Professionals’ views on interventions to reduce and prevent problematic alcohol use in older adults

BACKGROUND: Interventions to address problematic alcohol use in older adults are needed as alcohol use is highly prevalent among those over 55 years of age. For interventions to be most effective, their working elements should be leveraged. However, understanding of working elements specifically in interventions for older adults is limited. The aim of this study was to understand how (i.e., which elements), in which context, and why (which mechanisms) interventions are successful in preventing or reducing (problematic) alcohol use among older adults, from the perspective of professionals providing these interventions. METHODS: Guided by a Realist Evaluation approach, an existing Initial Program Theory (IPT) on working elements in alcohol interventions, was tested by conducting semi-structured interviews with professionals (N = 20). These professionals provide interventions targeting alcohol use across several contexts: with or without practitioner involvement; in-person or not; and in an individual or in a group setting. Data were coded and links between contexts, elements, mechanisms and outcomes were sought for in order to confirm, refute or refine the IPT. RESULTS: Several general working elements were found: 1) pointing out the risks and consequences of drinking behavior, 2) paying attention to abstinence, 3) contact with peers, 4) personalized content and 5) providing support. We also found context-specific working elements:1) personalized content and conversations in interventions with practitioners, 2) safety, trust and feeling connected in in-person interventions and 3) sharing experiences and tips in group interventions. CONCLUSIONS: Findings are in general in line with the IPT. Our findings emphasize the need for social contacts and support for older adults. The mechanisms awareness and accessibility were important contributors to positive interventions outcomes. Further research should study the perspective of older adults and their relatives on interventions. KEY MESSAGES: • Social contacts and support are needed in interventions to reduce and prevent problematic alcohol use in older adults. • Awareness and accessibility are important contributors to positive interventions outcomes in interventions to reduce and prevent problematic alcohol use in older adults.