A Pilot Study of Online Feedback for Adult Drinkers 50 and Older: Feasibility and Preferences

Background and Purpose: Normative and personalized feedback (NF and PF, respectively) are moderately effective brief interventions for hazardous drinking among older adults. Utilized almost solely in primary care, these interventions take valuable time and resources from physicians who are potentially evaluating a number of health conditions. In an effort to develop feedback for alternative settings, this study tested the feasibility of online feedback for drinkers 50 and older. Two types of feedback were tested for initial efficacy in motivating drinkers to plan to reduce drinking. NF provided participants with information about how their drinking compared to their same age and gendered peers. PF provided information about level of risk related to both amount of drinking and comorbid medical conditions. Finally, differential efficacy between NF and PF and participants’ preferences for interventions were explored.

Method: Using Amazon’s Mechanical Turk, 132 male (n=73) and female (n=59) drinkers aged 50 to 75+ were recruited to complete an online survey during which they were asked about: their perceptions of their drinking, the quantity and frequency of drinking, and if they had any comorbid health and/or mental health disorders. They were then provided NF or PF, which was tailored to their report of quantity and frequency of drinking, and then immediately evaluated for their reactions (e.g., “Does this worry you?”, “Are you surprised by this?”, “how helpful is this information for you?”). Plan to change drinking was a proxy for behavioral outcome. Finally participants were asked about motivations and preferences for interventions. 

Results: There were no baseline differences between NF and PF. Participants on average drank 2.73 (SD=2) standard drinks per drinking day, reported binge drinking 2.32 days per month, and reported just under 8 drinks per week. Thirty percent (29.5%) reported drinking beyond safety guidelines defined by NIAAA. Participants did not identify their alcohol use as excessive (M=3.0, SD=2.2) or problematic (M=2.6, SD=2.1; range 1-8, 8=extremely excessive or problematic). 17.4% reported taking a medication in which alcohol is contraindicated. Just over 5% had diabetes and 13.6% had depression. Generally, participants were a little surprised by feedback (M=3.9, SD=2.8) but not worried (M=2.8, SD=2.1). After feedback, 43.9% planned to decrease drinking. NF significantly predicted plan for change over PF (B=.180, p <.05), as did worry (B=.339, p <.001) (R²=.332). Participants reported feedback was somewhat helpful (M=5.07, SD=1.2), with no differences between feedback types. Participants reported a preference for an online intervention (44.7%) over all other types of intervention to help them reduce drinking.

Conclusion and Implications: Findings suggest that online feedback for adults 50 and older is feasible and potentially effective in motivating plans for change. NF was more motivating than PF for this group. Considering preferences, findings indicate that an online intervention for middle aged and older adult drinkers is feasible and desirable (for at least individuals who are computer savvy), potentially providing an important affordable adjunct to primary care. Generalizability is limited due to recruitment method. Additional limitations are discussed.