Employment outcomes of abstinence‐contingent wage supplements for adults experiencing homelessness and alcohol use disorder

Alcohol use disorder, unemployment, and homelessness are interrelated problems that are concentrated among people living in poverty. A recent clinical trial evaluating an employment-based contingency management intervention called abstinence-contingent wage supplements (ACWS) found that ACWS promoted alcohol abstinence, increased employment, and reduced poverty among unemployed adults experiencing homelessness and alcohol use disorder. This secondary analysis evaluated employment and poverty outcomes during the intervention for the 62 participants randomized into the ACWS group using paystubs and self-reported measures collected during the intervention. Paystub measures correlated positively with self-reported outcomes. Most ACWS participants (n = 41; 66%) obtained employment during the intervention. During the intervention, employed participants became employed in 6.0 weeks, worked at a job or training program for 15 weeks, worked 33.7 hr per week while employed or in training, and earned $1,054.31 per pay period, on average. Most employed participants earned enough income to qualify as living out of poverty for at least one pay period (80%). While employed, participants lived above the poverty level for most pay periods (79%) during the intervention. Understanding the effects of the ACWS intervention on employment and poverty may prove useful in providing targeted support to people at increased risk of poverty-related health problems.