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

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.