Online Education to Inform the Elderly About Age-related Alcohol Risks

This proposed Phase 2 The Small Business Innovation Research study is a randomized trial of
the effectiveness of "A Toast to Health in Later Life!" a web-based patient educational
program designed to prevent hazardous and harmful drinking in older adults. The project's
specific objectives are to 1) provide reliable information on the extent to which "A Toast to
Health in Later Life!" reduces alcohol-related risks and problems among older patients who
drink and 2) evaluate the extent to which these reductions are associated with increases in
health-related quality of life, patient knowledge and self-efficacy and decreases in the use
of health services and the costs of care. The proposal is being submitted in response to the
The National Institute on Alcohol Abuse and Alcoholism's interest in the "development and
evaluation of educational materials designed to intervene with the elderly around specific
age-related risks for alcohol problems" and to the National Institute of Health's highest
priority areas in health economics research because it aims to measure the actual or
potential impact of a specific intervention "on healthcare utilization and health outcomes."
The study will take place with 600 patients who currently drink and receive their care at a
large community-based medical center in in L.A. County that serves a stable and diverse
population. Older people can experience alcohol's unfavorable health effects even at
relatively low consumption levels because of age-related physiological changes and drinking's
potentially adverse interactions with chronic illness, increased medication-use and
diminishing functional status. About 14.5% of older adults drink in excess of the The
National Institute on Alcohol Abuse and Alcoholism's recommended limits. Excessive alcohol
consumption is responsible for an average of 88,000 deaths and 2.5 million years of potential
life lost each year in the U.S. and cost the 50 States a median of $2.9 billion in 2006. Most
of the costs are due to binge drinking. According to The Centers for Disease Control and
Prevention, older adults binge-drink more frequently than their younger counterparts, and
drinking too much contributes to over 54 different injuries and diseases (including car
crashes and violence). Further, the chance of getting sick and dying from alcohol problems
increases significantly for those who binge drink more often. When health and drinking
patterns are accounted for, about half of all older drinkers may be at risk for experiencing
alcohol-related harm even if they drink within recommended limits. Considering that about
10,000 people will turn 65 every day for the next decade, and that the proportion of older
adults will increase to more than 20% of the U.S. population by 2030, the number of older
people with alcohol-related risks will increase even if drinking prevalence remains constant.
Despite this, many physicians fail to discuss drinking with older patients, partly because
they do not have the time and training to do so and partly because the available education
focuses on younger drinkers. To complicate matters, observational evidence suggests that in
some older adults, moderate consumption may have beneficial effects on cardiovascular
functioning and mortality. "A Toast to Health in Later Life!" covers the spectrum of drinking
and its benefits and risks. If effective and cost-effective, the product has the potential to
achieve important clinical and societal benefits.

Inclusion Criteria:

- 55 years of age or older

- have had one or more drinks containing alcohol in the past 3 months

- have an active email account

- have access to high-speed Internet

- are able and willing to spend about 30 minutes on three separate occasions to complete
an online alcohol use class and answer questions in English

Exclusion Criteria:

- Non alcohol drinkers (having no drinks containing alcohol in the past 3 months)