF) Critical Dialogue: Prompted by thematic images, aims to help participants develop a deeper understanding of how marginalizing processes (e.g., systematic stigma; feelings of rage as victims of discrimination) impact participants' lives and behavior. Quality of Life Wheel: Aims to increase self-efficacy and help participants develop a vision for their future, breaking this vision down into small, feasible, measureable goals they can implement on a weekly basis (e.g. quitting smoking, improving relationships with family members, paying down debt). PF: Whether the intervention is delivered by a peer facilitator.	QLW & CBP- PF n=37 Participants Combination of goal development and implementation with community mobilization intervention including 9 weekly sessions spread across 15 weeks.Peer Facilitator (PF) Capacity Building Project: Designed to create collaborative efforts to overcome and dismantle marginalizing processes by building positive social and organizational relationships and community capacity through the development and implementation of community projects aiming to address social determinants of health. Quality of Life Wheel: Aims to increase self-efficacy and help participants develop a vision for their future, breaking this vision down into small, feasible, measureable goals they can implement on a weekly basis (e.g. quitting smoking, improving relationships with family members, paying down debt). PF: Whether the intervention is delivered by a peer facilitator.	CD & QLW & CBP- PF n=39 Participants Combination of group behavioral intervention, goal development and implementation, and community mobilization intervention including 15 weekly sessions.Peer Facilitator (PF) Critical Dialogue: Prompted by thematic images, aims to help participants develop a deeper understanding of how marginalizing processes (e.g., systematic stigma; feelings of rage as victims of discrimination) impact participants' lives and behavior. Capacity Building Project: Designed to create collaborative efforts to overcome and dismantle marginalizing processes by building positive social and organizational relationships and community capacity through the development and implementation of community projects aiming to address social determinants of health. Quality of Life Wheel: Aims to increase self-efficacy and help participants develop a vision for their future, breaking this vision down into small, feasible, measureable goals they can implement on a weekly basis (e.g. quitting smoking, improving relationships with family members, paying down debt). PF: Whether the intervention is delivered by a peer facilitator.	Core PF n=36 Participants This condition will include 3 core sessions that are not a part of the components being tested. These are support sessions to the components being tested and is hypothesized to have the smallest impact on substance use outcomes. Peer Facilitator (PF) PF: Whether the intervention is delivered by a peer facilitator.	Total n=602 Participants Total of all reporting groups
Age, Categorical <=18 years	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants	0 Participants n=4 Participants	0 Participants n=21 Participants	0 Participants n=10 Participants	0 Participants n=115 Participants	0 Participants n=6 Participants	0 Participants n=6 Participants	0 Participants n=64 Participants	0 Participants n=17 Participants	0 Participants n=21 Participants	0 Participants n=22 Participants	0 Participants n=8 Participants	0 Participants n=16 Participants	0 Participants n=135 Participants	0 Participants n=136 Participants
Age, Categorical Between 18 and 65 years	37 Participants n=5 Participants	37 Participants n=7 Participants	39 Participants n=5 Participants	37 Participants n=4 Participants	35 Participants n=21 Participants	37 Participants n=10 Participants	37 Participants n=115 Participants	37 Participants n=6 Participants	39 Participants n=6 Participants	36 Participants n=64 Participants	37 Participants n=17 Participants	38 Participants n=21 Participants	37 Participants n=22 Participants	37 Participants n=8 Participants	38 Participants n=16 Participants	36 Participants n=135 Participants	594 Participants n=136 Participants
Age, Categorical >=65 years	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants	2 Participants n=4 Participants	1 Participants n=21 Participants	0 Participants n=10 Participants	2 Participants n=115 Participants	0 Participants n=6 Participants	0 Participants n=6 Participants	1 Participants n=64 Participants	0 Participants n=17 Participants	1 Participants n=21 Participants	0 Participants n=22 Participants	0 Participants n=8 Participants	1 Participants n=16 Participants	0 Participants n=135 Participants	8 Participants n=136 Participants
Sex: Female, Male Female	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants	0 Participants n=4 Participants	0 Participants n=21 Participants	0 Participants n=10 Participants	0 Participants n=115 Participants	0 Participants n=6 Participants	0 Participants n=6 Participants	0 Participants n=64 Participants	0 Participants n=17 Participants	0 Participants n=21 Participants	0 Participants n=22 Participants	0 Participants n=8 Participants	0 Participants n=16 Participants	0 Participants n=135 Participants	0 Participants n=136 Participants
Sex: Female, Male Male	37 Participants n=5 Participants	37 Participants n=7 Participants	39 Participants n=5 Participants	39 Participants n=4 Participants	36 Participants n=21 Participants	37 Participants n=10 Participants	39 Participants n=115 Participants	37 Participants n=6 Participants	39 Participants n=6 Participants	37 Participants n=64 Participants	37 Participants n=17 Participants	39 Participants n=21 Participants	37 Participants n=22 Participants	37 Participants n=8 Participants	39 Participants n=16 Participants	36 Participants n=135 Participants	602 Participants n=136 Participants
Ethnicity (NIH/OMB) Hispanic or Latino	4 Participants n=5 Participants	7 Participants n=7 Participants	4 Participants n=5 Participants	4 Participants n=4 Participants	3 Participants n=21 Participants	4 Participants n=10 Participants	5 Participants n=115 Participants	3 Participants n=6 Participants	4 Participants n=6 Participants	6 Participants n=64 Participants	4 Participants n=17 Participants	4 Participants n=21 Participants	6 Participants n=22 Participants	2 Participants n=8 Participants	4 Participants n=16 Participants	2 Participants n=135 Participants	66 Participants n=136 Participants
Ethnicity (NIH/OMB) Not Hispanic or Latino	33 Participants n=5 Participants	30 Participants n=7 Participants	34 Participants n=5 Participants	35 Participants n=4 Participants	32 Participants n=21 Participants	32 Participants n=10 Participants	34 Participants n=115 Participants	34 Participants n=6 Participants	35 Participants n=6 Participants	31 Participants n=64 Participants	33 Participants n=17 Participants	35 Participants n=21 Participants	31 Participants n=22 Participants	35 Participants n=8 Participants	35 Participants n=16 Participants	34 Participants n=135 Participants	533 Participants n=136 Participants
Ethnicity (NIH/OMB) Unknown or Not Reported	0 Participants n=5 Participants	0 Participants n=7 Participants	1 Participants n=5 Participants	0 Participants n=4 Participants	1 Participants n=21 Participants	1 Participants n=10 Participants	0 Participants n=115 Participants	0 Participants n=6 Participants	0 Participants n=6 Participants	0 Participants n=64 Participants	0 Participants n=17 Participants	0 Participants n=21 Participants	0 Participants n=22 Participants	0 Participants n=8 Participants	0 Participants n=16 Participants	0 Participants n=135 Participants	3 Participants n=136 Participants
Race (NIH/OMB) American Indian or Alaska Native	1 Participants n=5 Participants	1 Participants n=7 Participants	1 Participants n=5 Participants	2 Participants n=4 Participants	0 Participants n=21 Participants	0 Participants n=10 Participants	1 Participants n=115 Participants	1 Participants n=6 Participants	0 Participants n=6 Participants	1 Participants n=64 Participants	1 Participants n=17 Participants	2 Participants n=21 Participants	1 Participants n=22 Participants	1 Participants n=8 Participants	1 Participants n=16 Participants	1 Participants n=135 Participants	15 Participants n=136 Participants
Race (NIH/OMB) Asian	0 Participants n=5 Participants	1 Participants n=7 Participants	0 Participants n=5 Participants	0 Participants n=4 Participants	0 Participants n=21 Participants	0 Participants n=10 Participants	1 Participants n=115 Participants	0 Participants n=6 Participants	0 Participants n=6 Participants	2 Participants n=64 Participants	1 Participants n=17 Participants	0 Participants n=21 Participants	0 Participants n=22 Participants	0 Participants n=8 Participants	1 Participants n=16 Participants	0 Participants n=135 Participants	6 Participants n=136 Participants
Race (NIH/OMB) Native Hawaiian or Other Pacific Islander	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants	0 Participants n=4 Participants	0 Participants n=21 Participants	0 Participants n=10 Participants	0 Participants n=115 Participants	0 Participants n=6 Participants	0 Participants n=6 Participants	0 Participants n=64 Participants	0 Participants n=17 Participants	0 Participants n=21 Participants	0 Participants n=22 Participants	0 Participants n=8 Participants	0 Participants n=16 Participants	0 Participants n=135 Participants	0 Participants n=136 Participants
Race (NIH/OMB) Black or African American	32 Participants n=5 Participants	28 Participants n=7 Participants	31 Participants n=5 Participants	34 Participants n=4 Participants	27 Participants n=21 Participants	30 Participants n=10 Participants	34 Participants n=115 Participants	32 Participants n=6 Participants	33 Participants n=6 Participants	30 Participants n=64 Participants	29 Participants n=17 Participants	36 Participants n=21 Participants	33 Participants n=22 Participants	31 Participants n=8 Participants	32 Participants n=16 Participants	27 Participants n=135 Participants	499 Participants n=136 Participants
Race (NIH/OMB) White	2 Participants n=5 Participants	2 Participants n=7 Participants	6 Participants n=5 Participants	1 Participants n=4 Participants	4 Participants n=21 Participants	2 Participants n=10 Participants	2 Participants n=115 Participants	3 Participants n=6 Participants	6 Participants n=6 Participants	3 Participants n=64 Participants	3 Participants n=17 Participants	0 Participants n=21 Participants	2 Participants n=22 Participants	2 Participants n=8 Participants	1 Participants n=16 Participants	8 Participants n=135 Participants	47 Participants n=136 Participants
Race (NIH/OMB) More than one race	2 Participants n=5 Participants	5 Participants n=7 Participants	0 Participants n=5 Participants	1 Participants n=4 Participants	2 Participants n=21 Participants	3 Participants n=10 Participants	1 Participants n=115 Participants	1 Participants n=6 Participants	0 Participants n=6 Participants	1 Participants n=64 Participants	3 Participants n=17 Participants	1 Participants n=21 Participants	1 Participants n=22 Participants	3 Participants n=8 Participants	3 Participants n=16 Participants	0 Participants n=135 Participants	27 Participants n=136 Participants
Race (NIH/OMB) Unknown or Not Reported	0 Participants n=5 Participants	0 Participants n=7 Participants	1 Participants n=5 Participants	1 Participants n=4 Participants	3 Participants n=21 Participants	2 Participants n=10 Participants	0 Participants n=115 Participants	0 Participants n=6 Participants	0 Participants n=6 Participants	0 Participants n=64 Participants	0 Participants n=17 Participants	0 Participants n=21 Participants	0 Participants n=22 Participants	0 Participants n=8 Participants	1 Participants n=16 Participants	0 Participants n=135 Participants	8 Participants n=136 Participants
Religion Christian	13 Participants n=5 Participants	20 Participants n=7 Participants	21 Participants n=5 Participants	16 Participants n=4 Participants	14 Participants n=21 Participants	23 Participants n=10 Participants	19 Participants n=115 Participants	16 Participants n=6 Participants	20 Participants n=6 Participants	15 Participants n=64 Participants	22 Participants n=17 Participants	19 Participants n=21 Participants	22 Participants n=22 Participants	19 Participants n=8 Participants	18 Participants n=16 Participants	22 Participants n=135 Participants	299 Participants n=136 Participants
Religion Muslim	14 Participants n=5 Participants	9 Participants n=7 Participants	4 Participants n=5 Participants	11 Participants n=4 Participants	11 Participants n=21 Participants	5 Participants n=10 Participants	14 Participants n=115 Participants	14 Participants n=6 Participants	7 Participants n=6 Participants	7 Participants n=64 Participants	9 Participants n=17 Participants	8 Participants n=21 Participants	7 Participants n=22 Participants	11 Participants n=8 Participants	12 Participants n=16 Participants	7 Participants n=135 Participants	150 Participants n=136 Participants
Religion Other	10 Participants n=5 Participants	8 Participants n=7 Participants	14 Participants n=5 Participants	12 Participants n=4 Participants	11 Participants n=21 Participants	9 Participants n=10 Participants	7 Participants n=115 Participants	7 Participants n=6 Participants	12 Participants n=6 Participants	15 Participants n=64 Participants	6 Participants n=17 Participants	12 Participants n=21 Participants	8 Participants n=22 Participants	7 Participants n=8 Participants	9 Participants n=16 Participants	7 Participants n=135 Participants	154 Participants n=136 Participants
Sexual Preference/Orientation Heterosexual	34 Participants n=5 Participants	36 Participants n=7 Participants	37 Participants n=5 Participants	33 Participants n=4 Participants	33 Participants n=21 Participants	30 Participants n=10 Participants	34 Participants n=115 Participants	33 Participants n=6 Participants	32 Participants n=6 Participants	36 Participants n=64 Participants	31 Participants n=17 Participants	34 Participants n=21 Participants	35 Participants n=22 Participants	35 Participants n=8 Participants	36 Participants n=16 Participants	33 Participants n=135 Participants	542 Participants n=136 Participants
Sexual Preference/Orientation LGBTQ+	3 Participants n=5 Participants	1 Participants n=7 Participants	2 Participants n=5 Participants	7 Participants n=4 Participants	3 Participants n=21 Participants	0 Participants n=10 Participants	5 Participants n=115 Participants	4 Participants n=6 Participants	7 Participants n=6 Participants	1 Participants n=64 Participants	6 Participants n=17 Participants	5 Participants n=21 Participants	2 Participants n=22 Participants	2 Participants n=8 Participants	3 Participants n=16 Participants	3 Participants n=135 Participants	54 Participants n=136 Participants
Marital Status Married	2 Participants n=5 Participants	5 Participants n=7 Participants	1 Participants n=5 Participants	1 Participants n=4 Participants	3 Participants n=21 Participants	5 Participants n=10 Participants	9 Participants n=115 Participants	2 Participants n=6 Participants	3 Participants n=6 Participants	6 Participants n=64 Participants	5 Participants n=17 Participants	4 Participants n=21 Participants	2 Participants n=22 Participants	3 Participants n=8 Participants	5 Participants n=16 Participants	2 Participants n=135 Participants	58 Participants n=136 Participants
Marital Status Not married	35 Participants n=5 Participants	32 Participants n=7 Participants	38 Participants n=5 Participants	38 Participants n=4 Participants	33 Participants n=21 Participants	32 Participants n=10 Participants	30 Participants n=115 Participants	35 Participants n=6 Participants	36 Participants n=6 Participants	31 Participants n=64 Participants	32 Participants n=17 Participants	35 Participants n=21 Participants	35 Participants n=22 Participants	34 Participants n=8 Participants	34 Participants n=16 Participants	34 Participants n=135 Participants	544 Participants n=136 Participants
Employment status Employed	7 Participants n=5 Participants	6 Participants n=7 Participants	8 Participants n=5 Participants	5 Participants n=4 Participants	6 Participants n=21 Participants	6 Participants n=10 Participants	13 Participants n=115 Participants	4 Participants n=6 Participants	7 Participants n=6 Participants	4 Participants n=64 Participants	9 Participants n=17 Participants	9 Participants n=21 Participants	6 Participants n=22 Participants	5 Participants n=8 Participants	1 Participants n=16 Participants	6 Participants n=135 Participants	102 Participants n=136 Participants
Employment status Unemployed	30 Participants n=5 Participants	31 Participants n=7 Participants	31 Participants n=5 Participants	34 Participants n=4 Participants	30 Participants n=21 Participants	31 Participants n=10 Participants	26 Participants n=115 Participants	33 Participants n=6 Participants	32 Participants n=6 Participants	33 Participants n=64 Participants	28 Participants n=17 Participants	30 Participants n=21 Participants	31 Participants n=22 Participants	32 Participants n=8 Participants	38 Participants n=16 Participants	30 Participants n=135 Participants	500 Participants n=136 Participants
Substance Use	0.18 %days past 30 days used substances STANDARD_DEVIATION 0.12 • n=5 Participants	0.24 %days past 30 days used substances STANDARD_DEVIATION 0.21 • n=7 Participants	0.21 %days past 30 days used substances STANDARD_DEVIATION 0.16 • n=5 Participants	0.18 %days past 30 days used substances STANDARD_DEVIATION 0.15 • n=4 Participants	0.17 %days past 30 days used substances STANDARD_DEVIATION 0.15 • n=21 Participants	0.23 %days past 30 days used substances STANDARD_DEVIATION 0.18 • n=10 Participants	0.19 %days past 30 days used substances STANDARD_DEVIATION 0.19 • n=115 Participants	0.19 %days past 30 days used substances STANDARD_DEVIATION 0.18 • n=6 Participants	0.17 %days past 30 days used substances STANDARD_DEVIATION 0.13 • n=6 Participants	0.24 %days past 30 days used substances STANDARD_DEVIATION 0.21 • n=64 Participants	0.16 %days past 30 days used substances STANDARD_DEVIATION 0.16 • n=17 Participants	0.20 %days past 30 days used substances STANDARD_DEVIATION 0.15 • n=21 Participants	0.25 %days past 30 days used substances STANDARD_DEVIATION 0.16 • n=22 Participants	0.21 %days past 30 days used substances STANDARD_DEVIATION 0.16 • n=8 Participants	0.20 %days past 30 days used substances STANDARD_DEVIATION 0.13 • n=16 Participants	0.17 %days past 30 days used substances STANDARD_DEVIATION 0.15 • n=135 Participants	0.20 %days past 30 days used substances STANDARD_DEVIATION 0.16 • n=136 Participants
Time since release from Incarceration	5.36 Years STANDARD_DEVIATION 1.34 • n=5 Participants	5.20 Years STANDARD_DEVIATION 1.26 • n=7 Participants	4.95 Years STANDARD_DEVIATION .83 • n=5 Participants	5.75 Years STANDARD_DEVIATION 1.45 • n=4 Participants	5.62 Years STANDARD_DEVIATION 1.74 • n=21 Participants	5.08 Years STANDARD_DEVIATION 1.13 • n=10 Participants	5.51 Years STANDARD_DEVIATION 1.44 • n=115 Participants	5.85 Years STANDARD_DEVIATION 1.92 • n=6 Participants	5.29 Years STANDARD_DEVIATION 1.50 • n=6 Participants	5.65 Years STANDARD_DEVIATION 1.32 • n=64 Participants	5.82 Years STANDARD_DEVIATION 2.70 • n=17 Participants	5.00 Years STANDARD_DEVIATION 1.21 • n=21 Participants	5.56 Years STANDARD_DEVIATION 1.31 • n=22 Participants	5.53 Years STANDARD_DEVIATION 1.19 • n=8 Participants	5.14 Years STANDARD_DEVIATION 1.18 • n=16 Participants	5.61 Years STANDARD_DEVIATION 1.86 • n=135 Participants	5.43 Years STANDARD_DEVIATION 1.52 • n=136 Participants

PRIMARY outcome

Timeframe: 5 months

Population: Participants who completed 5 months post baseline follow-up

Outcome measures

Outcome measures
Measure	CD-LC n=9 Participants Group behavioral intervention with 9 weekly sessions lasting 2 hours. Critical Dialogue (CD), Licensed Clinician (LC). Critical Dialogue: Prompted by thematic images, aims to help participants develop a deeper understanding of how marginalizing processes (e.g., systematic stigma; feelings of rage as victims of discrimination) impact participants' lives and behavior. LC: Whether the intervention is delivered by a licensed clinician.	CBP- LC n=22 Participants Group community mobilizing intervention with 9 weekly sessions spread in 15 weeks. Capacity Building Project (CBP), Licensed Clinician (LC) Capacity Building Project: Designed to create collaborative efforts to overcome and dismantle marginalizing processes by building positive social and organizational relationships and community capacity through the development and implementation of community projects aiming to address social determinants of health. LC: Whether the intervention is delivered by a licensed clinician.	QLW- LC n=25 Participants Group intervention where participants learn to develop and implement personal goals that are measurable, attainable, realistic, and time bound. Intervention includes 9 sessions. Quality of Life Wheel, Licensed Clinician (LC) Quality of Life Wheel: Aims to increase self-efficacy and help participants develop a vision for their future, breaking this vision down into small, feasible, measureable goals they can implement on a weekly basis (e.g. quitting smoking, improving relationships with family members, paying down debt). LC: Whether the intervention is delivered by a licensed clinician.	CD & CBP- LC n=31 Participants Combination of group behavioral intervention and community mobilization intervention including 15 weekly sessions.Licensed Clinician (LC) Critical Dialogue: Prompted by thematic images, aims to help participants develop a deeper understanding of how marginalizing processes (e.g., systematic stigma; feelings of rage as victims of discrimination) impact participants' lives and behavior. Capacity Building Project: Designed to create collaborative efforts to overcome and dismantle marginalizing processes by building positive social and organizational relationships and community capacity through the development and implementation of community projects aiming to address social determinants of health. LC: Whether the intervention is delivered by a licensed clinician.	CD & QLW- LC n=23 Participants Combination of group behavioral intervention and community mobilization intervention including 15 weekly sessions.Licensed Clinician (LC) Critical Dialogue: Prompted by thematic images, aims to help participants develop a deeper understanding of how marginalizing processes (e.g., systematic stigma; feelings of rage as victims of discrimination) impact participants' lives and behavior. Quality of Life Wheel: Aims to increase self-efficacy and help participants develop a vision for their future, breaking this vision down into small, feasible, measureable goals they can implement on a weekly basis (e.g. quitting smoking, improving relationships with family members, paying down debt). LC: Whether the intervention is delivered by a licensed clinician.	QLW & Capacity Building ProjectCBP- LC n=14 Participants Combination of goal development and implementation with community mobilization intervention including 9 weekly sessions spread across 15 weeks. Licensed Clinician (LC) Capacity Building Project: Designed to create collaborative efforts to overcome and dismantle marginalizing processes by building positive social and organizational relationships and community capacity through the development and implementation of community projects aiming to address social determinants of health. Quality of Life Wheel: Aims to increase self-efficacy and help participants develop a vision for their future, breaking this vision down into small, feasible, measureable goals they can implement on a weekly basis (e.g. quitting smoking, improving relationships with family members, paying down debt). LC: Whether the intervention is delivered by a licensed clinician.	QLW & CD & CBP-LC n=27 Participants Combination of group behavioral intervention, goal development and implementation, and community mobilization intervention including 15 weekly sessions.Licensed Clinician (LC) Critical Dialogue: Prompted by thematic images, aims to help participants develop a deeper understanding of how marginalizing processes (e.g., systematic stigma; feelings of rage as victims of discrimination) impact participants' lives and behavior. Capacity Building Project: Designed to create collaborative efforts to overcome and dismantle marginalizing processes by building positive social and organizational relationships and community capacity through the development and implementation of community projects aiming to address social determinants of health. Quality of Life Wheel: Aims to increase self-efficacy and help participants develop a vision for their future, breaking this vision down into small, feasible, measureable goals they can implement on a weekly basis (e.g. quitting smoking, improving relationships with family members, paying down debt). LC: Whether the intervention is delivered by a licensed clinician.	Core LC n=24 Participants This condition will include 3 core sessions that are not a part of the components being tested. These are support sessions to the components being tested and is hypothesized to have the smallest impact on substance use outcomes.Licensed Clinician (LC) LC: Whether the intervention is delivered by a licensed clinician.	CD- PF n=21 Participants Group behavioral intervention with 9 weekly sessions lasting 2 hours. Critical Dialogue (CD), Peer Facilitator (PF) Critical Dialogue: Prompted by thematic images, aims to help participants develop a deeper understanding of how marginalizing processes (e.g., systematic stigma; feelings of rage as victims of discrimination) impact participants' lives and behavior. PF: Whether the intervention is delivered by a peer facilitator.	CBP- PF n=24 Participants Group community mobilizing intervention with 9 weekly sessions spread in 15 weeks. Capacity Building Project (CBP), Peer Facilitator (PF) Capacity Building Project: Designed to create collaborative efforts to overcome and dismantle marginalizing processes by building positive social and organizational relationships and community capacity through the development and implementation of community projects aiming to address social determinants of health. PF: Whether the intervention is delivered by a peer facilitator.	QLW-PF n=25 Participants Group intervention where participants learn to develop and implement personal goals that are measurable, attainable, realistic, and time bound. Intervention includes 9 sessions. Quality of Life wheel, Peer Facilitator (PF) Quality of Life Wheel: Aims to increase self-efficacy and help participants develop a vision for their future, breaking this vision down into small, feasible, measureable goals they can implement on a weekly basis (e.g. quitting smoking, improving relationships with family members, paying down debt). PF: Whether the intervention is delivered by a peer facilitator.	CD & CBP- PF n=26 Participants Combination of group behavioral intervention and community mobilization intervention including 15 weekly sessions. Peer Facilitator (PF) Critical Dialogue: Prompted by thematic images, aims to help participants develop a deeper understanding of how marginalizing processes (e.g., systematic stigma; feelings of rage as victims of discrimination) impact participants' lives and behavior. Capacity Building Project: Designed to create collaborative efforts to overcome and dismantle marginalizing processes by building positive social and organizational relationships and community capacity through the development and implementation of community projects aiming to address social determinants of health. PF: Whether the intervention is delivered by a peer facilitator.	CD & QLW- PF n=23 Participants Combination of group behavioral intervention and community mobilization intervention including 15 weekly sessions.Peer Facilitator (PF) Critical Dialogue: Prompted by thematic images, aims to help participants develop a deeper understanding of how marginalizing processes (e.g., systematic stigma; feelings of rage as victims of discrimination) impact participants' lives and behavior. Quality of Life Wheel: Aims to increase self-efficacy and help participants develop a vision for their future, breaking this vision down into small, feasible, measureable goals they can implement on a weekly basis (e.g. quitting smoking, improving relationships with family members, paying down debt). PF: Whether the intervention is delivered by a peer facilitator.	QLW & CBP- PF n=27 Participants Combination of goal development and implementation with community mobilization intervention including 9 weekly sessions spread across 15 weeks.Peer Facilitator (PF) Capacity Building Project: Designed to create collaborative efforts to overcome and dismantle marginalizing processes by building positive social and organizational relationships and community capacity through the development and implementation of community projects aiming to address social determinants of health. Quality of Life Wheel: Aims to increase self-efficacy and help participants develop a vision for their future, breaking this vision down into small, feasible, measureable goals they can implement on a weekly basis (e.g. quitting smoking, improving relationships with family members, paying down debt). PF: Whether the intervention is delivered by a peer facilitator.	CD & QLW & CBP- PF n=31 Participants Combination of group behavioral intervention, goal development and implementation, and community mobilization intervention including 15 weekly sessions.Peer Facilitator (PF) Critical Dialogue: Prompted by thematic images, aims to help participants develop a deeper understanding of how marginalizing processes (e.g., systematic stigma; feelings of rage as victims of discrimination) impact participants' lives and behavior. Capacity Building Project: Designed to create collaborative efforts to overcome and dismantle marginalizing processes by building positive social and organizational relationships and community capacity through the development and implementation of community projects aiming to address social determinants of health. Quality of Life Wheel: Aims to increase self-efficacy and help participants develop a vision for their future, breaking this vision down into small, feasible, measureable goals they can implement on a weekly basis (e.g. quitting smoking, improving relationships with family members, paying down debt). PF: Whether the intervention is delivered by a peer facilitator.	Core PF n=27 Participants This condition will include 3 core sessions that are not a part of the components being tested. These are support sessions to the components being tested and is hypothesized to have the smallest impact on substance use outcomes. Peer Facilitator (PF) PF: Whether the intervention is delivered by a peer facilitator.
Percentage of Days of Alcohol or Substance Misuse in the Past 30 Days	0.15 % days misusing substances past 30 days Standard Deviation 0.12	0.16 % days misusing substances past 30 days Standard Deviation 0.10	0.21 % days misusing substances past 30 days Standard Deviation 0.12	0.16 % days misusing substances past 30 days Standard Deviation 0.12	0.14 % days misusing substances past 30 days Standard Deviation 0.11	0.22 % days misusing substances past 30 days Standard Deviation 0.25	0.18 % days misusing substances past 30 days Standard Deviation 0.13	0.17 % days misusing substances past 30 days Standard Deviation 0.13	0.14 % days misusing substances past 30 days Standard Deviation 0.15	0.21 % days misusing substances past 30 days Standard Deviation 0.11	0.16 % days misusing substances past 30 days Standard Deviation 0.12	0.15 % days misusing substances past 30 days Standard Deviation 0.13	0.19 % days misusing substances past 30 days Standard Deviation 0.12	0.14 % days misusing substances past 30 days Standard Deviation 0.11	0.19 % days misusing substances past 30 days Standard Deviation 0.16	0.14 % days misusing substances past 30 days Standard Deviation 0.10

SECONDARY outcome

Timeframe: 5 months

Number of people abstinent from alcohol and drug use, which is assessed via the timeline follow back scale