• alcohol;
  • physician advice;
  • at-risk drinking

OBJECTIVES: To describe differences between older at-risk drinkers, as determined using the Comorbidity Alcohol Risk Evaluation Tool, who reduced drinking and those who did not after an initial intervention and to determine factors associated with early reductions in drinking.

DESIGN: Secondary analyses of data from a randomized controlled trial.

SETTING: Seven primary care sites.

PARTICIPANTS: Subjects randomized to the intervention group who completed the first health educator call approximately 2 weeks after enrollment (n=239).

INTERVENTION: Personalized risk reports, booklets on alcohol-associated risks, and advice from physicians, followed by a health educator call.

MEASURMENTS: Reductions in number of alcoholic drinks.

RESULTS: Thirty-nine percent of the sample had reduced drinking within 2 weeks of receiving the initial intervention. According to the final multiple logistic regression model, those who were concerned about alcohol-related risks (odds ratio (OR)=2.03, 95% confidence interval (CI)=1.01–4.07), read through the educational booklet (OR=2.97, 95% CI=1.48–5.95), or perceived that their physicians discussed risks and advised changing drinking behaviors (OR=4.1, 95% CI=2.02–8.32) had greater odds of reducing drinking by the first health educator call.

CONCLUSION: Concern about risks, reading educational material, and perception of physicians providing advice to reduce drinking were associated with early reductions in alcohol use in older at-risk drinkers. Understanding these factors will enable development of better intervention strategies to reduce unhealthy alcohol use.