Two recent randomized controlled efficacy trials showed that harm-reduction treatment for alcohol use disorder (AUD)—or patient-driven treatment that does not require abstinence and instead supports decreased alcohol-related harm and improved quality of life (QoL)—is efficacious for adults experiencing homelessness and AUD. The present study provides qualitative and quantitative analysis of one component of harm-reduction treatment, participants’ harm-reduction goal-setting, within these two trials. Aims of this secondary, dual-trial study (Trial 1 N = 208, Trial 2 N = 86) were to describe participant-generated harm-reduction goals and determine whether aspects of harm-reduction goal-setting predict treatment outcomes. Across both trials, qualitative findings indicated improving QoL, meeting basic needs, improving physical and mental health, and changing drinking behavior were participants’ top four goals. Only 2%–6% of goals centered on attaining alcohol abstinence. Regarding quantitative findings, Trial 1 showed statistically significant increases in goals generation over the course of treatment, while proportion of achieved goals stayed constant. In Trial 2, number of goals generated remained constant, while proportion of goals achieved increased. Trial 2 findings showed greater goal generation over time was associated with better physical health-related QoL, and drinking-related goals predicted improved alcohol outcomes. Overall, this secondary, dual-trial study suggests patient-driven goal-setting in harm-reduction treatment is feasible: Participants generated diverse, personalized, and clinically relevant goals. This study built on positive efficacy trial findings, indicating participants’ generation of goals was associated with improved treatment outcomes. More research is needed to further understand more nuanced relationships between harm-reduction goal-setting and treatment outcomes.

Native Hawaiian and other Pacific Islanders, and the environment that they are in relationship with, have been the targets of exploitation, extraction, and destruction. Environmental atrocities throughout the Pacific have demonstrated the ways imperialism, capitalism and white supremacy drive destruction through efforts to dominate and exploit for material gain. The relationship between Pacific people and the environment, which defines who they are socially, spiritually, and ancestrally, continues to be damaged and even severed by these injustices. The purpose of this paper is to provide examples of major environmental injustices in the Pacific and to develop a deeper understanding of the relationship between settler colonialism and environmental injustices. Indigenous Knowledge (IK), with a focus on Traditional Ecological Knowledge (TEK), is incorporated to demonstrate not just the deep impact of injustices on Pacific people's cultures, but also to highlight how this way of knowing cultivates a path to revitalization and community resilience. Cultural practices rooted in TEK, such as the preservation of food systems, promote reciprocity between living beings and self-determination, necessary for community flourishing. With this understanding, Pacific peoples' relationship with their land offers further evidence of the critical role culture and IK can play in environmental justice policies and practices.

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Aims: This secondary study characterized components of and engagement in the life-enhancing alcohol-management program (LEAP), which is resident-driven housing first programming. Methods:We used a process akin to conventional content analysis to operationalize the LEAP according to its component activities. We used generalized linear modeling to identify predictors of LEAP activity participation and to predict alcohol and quality-of-life outcomes from participation in specific LEAP activities categories.This study is secondary to a larger parent study (N = 116) testing the effects of resident-driven programming in a Housing First setting on alcohol and quality-of-life outcomes (Clifasefi et al., 2020). Participants in this secondary study were 66 residents (n = 7; 10.6% female) of a Housing First program serving people experiencing chronic homelessness and AUD. See Table 1 for baseline values on sociodemographic and alcohol-related variables. | MeasuresDemographic information (e.g. sex assigned at birth, age, race, ethnicity, education level, employment, homelessness in the past year, Veterans status), as well as current substance-use treatment attendance and mutual-help

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