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We explored factors associated with the importance and confidence dimensions of motivation to reduce drinking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Participants (<jats:italic>N<\/jats:italic>\u2009=\u2009121) with unhealthy alcohol use (i.e., over NIH guidelines) receiving care in hepatology clinics from a safety\u2010net hospital (SN, <jats:italic>N<\/jats:italic>\u2009=\u200954) and two Veterans Affairs Healthcare Systems (VA, <jats:italic>N<\/jats:italic>\u2009=\u200967) were enrolled in an alcohol intervention trial from March 2022 through October 2023. Baseline assessments included Generalised Anxiety Disorder (GAD\u20107), Patient Health Questionnaire (PHQ\u20108), Alcohol Use Disorders Identification Test (AUDIT), COVID\u201019 stress; and measures of importance and confidence to decrease alcohol use (readiness rulers, scales of 1\u201310). Liver disease aetiology and severity were extracted from electronic health records. We performed multivariable linear regression models with forward selection to assess pre\u2010specified variables' associations with importance and confidence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The sample was 84% male, 40% Latino, 31% White, 18% Black and 11% other races; median age was 61\u2009years. Median (Q1\u2013Q3) AUDIT score was 16 (12\u201324), importance was 9 (6\u201310) and confidence was 8 (5\u20139). On multivariable analysis, VA site (vs. SN) participants had a 0.97\u2010point lower importance score (<jats:italic>p<\/jats:italic>\u2009=\u20090.02); higher symptoms of depression (PHQ\u20108 score\u2009\u2265\u200910 vs. &lt;\u200910) and AUDIT scores (for each point increase) were associated with higher importance score (estimates 1.2 and 0.08, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05, respectively). Liver disease aetiology and severity were not significantly associated with outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Depression, alcohol problem severity and treatment site may influence motivation to reduce alcohol use and could inform future hepatology\u2010based interventions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.18387","type":"journal-article","created":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T10:08:34Z","timestamp":1731319714000},"page":"481-490","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Factors Associated With Motivation to Reduce Alcohol Use Among Patients With Chronic Liver Disease"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4228-1504","authenticated-orcid":false,"given":"Derek D.","family":"Satre","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences University of California  San Francisco California USA"},{"name":"Kaiser Permanente Northern California Division of Research  Pleasanton California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhweeja","family":"Dasarathy","sequence":"additional","affiliation":[{"name":"Vanderbilt School of Medicine  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven L.","family":"Batki","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences University of California  San Francisco California USA"},{"name":"Mental Health Service Veterans Affairs San Francisco Health Care System  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Ostacher","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Stanford University School of Medicine  Palo Alto California USA"},{"name":"Department of Psychiatry Veterans Affairs Palo Alto Health Care System  Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah R.","family":"Snyder","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine University of California  San Francisco California USA"},{"name":"Department of Psychiatry and Behavioral Sciences University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Hua","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences University of California  San Francisco California USA"},{"name":"Mental Health Service Veterans Affairs San Francisco Health Care System  San Francisco California 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San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meimei","family":"Liao","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Veterans Affairs Palo Alto Health Care System  Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Tana","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Zuckerberg San Francisco General  San Francisco California USA"},{"name":"Department of Medicine, Division of Gastroenterology and Hepatology University of California  San Francisco California USA"},{"name":"University of California san Francisco Liver Center  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po\u2010Hung","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology &amp; Hepatology, Department of Medicine Johns Hopkins University School 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