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Three Approaches to Workplace Alcohol, Drug, and Rx Prevention: 20 Years of Research to Practice

Joel Bennett
Joel Bennett
Joel BennettOwner, Organizational Wellness & Learning Systems, Inc. and Health, Wellness and Fitness Consultant

Reviews 20 years of research disseminating evidence-based workplace substance misuse prevention through innovative diffusions Co-authors: Shawn Reynolds, PhD, Research Scientist, Organizational Wellness & Learning Systems; Joel Bennett, PhD, President, Organizational Wellness & Learning Systems; Gale Lucas, PhD, Director of Research, Organizational Wellness & Learning Systems; Brittany Linde, PhD, Research Associate, Organizational Wellness & Learning Systems; Michael Neeper, MA, Research Assistant, Organizational Wellness & Learning Systems

Three Approaches to Workplace Alcohol, Drug, and Rx Prevention: 20 Years of Research to Practice

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THREE APPROACHES TO
WORKPLACE ALCOHOL, DRUG, AND
RX PREVENTION
20 YEARS OF RESEARCH-TO-PRACTICE
Joel Bennett, PhD – Organizational Wellness & Learning Systems
Also see Recent Advances in Work-site Alcohol Research
Smithers Institute Conference
King-Shaw Conference Center, ILR School
Cornell University
November 17-18, 2016
Presentation delivered as a symposium to the 2018 Total Worker Health (2nd International Symposium) – May 8-11, Bethesda, MD
https://www.cdc.gov/niosh/twh/symposium.html
Strategies for Opioid and other Substance Abuse Programs
Session Chair: Jim Newhall, PhD, Health Scientist, NIOSH Office for Total Worker Health
SPEAKER BACKGROUND
• Designing, delivering, adapting workplace mental health and substance abuse
prevention training in workplaces for over 20 years
• Integrating wellness and mental health via clinical trials
• Over 100,000 workers – many industries (e.g., health, gov’t, education)
• Recognized by the U.S. Surgeon General as effective
2
2003
Team Awareness
Team Resilience
Choices in Health Promotion
2001
2010
2017
2015
Health Consciousness
2016
OUTLINE
• Origins
• Initial Model
• Dissemination Work (Adaptations)
• Meta-Analysis in Progress
• Integral Prevention Model
• Current Efforts: Rx Prevention, SBIRT, EAP PBRN
Trice, H. M. (1990). Implications for intervention and prevention in three streams
of EAP-related research. In P. M. Roman (Ed.), Alcohol problem intervention
in the workplace: Employee assistance programs and Strategic alternatives.
(pp.339– 359). Westport, CT: Quorum.
Trice, H. M. & Sonnenstuhl, W. J. (1990). On the construction of drinking norms
in work organizations. Journal of Studies on Alcohol, 51, 201–220.
Ames, G.M., & Janes, C. (1992). A cultural approach to conceptualizing alcohol
and the workplace. Alcohol Health & Research World, 16, 112–119.
Frone, M. R. (1999). Work stress and alcohol use. Alcohol research and
health, 23(4), 284-291.
Ames, G., & Delaney, W. (1992). Minimization* of Workplace Alcohol Problems:
The Supervisor's Role. Alcoholism: Clinical and Experimental Research, 16(2),
180-189.
Ames, G., Delaney, W., & Janes, C. (1992). Obstacles to effective alcohol policy in
the workplace: a case study. British journal of addiction, 87(7), 1055-1069.
ORIGINS
Employees may be the only (influential) person in a coworker’s
life who knows about a problem, and can share skills, role model,
encourage help-seeking, or refer to a resource
Let’s give (a) employees skills and destigmatize help-seeking,
and (b) their group an opportunity for safe and open talk
Do so while promoting benefits (wellness) and policy adherence
And, as appropriate, reinforce efforts at social capital,
engagement, and resilience
This logic can be extended to any and all
health and stress conditions
Bennett, J.B., Lehman, W.E.K., Reynolds, G.S.,(2000) Team awareness for workplace substance abuse prevention: The
empirical and conceptual development of a training program. Prevention Science, 1 (3), 157-172.
INITIAL
MODEL
*Grounded Model
informed by over a
dozen studies at TCU
Institute of Behavioral
Research with Dr.
Wayne Lehman
Ad

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Three Approaches to Workplace Alcohol, Drug, and Rx Prevention: 20 Years of Research to Practice

  • 1. THREE APPROACHES TO WORKPLACE ALCOHOL, DRUG, AND RX PREVENTION 20 YEARS OF RESEARCH-TO-PRACTICE Joel Bennett, PhD – Organizational Wellness & Learning Systems Also see Recent Advances in Work-site Alcohol Research Smithers Institute Conference King-Shaw Conference Center, ILR School Cornell University November 17-18, 2016 Presentation delivered as a symposium to the 2018 Total Worker Health (2nd International Symposium) – May 8-11, Bethesda, MD https://www.cdc.gov/niosh/twh/symposium.html Strategies for Opioid and other Substance Abuse Programs Session Chair: Jim Newhall, PhD, Health Scientist, NIOSH Office for Total Worker Health
  • 2. SPEAKER BACKGROUND • Designing, delivering, adapting workplace mental health and substance abuse prevention training in workplaces for over 20 years • Integrating wellness and mental health via clinical trials • Over 100,000 workers – many industries (e.g., health, gov’t, education) • Recognized by the U.S. Surgeon General as effective 2 2003 Team Awareness Team Resilience Choices in Health Promotion 2001 2010 2017 2015 Health Consciousness 2016
  • 3. OUTLINE • Origins • Initial Model • Dissemination Work (Adaptations) • Meta-Analysis in Progress • Integral Prevention Model • Current Efforts: Rx Prevention, SBIRT, EAP PBRN
  • 4. Trice, H. M. (1990). Implications for intervention and prevention in three streams of EAP-related research. In P. M. Roman (Ed.), Alcohol problem intervention in the workplace: Employee assistance programs and Strategic alternatives. (pp.339– 359). Westport, CT: Quorum. Trice, H. M. & Sonnenstuhl, W. J. (1990). On the construction of drinking norms in work organizations. Journal of Studies on Alcohol, 51, 201–220. Ames, G.M., & Janes, C. (1992). A cultural approach to conceptualizing alcohol and the workplace. Alcohol Health & Research World, 16, 112–119. Frone, M. R. (1999). Work stress and alcohol use. Alcohol research and health, 23(4), 284-291. Ames, G., & Delaney, W. (1992). Minimization* of Workplace Alcohol Problems: The Supervisor's Role. Alcoholism: Clinical and Experimental Research, 16(2), 180-189. Ames, G., Delaney, W., & Janes, C. (1992). Obstacles to effective alcohol policy in the workplace: a case study. British journal of addiction, 87(7), 1055-1069. ORIGINS
  • 5. Employees may be the only (influential) person in a coworker’s life who knows about a problem, and can share skills, role model, encourage help-seeking, or refer to a resource Let’s give (a) employees skills and destigmatize help-seeking, and (b) their group an opportunity for safe and open talk Do so while promoting benefits (wellness) and policy adherence And, as appropriate, reinforce efforts at social capital, engagement, and resilience This logic can be extended to any and all health and stress conditions
  • 6. Bennett, J.B., Lehman, W.E.K., Reynolds, G.S.,(2000) Team awareness for workplace substance abuse prevention: The empirical and conceptual development of a training program. Prevention Science, 1 (3), 157-172. INITIAL MODEL *Grounded Model informed by over a dozen studies at TCU Institute of Behavioral Research with Dr. Wayne Lehman
  • 7. Why are you here? How do you/employer care about each other? How can you respond vs. tolerate problems? What are best ways to address stress? How can you listen better, help more, get help? Bennett, J.B., Lehman, W.E.K., Reynolds, G.S.,(2000) Team awareness for workplace substance abuse prevention: The empirical and conceptual development of a training program. Prevention Science, 1 (3), 157-172.
  • 10. Why are you here? How do you/employer care about each other? How can you respond vs. tolerate problems? What are best ways to address stress? How can you listen better, help more, get help? [1] Bennett, J.B., Aden, C. A., Broome, K &. Mitchell, K., & Rigdon, D. (2010). Team Resilience for Young Restaurant Workers: Research- to-Practice Adaptation and Assessment. Journal of Occupational Health Psychology, 15(3):223-236. Team Awareness Small Business Policy Deficient Community Salient Owner Relevant Same modules 4 hour version Access to local resources in community 2002-2005 Team Resilience[1] Emerging Adulthood Transition to Work Restaurant Risks Community Confidence Commitment Centering Compassion 2007-2011 Team Readiness (mini-modules) Military Readiness Post (Deployment) Stress Joint Service Support Your Raw Coping Power Do The Right Thing! Tolerate or Respond? Paths in & Out of Stress Really Listening (Buddy Stress) 2008-2013 2012-2015 2014
  • 11. and adaptations (Team Resilience, Team Readiness, TeamUpNow) • effect sizes, Hedge’s g except for resilience. • resilience outcome is a t value, representing difference between mean of the sample and the mid-point value of the resilience scale. • for outcomes from multiple studies, weighted mean Hedge’s g and pooled standard errors (SE) were computed by weighting each study’s effect size g and SE by the study’s sample size. • effect sizes presented are absolute values and not representative of the direction of the effect of training on the outcome. META-ANALYSIS IN PROGRESS
  • 13. Improved Climate Improved Help & Care Help-Seeking EAP Utilization Encouraged Others Was Encouraged Responsiveness Outcome K Time Tx/Cont. Organizational Wellness1 1 6 Mo 351/187 Coworker Trust1-3 4 1 Mo 624/384 Hectic Work Pace1 1 6 m 351/187 Counterproduct ive Coworkers4 1 12 mo 235/230 Stigma1,5,6 3 1 & 6 Mo 654/412 Outcome K Time n Tx/ Control Willingness to Seek Help Attitudes7 1 1 Mo 567/338 Sought Help or Was Encouraged2,3 2 6 Mo 87/83 Encouraged others to use EAP2,3 2 6 Mo 87/83 Received Counseling7 1 6 Mo 557/335 Coworker Responsiveness6 2 1 & 6 Mo 191/202 Org. Wellness Coworker Trust Hectic Work Pace Counterproductivity Stigma -0.5 0 0.5 1.0 Effect Sizes -0.5 0 0.5 1.0 1.5 2 2.5 Effect Sizes Study references available upon request
  • 14. Coping & Resilience Reduced Alcohol Risk Outcome K Time N Tx/Contl Work Stress1 1 6 mo 351/187 Personal Stress4 1 12 mo 235/230 Healthy Unwinding after work8 1 1 mo 125/139 Stress Competent9 1 1 mo 158/158 Resilience10,11 2 1 mo 227/0 Outcome K Time n Tx/Contl Work Productivity Problems6,7,12 4 1-12 Mo. 836/606 Alcohol Frequency6,7 2 6 Mo. 624/415 Heavy Drinking1,12 2 6-12 Mo 789/469 Binge Drinking12,13,14 3 3-18 Mo 342/247 Coworker Drinking Climate1,6,13 3 1-6 Mo 559/378 Work Stress Personal Stress Healthy Unwinding Stress Competent Resilience Productivity Problems Alcohol Frequency Heavy Drinking Binge Drinking Drinking Climate -0.5 0 0.5 1.0 1.5 2.0 Effect Sizes -0.5 0 0.5 1.0 1.5 Effect Sizes Study references available upon request
  • 15. Willingness to seek help at posttest was associated with higher help seeking after training, and the effect of the prevention interventions on help seeking was completely mediated by employee attitudes to seek help. More support for direct route (training impacts drinking) than via the cascade path. CASCADE MODEL Reynolds, G. S., & Bennett, J. B. (2015). A cluster randomized trial of alcohol prevention in small businesses: A cascade model of help seeking and risk reduction. American journal of health promotion, 29(3), 182-191. SMALL BUSINESS WELLNESS INITIATIVE
  • 17. Original Models were culture of health models Research to Practice Pressure to Adapt Fidelity Innovation Complex multi- stakeholder environment with NO FUNDING
  • 18. CONSULTING ON DISSEMINATION 1. National Restaurant Chain 2. National Guard 3. NECA-IBEW (Electricians) 4. Youth Corp 5. Native American Tribes 6. Small Businesses 7. African-American Ex-Offenders 8. Island of Guam 9. South African Municipality 10. Non-Profits (Operating Via State Incentive Grants): Oregon, Indiana, Tennessee, Colorado, New Hampshire 11.“Resilience & Thriving” Facilitators (90) Fidelity Adaptation Intervention CapacityBuilding 10 1 2 3 4 5 6 7 8 9 11 Bennett, J.B., Cook, R., & Pelletier, K. (2010). An Integral Framework for Organizational Wellness: Core Technology, Practice Models, and Case Studies. In J. C. Quick, & Tetrick, L. E., (Eds.). Handbook of occupational health psychology. Washington, DC; American Psychological Association. Bennett, J.B. & Tetrick, L. (2013). The We in Wellness: Workplace Health Promotion as a Positive Force for Health in Society. In Olson-Buchanan, J. B., Bryan, L. L. K., & Thompson, L. F. (Eds.). Using Industrial Organizational Psychology for the Greater Good: Helping Those who Help Others. Routledge.
  • 19. CURRENT WORK, TRAINING & DERIVATIVES DERIVATIVES NIAAA Electronic Alcohol Screening and Intervention in Work Settings Grant Number R44 AA022570 Empowered Health Consciousness and Prevention of Prescription Misuse: The Wellness Alternative EAP Practice-Based Research Network White-Paper and New Webinar Series
  • 20. CURRENTLY • Continue to innovate • Continue to conduct training-of-trainers on ongoing basis • 2018 to date, 50 facilitators trained in the “Resilience to Thriving Module” (CEU collaboration with the National Wellness Institute) • Large client pilot training for volunteer peer-to-peer agents (NUDGE model)
  • 21. 60 48 48 40 68 36 24 16 20 28 Confident can enourage coworkers to get help Understand stigma and can talk in ways to help reduce Understand tolerance and options for responding Know resources for resilience and stress Know how my personal story ties into program values Pre Post Pre-post Ratings by Peer Volunteers (n = 24) Learning NUDGE training (Percent “Strongly Agree” – Note. All items have > 90% Agree/Strongly Agree at post)
  • 22. ONLINE TEAM RESILIENCE • Two samples (n=118 and n=181) received the Web-based training and provided immediate reactions in a posttest-only design. The second sample also included a control condition (n=201). • Findings support the model and program efficacy. • Workplace resilience greater in intervention than in the control group.
  • 23. SBIRT: ONLINE WELL-BEING WITH GAME CAPACITY • Significant opportunity with online wellness health risk assessments • Vast majority have alcohol items and virtually none of them use for screening & referral (no EAP links!!!) • SBIRT (Screening, Brief Intervention, and Referral to Treatment) model • Opportunity to position within a destigmatized, universal access point • Case finding tool, integrate with wellness, bring evidence-based practices to workplace wellness
  • 24. Recent Articles Let us know if you would like a copy http://organizationalwellness.com/contact/ Bennett, J. B., Lucas, G.M., Linde, B., & Neeper, M. A., Hudson, M., Gatchel, R. (in press) A Process Model of Health Consciousness: Its Application to the Prevention of Workplace Prescription Drug Misuse. Journal of Applied Biobehavioral Science. Lucas, G. M., Neeper, M., Linde, B., & Bennett, J. (2017). Efficacy of a brief health consciousness and prescription drug intervention in the workplace. Journal of Medical Internet Research, 19, 1-5. Bennett, J. B., Lucas, G.M., & Neeper, M. A. (2016). Preventing worker prescription drug misuse: Time for a new integrated approach. EASNA Research Notes, 6, 1-6. Neeper, M., Bennett, J., Galvin, D., & Lucas, G. M. (2016). Workplace prevention of prescription drug abuse: Pilot assessment of a new psycho-educational program. Addiction Research and Therapy, 7, 277-281
  • 25. Item Pre Post ±T(p) Health Consciousness Marker Item Staying conscious of my own health can protect me from misusing prescription drugs. 4.41(.66) 4.67(.61) 4.37*** Personal Knowledge of PD 1. I know the differences between proper use, misuse, and abuse of prescription drugs. 4.46(.79) 4.71(.74) 3.32*** 2. I know things that parents can do to prevent their teenagers from abuse of prescription drugs. 3.45(1.15) 4.39(.80) 9.62*** 3. I can identify healthy alternatives for dealing with pain or stress other than use of prescription drugs. 4.15(.78) 4.70(.59) 7.95** 4. I clearly understand the reasons for not sharing prescription drugs at work. 4.71(.56) 4.84(.47) 2.99** Protective Factors for PD misuse at Work 5. I am motivated to understand factors that could lead to misuse prescription drugs. 4.32(.85) 4.56(.75) 3.57*** 6. I have healthy life-style and coping factors that keep me from misusing such drugs. 4.37(.74) 4.61(.65) 3.57*** 7. I am confident that I have the skills I need to avoid misuse of prescription drugs. 4.53(.66) 4.68(.67) 2.73** 8. I can weigh the benefits and risks of using prescription drugs. 4.43(.75) 4.76(.52) 5.39*** 9. Overall, I am confident that I can do things to avoid misuse of prescription drugs. 4.62(.60) 4.83(.48) 3.93*** Bennett, J. B., Lucas, G.M., Linde, B., & Neeper, M. A., Hudson, M., Gatchel, R. (in press) A Process Model of Health Consciousness: Its Application to the Prevention of Workplace Prescription Drug Misuse. Journal of Applied Biobehavioral Science.
  • 26. Recognize behavior is risk or protective Take corrective action Use protective factors or health- enhancing resources Desire to stay conscious of current health levels Core Health Consciousness Processes 1 2 3 4 Salient Roles Parent Spouse Coworker Supervisor Child of aging parent Salient Motives Pain or anxiety Need to perform Lack of energy Need for sleep Awareness of Alternatives Mind-Body practice Physical therapy Diet/exercise Counseling Self-Help Health behaviors and outcomes Bennett, J. B., Lucas, G.M., Linde, B., & Neeper, M. A., Hudson, M., Gatchel, R. (in press) A Process Model of Health Consciousness: Its Application to the Prevention of Workplace Prescription Drug Misuse. Journal of Applied Biobehavioral Science.
  • 28. CONTACT INFORMATION Joel Bennett Organizational Wellness & Learning Systems 3200 Riverfront (Suite 102) Fort Worth, Texas, 76107 817.921.4260 owls@organizationalwellness.com