A multifaceted intervention procedure was used at nine sites to reduce the substance use of high-risk women of child-bearing age. The intervention arm featured an intensive home visit/case management system delivered by support specialists through direct programming or referrals. Six domains (mental health, social support, family functioning, self-efficacy/general well being, alcohol use, and tobacco and other drug use) were the focus of the program. Substance use was significantly correlated (P < 0.05) with specific measures of mental health, social support, family functioning, and self-efficacy/general well being, supporting the viability of the project domains. Improvements were statistically significant (P < 0.05) in 14 of the 16 areas rated. The first phase of the intervention project suggests that the approach is effective. (C) 2003 Published by Elsevier Inc.