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Morse AK, Askovic M, Sercombe J, Dean K, Fisher A, Marel C, Chatterton ML, Kay-Lambkin F, Barrett E, Sunderland M, Harvey L, Peach N, Teesson M, Mills KL. A systematic review of the efficacy, effectiveness and cost-effectiveness of workplace-based interventions for the prevention and treatment of problematic substance use. Front Public Health 2022; 10:1051119. [PMID: 36419993 PMCID: PMC9676969 DOI: 10.3389/fpubh.2022.1051119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 10/18/2022] [Indexed: 11/09/2022] Open
Abstract
Employee alcohol and other drug use can negatively impact the workplace, resulting in absenteeism, reduced productivity, high turnover, and worksite safety issues. As the workplace can influence employee substance use through environmental and cultural factors, it also presents a key opportunity to deliver interventions, particularly to employees who may not otherwise seek help. This is a systematic review of workplace-based interventions for the prevention and treatment of problematic substance use. Five databases were searched for efficacy, effectiveness and/or cost-effectiveness studies and reviews published since 2010 that measured use of psychoactive substances (i.e., alcohol, cannabis, hallucinogens, inhalants, opioids, sedatives, hypnotics, anxiolytics, and stimulants) as a primary or secondary outcome, in employees aged over 18. Thirty-nine articles were identified, 28 describing primary research and 11 reviews, most of which focused solely on alcohol use. Heterogeneity between studies with respect to intervention and evaluation design limited the degree to which findings could be synthesized, however, there is some promising evidence for workplace-based universal health promotion interventions, targeted brief interventions, and universal substance use screening. The few studies that examined implementation in the workplace revealed specific barriers including lack of engagement with e-health interventions, heavy use and reluctance to seek help amongst male employees, and confidentiality concerns. Tailoring interventions to each workplace, and ease of implementation and employee engagement emerged as facilitators. Further high-quality research is needed to examine the effectiveness of workplace substance use testing, Employee Assistance Programs, and strategies targeting the use of substances other than alcohol in the workplace. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=227598, PROSPERO [CRD42021227598].
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Affiliation(s)
- Ashleigh K. Morse
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Mina Askovic
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Jayden Sercombe
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Kate Dean
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Alana Fisher
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
- eCentre Clinic, School of Psychological Sciences, Macquarie University, Sydney, NSW, Australia
| | - Christina Marel
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | | | - Frances Kay-Lambkin
- Priority Research Centre for Brain and Mental Health, University of Newcastle, Newcastle, NSW, Australia
| | - Emma Barrett
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Matthew Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Logan Harvey
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Natalie Peach
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Katherine L. Mills
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
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Huerta T, Fareed N, Hefner JL, Sieck CJ, Swoboda C, Taylor R, McAlearney AS. Patient Engagement as Measured by Inpatient Portal Use: Methodology for Log File Analysis. J Med Internet Res 2019; 21:e10957. [PMID: 30907733 PMCID: PMC6452277 DOI: 10.2196/10957] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 12/28/2018] [Accepted: 12/29/2018] [Indexed: 12/21/2022] Open
Abstract
Background Inpatient portals (IPPs) have the potential to increase patient engagement and satisfaction with their health care. An IPP provides a hospitalized patient with similar functions to those found in outpatient portals, including the ability to view vital signs, laboratory results, and medication information; schedule appointments; and communicate with their providers. However, IPPs may offer additional functions such as meal planning, real-time messaging with the inpatient care team, daily schedules, and access to educational materials relevant to their specific condition. In practice, IPPs have been developed as websites and tablet apps, with hospitals providing the required technology as a component of care during the patient’s stay. Objective This study aimed to describe how inpatients are using IPPs at the first academic medical center to implement a system-wide IPP and document the challenges and choices associated with this analytic process. Methods We analyzed the audit log files of IPP users hospitalized between January 2014 and January 2016. Data regarding the date/time and duration of interactions with each of the MyChart Bedside modules (eg, view lab results or medications and patient schedule) and activities (eg, messaging the provider and viewing educational videos) were captured as part of the system audit logs. The development of a construct to describe the length of time associated with a single coherent use of the tool—which we call a session—provides a foundational unit of analysis. We defined frequency as the number of sessions a patient has during a given provision day. We defined comprehensiveness in terms of the percentage of functions that an individual uses during a given provision day. Results The analytic process presented data challenges such as length of stay and tablet-provisioning factors. This study presents data visualizations to illustrate a series of data-cleaning issues. In the presence of these robust approaches to data cleaning, we present the baseline usage patterns associated with our patient panel. In addition to frequency and comprehensiveness, we present considerations of median data to mitigate the effect of outliers. Conclusions Although other studies have published usage data associated with IPPs, most have not explicated the challenges and choices associated with the analytic approach deployed within each study. Our intent in this study was to be somewhat exhaustive in this area, in part, because replicability requires common metrics. Our hope is that future researchers in this area will avail themselves of these perspectives to engage in critical assessment moving forward.
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Affiliation(s)
- Timothy Huerta
- Department of Family Medicine, College of Medicine, The Ohio State University, Columbus, OH, United States.,Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH, United States.,Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, OH, United States.,CATALYST: Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Naleef Fareed
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH, United States.,CATALYST: Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Jennifer L Hefner
- Department of Family Medicine, College of Medicine, The Ohio State University, Columbus, OH, United States.,Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, OH, United States.,CATALYST: Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Cynthia J Sieck
- Department of Family Medicine, College of Medicine, The Ohio State University, Columbus, OH, United States.,CATALYST: Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Christine Swoboda
- CATALYST: Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Robert Taylor
- CATALYST: Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Ann Scheck McAlearney
- Department of Family Medicine, College of Medicine, The Ohio State University, Columbus, OH, United States.,Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH, United States.,Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, OH, United States.,CATALYST: Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, College of Medicine, The Ohio State University, Columbus, OH, United States
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Gómez-Recasens M, Alfaro-Barrio S, Tarro L, Llauradó E, Solà R. A workplace intervention to reduce alcohol and drug consumption: a nonrandomized single-group study. BMC Public Health 2018; 18:1281. [PMID: 30458742 PMCID: PMC6247683 DOI: 10.1186/s12889-018-6133-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 10/19/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The consumption of alcohol and other drugs causes social and health problems in industrialized societies. Furthermore, alcohol and drug consumption in the workplace is associated with work accidents, absenteeism and low productivity. The aim of the current study is to reduce alcohol and drug consumption among workers in the service industry and, as a secondary aim, to improve their healthy habits through the reduction of alcohol and other drug consumption in their leisure time. METHODS This nonrandomized, single-group study was conducted in 12 work centers. The intervention began in 2009 and emphasized 1) health promotion and health monitoring, which included a) alcohol and drug awareness and b) the evaluation and monitoring of alcohol and drug consumption through a semistructured interview designed to assess risky consumption; urine tests aimed at detecting alcohol, cannabis and cocaine use; an Alcotest based on expired air to test for the recent consumption of alcohol and a saliva exam to test for the recent consumption of six drugs; and 2) secondary prevention if risky consumption was identified. Risky alcohol consumption was defined as the ingestion of more than 28 standard drink units (SDUs)/week among men and more than 17 SDUs/week among women (taking into account both work and leisure time). Drug consumption was considered risky consumption. RESULTS A total of 1103 workers participated, and each received 5 h of awareness training. Those who presented with risky consumption received secondary prevention training. The prevalence of risky alcohol consumption decreased by 4.1% (baseline: 14.7% reduced to 10.6% in the first year; p = 0.001), a reduction that was maintained over a 3-year follow-up period. CONCLUSION A comprehensive program of worker health surveillance that involves stakeholders and includes monitoring can be a means of potentially improving compliance with workplace promotion programs, resulting in the facilitation of such beneficial, desired behavior change in areas such as alcohol and drug consumption.
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Affiliation(s)
- Montse Gómez-Recasens
- Universitat Rovira i Virgili, Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Health Education and Promotion, Reus, Spain
- Medical service of Fomento de Construcciones y Contratas, Delegación Catalunya II, 43007 Tarragona, Spain
| | - Silvana Alfaro-Barrio
- Medical service of Fomento de Construcciones y Contratas, Delegación Catalunya II, 43007 Tarragona, Spain
| | - Lucia Tarro
- Universitat Rovira i Virgili, Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Health Education and Promotion, Reus, Spain
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Reus, Spain
| | - Elisabet Llauradó
- Universitat Rovira i Virgili, Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Health Education and Promotion, Reus, Spain
| | - Rosa Solà
- Universitat Rovira i Virgili, Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Health Education and Promotion, Reus, Spain
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Reus, Spain
- Hospital Universitari Sant Joan de Reus, Reus, Spain
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Pidd K, Roche A, Cameron J, Lee N, Jenner L, Duraisingam V. Workplace alcohol harm reduction intervention in Australia: Cluster non-randomised controlled trial. Drug Alcohol Rev 2018; 37:502-513. [PMID: 29349868 DOI: 10.1111/dar.12660] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 12/05/2017] [Accepted: 12/13/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND AIMS The workplace holds substantial potential as an alcohol harm reduction and prevention setting. Few studies have rigorously examined strategies to reduce workplace alcohol-related harm. Hence, an in-situ 3 year trial of a comprehensive alcohol harm reduction intervention in Australian manufacturing workplaces was undertaken. DESIGN AND METHODS Informed by a gap analysis, a multi-site trial was undertaken. Three manufacturing industry companies, located at four separate worksites, with a minimum of 100 employees were recruited through a local industry network. Based on worksite location, two worksites were allocated to the intervention group and two to the comparison group. The pre-specified primary outcome measure, risky drinking (Alcohol Use Disorders Identification Test, AUDIT-C) and other self-report measures were collected pre-intervention (T1), 12 months (T2) and 24 months post-intervention (T3). RESULTS No significant intervention effect was observed for the primary outcome measure, risky drinking. Significant intervention effects were observed for increased awareness of alcohol policy and employee assistance. At T3, the odds of intervention group participants being aware of the workplace policy and aware of employee assistance were 48.9% (95% confidence interval 29.3-88.9%) and 79.7% (11.5%, 91.8%), respectively, greater than comparison group participants. DISCUSSION AND CONCLUSIONS Comprehensive tailored workplace interventions can be effective in improving workplace alcohol policy awareness. This is one of few workplace alcohol trials undertaken to-date and the findings make an important contribution to the limited evidence base for workplace alcohol harm prevention initiatives.
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Affiliation(s)
- Ken Pidd
- National Centre for Education and Training on Addiction (NCETA), Flinders University, Adelaide, Australia
| | - Ann Roche
- National Centre for Education and Training on Addiction (NCETA), Flinders University, Adelaide, Australia
| | - Jacqui Cameron
- National Centre for Education and Training on Addiction (NCETA), Flinders University, Adelaide, Australia.,Department of General Practice, Melbourne Medical School, University of Melbourne, Melbourne, Australia
| | - Nicole Lee
- 360 Edge, Melbourne, Australia.,National Drug Research Institute, Curtin University, Perth, Australia
| | | | - Vinita Duraisingam
- National Centre for Education and Training on Addiction (NCETA), Flinders University, Adelaide, Australia
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McAlearney AS, Sieck CJ, Hefner JL, Aldrich AM, Walker DM, Rizer MK, Moffatt-Bruce SD, Huerta TR. High Touch and High Tech (HT2) Proposal: Transforming Patient Engagement Throughout the Continuum of Care by Engaging Patients with Portal Technology at the Bedside. JMIR Res Protoc 2016; 5:e221. [PMID: 27899338 PMCID: PMC5172441 DOI: 10.2196/resprot.6355] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 09/20/2016] [Accepted: 09/22/2016] [Indexed: 01/04/2023] Open
Abstract
Background For patients with complex care needs, engagement in disease management activities is critical. Chronic illnesses touch almost every person in the United States. The costs are real, personal, and pervasive. In response, patients often seek tools to help them manage their health. Patient portals, personal health records tethered to an electronic health record, show promise as tools that patients value and that can improve health. Although patient portals currently focus on the outpatient experience, the Ohio State University Wexner Medical Center (OSUWMC) has deployed a portal designed specifically for the inpatient experience that is connected to the ambulatory patient portal available after discharge. While this inpatient technology is in active use at only one other hospital in the United States, health care facilities are currently investing in infrastructure necessary to support large-scale deployment. Times of acute crisis such as hospitalization may increase a patient’s focus on his/her health. During this time, patients may be more engaged with their care and especially interested in using tools to manage their health after discharge. Evidence shows that enhanced patient self-management can lead to better control of chronic illness. Patient portals may serve as a mechanism to facilitate increased engagement. Objective The specific aims of our study are (1) to investigate the independent effects of providing both High Tech and High Touch interventions on patient-reported outcomes at discharge, including patients’ self-efficacy for managing chronic conditions and satisfaction with care; and (2) to conduct a mixed-methods analysis to determine how providing patients with access to MyChart Bedside (MCB, High Tech) and training/education on patient portals, and MyChart Ambulatory (MCA, High Touch) will influence engagement with the patient portal and relate to longer-term outcomes. Methods Our proposed 4-year study uses a mixed-methods research (MMR) approach to evaluate a randomized controlled trial studying the effectiveness of a High Tech intervention (MCB, the inpatient portal), and an accompanying High Touch intervention (training patients to use the portal to manage their care and conditions) in a sample of hospitalized patients with two or more chronic conditions. This study measures how access to a patient portal tailored to the inpatient stay can improve patient experience and increase patient engagement by (1) improving patients’ perceptions of the process of care while in the hospital; (2) increasing patients’ self-efficacy for managing chronic conditions; and (3) facilitating continued use of a patient portal for care management after discharge. In addition, we aim to enhance patients’ use of the portal available to outpatients (MCA) once they are discharged. Results This study has been funded by the Agency for Healthcare Research and Quality (AHRQ). Research is ongoing and expected to conclude in August 2019. Conclusions Providing patients real-time access to health information can be a positive force for change in the way care is provided. Meaningful use policies require minimum demonstrated use of patient portal technology, most often in the ambulatory setting. However, as the technology matures to bridge the care transition, there is a greater need to understand how patient portals transform care delivery. By working in concert with patients to address and extend current technologies, our study aims to advance efforts to increase patients’ engagement in their care and develop a template for how other hospitals might integrate similar technologies.
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Affiliation(s)
- Ann Scheck McAlearney
- Research Division, Department of Family Medicine, The Ohio State University, Columbus, OH, United States
| | - Cynthia J Sieck
- Research Division, Department of Family Medicine, The Ohio State University, Columbus, OH, United States
| | - Jennifer L Hefner
- Research Division, Department of Family Medicine, The Ohio State University, Columbus, OH, United States
| | - Alison M Aldrich
- Research Division, Department of Family Medicine, The Ohio State University, Columbus, OH, United States
| | - Daniel M Walker
- Research Division, Department of Family Medicine, The Ohio State University, Columbus, OH, United States
| | - Milisa K Rizer
- Information Technology, Wexner Medical Center, Ohio State University, Columbus, OH, United States.,Clinical Division, Department of Family Medicine, The Ohio State University, Columbus, OH, United States.,Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Susan D Moffatt-Bruce
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH, United States.,Quality & Patient Safety, Wexner Medical Center, The Ohio State University, Columbus, OH, United States.,Department of Surgery, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Timothy R Huerta
- Research Division, Department of Family Medicine, The Ohio State University, Columbus, OH, United States.,Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH, United States
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Kolar C, von Treuer K. Alcohol Misuse Interventions in the Workplace: A Systematic Review of Workplace and Sports Management Alcohol Interventions. Int J Ment Health Addict 2015. [DOI: 10.1007/s11469-015-9558-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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Krpalek D, Meredith P, Ziviani J. Investigating Mediated Pathways Between Adult Attachment Patterns and Reported Rates of Absenteeism and Presenteeism. JOURNAL OF WORKPLACE BEHAVIORAL HEALTH 2014. [DOI: 10.1080/15555240.2014.956928] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Dragana Krpalek
- a Department of Occupational Therapy, The University of Queensland , St Lucia , Queensland , Australia
| | - Pamela Meredith
- a Department of Occupational Therapy, The University of Queensland , St Lucia , Queensland , Australia
| | - Jenny Ziviani
- b Department of Occupational Therapy, The University of Queensland and Queensland Health , St Lucia , Queensland , Australia
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Lee NK, Roche AM, Duraisingam V, Fischer J, Cameron J, Pidd K. A Systematic Review of Alcohol Interventions Among Workers in Male-Dominated Industries. JOURNAL OF MENS HEALTH 2014. [DOI: 10.1089/jomh.2014.0008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Jacobson JM, Sacco P. Employee assistance program services for alcohol and other drug problems: implications for increased identification and engagement in treatment. Am J Addict 2012; 21:468-75. [PMID: 22882398 DOI: 10.1111/j.1521-0391.2012.00256.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Fourteen million U.S. workers meet the diagnostic criteria for substance dependence, costing millions in lost productivity. Prior research suggests that employees who follow through with their Employee Assistance Program's (EAP) recommendations are more likely to participate and remain engaged in alcohol and other drug (AOD) treatment programs. This study identified rates of lifetime EAP service use for AOD problems and compared adults who reported using EAP services for AOD problems with those who used services other than EAP. METHODS Researchers analyzed a subset of participants from the National Epidemiologic Survey of Alcohol and Related Conditions who reported having received help for an AOD problem (NESARC, 2001-2002). Statistical analyses tested for differences in sociodemographic variables, lifetime mental health and substance abuse disorders, and health disability between EAP services users and users of other types of services. RESULTS Among adults who sought services for AOD problems (n= 2,272), 7.58% (n= 166) reported using EAP services for these problems at some point during their lives. Major depressive disorder (lifetime), a drug use disorder (lifetime), and Black race/ethnicity were associated with a greater likelihood that someone would seek EAP services for help with their AOD problem. CONCLUSIONS Results provide a foundation for researchers to understand who uses EAP services for AOD problems. Health and mental health professionals should increase their knowledge of EAP services to improve continuity of care for employees with AOD problems. EAPs are in a unique position to reach out to vulnerable employees in the workplace and engage them in treatment.
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Affiliation(s)
- Jodi M Jacobson
- University of Maryland, School of Social Work, Baltimore, Maryland 21201, USA.
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