title: Do health educator telephone calls reduce at-risk drinking among older adults in primary care?
abstract: 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.
  
  
  METHODS
  Secondary analyses of data from a randomized controlled trial.
  
  
  METHODS
  Subjects randomized to the intervention arm of the trial (n = 310).
  
  
  METHODS
  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.
  
  
  METHODS
  Risk outcomes (at-risk or not at-risk) at 3 and 12 months after enrollment.
  
  
  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.
authors.affiliation: VA Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA. jlin1207@ucla.edu
authors.forename: James C
authors.initials: JC
authors.lastname: Lin
authors.forename: Mitchell P
authors.initials: MP
authors.lastname: Karno
authors.forename: Lingqi
authors.initials: L
authors.lastname: Tang
authors.forename: Kristen L
authors.initials: KL
authors.lastname: Barry
authors.forename: Frederic C
authors.initials: FC
authors.lastname: Blow
authors.forename: James W
authors.initials: JW
authors.lastname: Davis
authors.forename: Karina D
authors.initials: KD
authors.lastname: Ramirez
authors.forename: Sandra
authors.initials: S
authors.lastname: Welgreen
authors.forename: Marc
authors.initials: M
authors.lastname: Hoffing
authors.forename: Alison A
authors.initials: AA
authors.lastname: Moore
mesh_terms: D000367:Age Factors; D000368:Aged; D000437:Alcoholism / Q000453:epidemiology / Q000517:prevention & control*; D016001:Confidence Intervals; D037001:Directive Counseling; D005260:Female; D006266:Health Education; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D010353:Patient Education as Topic; D011320:Primary Health Care; D012307:Risk Factors; D012309:Risk-Taking; D012959:Socioeconomic Factors; D013689:Telephone; D014481:United States / Q000453:epidemiology