Recent data indicate that a substantial proportion of adults 65 years of age and older are engaging in unsafe, at-risk drinking, either based on the amount of alcohol they drink or alcohol use combined with other comorbidities or medications. Several brief interventions to address the problem of excessive drinking in the elderly, designed mainly for in-person delivery, most in primary care physicians' offices, have yielded promising results, but these interventions are resource intensive and of limited scalability. And, while additional research has shown that web-based interventions addressing alcohol misuse can be efficacious, these promising interventions have not been specifically developed for, or applied to, the elderly, despite the growing need for interventions for this population who currently comprise over 43 million people. While one may conclude that that older adults are not likely to access an Internet-based site focused on alcohol, data from an open Internet- based alcohol screening and brief intervention found that while younger adults were more likely to access the site, elderly drinkers were significantly more likely to report weekly drinking in excess of recommended limits. Indeed, new research from the PEW Research Center has found that older adults are increasingly using the Internet to find health information. Building on ISA's extensive experience in the development and test of substance abuse prevention and health promotion interventions (including previously developed and tested web-based interventions), the proposed project will develop and test an innovative web-based program - science-based, media-rich, tailored, and easily navigated - designed to reduce at-risk drinking by older adults and the subsequent negative and costly health consequences. To overcome the stigma often associated with alcohol misuse among the elderly, the alcohol misuse prevention will be imbedded within a larger health promotion program designed to improve overall health behaviors related to stress management, healthy eating, and physical activity. Phase I will involve focus groups and the development and feasibility testing of the prototype, along with specific milestones that must met before moving to Phase II. Phase II will involve the full development of the web-based program for older adults followed by a field test of the program, including a randomized controlled trial with older adults. Mather LifeWays, a leader in the development and implementation of innovative programs and services to over 30,000 older adults annually through its residences and community outreach, has enthusiastically agreed to serve as the site for both phases of the project and to work with ISA's Center for Workforce Health to market the completed program.
Unsafe alcohol consumption puts older adults at particular risk for multiple health problems, accidents, and hazardous interactions with medications requiring increased services and health care costs. While a number of intervention of have been shown to be effective in reducing at-risk drinking among older adults, the vast majority have been in-person interventions implemented by health professionals. The goal of this Fast-Track project is the development and test of an innovative, web-based alcohol misuse prevention intervention imbedded into a more general health promotion program for older adults that will provide a mechanism for broad dissemination of an efficacious and cost-effective intervention for Continuing Care Retirement Communities and other organizations that provide services to older adults. The ultimate goal of the project is to reduce at-risk drinking so that older adults cn live more healthful and engaged lives.