Do Health Educator Telephone Calls Reduce At-risk Drinking Among Older Adults in Primary Care?

• Published in: Journal of general internal medicine : JGIM Vol. 25; no. 4; pp. 334 - 339
• Main Authors: Lin, James C., Karno, Mitchell P., Tang, Lingqi, Barry, Kristen L., Blow, Frederic C., Davis, James W., Ramirez, Karina D., Welgreen, Sandra, Hoffing, Marc, Moore, Alison A.
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01.04.2010; Springer; Springer Nature B.V
• Subjects: Age Factors; Aged; Alcohol use; Alcoholism - epidemiology; Alcoholism - prevention & control; Alcoholism and acute alcohol poisoning; Biological and medical sciences; Confidence Intervals; Directive Counseling; Female; General aspects; Health Education; Humans; Internal Medicine; Intervention; Logistic Models; Male; Medical sciences; Medicine; Medicine & Public Health; Miscellaneous; Odds Ratio; Older people; Original; Original Article; Patient Education as Topic; Primary care; Primary Health Care; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk Factors; Risk-Taking; Socioeconomic Factors; Telemedicine; Telephone; Toxicology; United States - epidemiology; United States; alcohol; at-risk drinking; telephone intervention; health educator; Human; Consumption; Ethanol; Telephone; Primary health care; Alcoholism; Alcohol; Drinking; Medicine; Alcoholic beverage; Telephone call; Elderly; Public health
• ISSN: 0884-8734; 1525-1497; 1525-1497
• DOI: 10.1007/s11606-009-1223-2

Background Alcohol screening and brief intervention for unhealthy alcohol use has not been consistently delivered in primary care as part of preventive healthcare. Objective To explore whether telephone-based intervention delivered by a health educator is efficacious in reducing at-risk drinking among older adults in primary care settings. Design Secondary analyses of data from a randomized controlled trial. Participants Subjects randomized to the intervention arm of the trial (n = 310). Interventions Personalized risk reports, advice from physicians, booklet about alcohol and aging, and up to three telephone calls from a health educator. All interventions were completed before the three-month follow-up. Measurements Risk outcomes (at-risk or not at-risk) at 3 and 12 months after enrollment. Main results In univariate analyses, compared to those who remained at risk, those who achieved not at-risk outcome at 3 months were more likely to be women, Hispanic or non-white, have lower levels of education, consume less alcohol, drink less frequently, and have lower baseline number of risks. In mixed-effects logistic regression models, completing all three health educator calls increased the odds of achieving not at-risk outcome compared to not completing any calls at 3 months (OR 5.31; 95% CI 1.92–14.7; p = 0.001), but not at 12 months (OR 2.01; 95% CI 0.71–5.67; p = 0.18). Conclusions Telephone-based intervention delivered by a health educator was moderately efficacious in reducing at-risk drinking at 3 months after enrollment among older adults receiving a multi-faceted intervention in primary care settings; however, the effect was not sustained at 12 months.