Background
Health promotion interventions often include multiple components and several patient contacts. The objective of this study was to examine how participation within a multi-component intervention (Project SHARE) is associated with changes in at-risk drinking among older adults.
Methods
Observational data analysis from a cluster-randomized trial of 31 primary care physicians and their patients aged ≥60 years, at a community-based practice with seven clinics. Recruitment occurred between 2005 and 2007. At-risk drinkers in a particular physician’s practice were randomly assigned as a group to usual care (n=640 patients) vs. intervention (n=546 patients). The intervention included personalized reports, educational materials, drinking diaries, in-person physician advice, and telephone counseling by health educators (HE). The primary outcome was at-risk drinking at follow-up, defined by scores on the Comorbidity Alcohol Risk Evaluation Tool (CARET). Predictors included whether a physician-patient alcohol risk discussion occurred, HE call occurred, drinking agreement with the HE was made, and patients self-reported keeping a drinking diary as suggested by the HE.
Results
At 6 months, there was no association of at-risk drinking with having had a physician-patient discussion. Compared to having had no HE call, the odds of at-risk drinking at 6 months were lower if an agreement was made OR patients reported keeping a diary (OR 0.58, 95% CI 0.37–0.90), or if an agreement was made AND patients reported keeping a diary (0.52, 0.28–0.97). At 12 months, a physician-patient discussion (0.61, 0.38–0.98) or an agreement AND reported use of a diary (0.45, 0.25–0.82) were associated with lower odds of at-risk drinking.
Conclusions
Within the Project SHARE intervention, discussing alcohol risk with a physician, making a drinking agreement and/or self-reporting the use of a drinking diary were associated with lower odds of at-risk drinking at follow-up. Future studies targeting at-risk drinking among older adults should consider incorporating both intervention components.