The Intersection of Substance Abuse and Worksite Wellness

1
The Intersection of Substance Abuse and Worksite
Wellness

• William McPeck, MSW, CHPD
• Director of Employee Health and Safety
• Maine State Government

2
The Need for S/A Prevention at Work

• Alcohol
• Rate of current alcohol use by full time employed
  adults age 18 or older was 63.2
• 2005 National Survey on Drug Use and Health
  National Findings
• http//oas.samhsa.gov

3
The Need for S/A Prevention at Work

• Alcohol
• Most binge and heavy alcohol users were employed
  in 2005 either full or part-time
• 80 of the binge drinkers were employed
• 80.8 of the heavy drinkers were employed
• Frone, Journal of Studies on Alcohol, 67(1), pp.
  147-156, 2006

4
The Need for S/A Prevention at Work

• Alcohol
• An estimated 1.83 workers drink before work
• An estimated 9.23 workers work with a hangover
• Frone, Journal of Studies on Alcohol, 67(1), pp.
  147-156, 2006

5
The Need for S/A Prevention at Work

• Alcohol
• About 15 of the US workforce uses or is impaired
  by alcohol on the job.
• University of Buffalo Research Institute on
  Addictions - 2006

6
The Need for S/A Prevention at Work

• Drugs
• Of the 17.2 million current illicit drug users
  aged 18 or older in 2005, 12.9 million or 74.8
  were employed either full or part-time
• 2005 National Survey on Drug Use and Health
  National Findings
• http//oas.samhsa.org

7
The Need for S/A Prevention at Work

• Drugs
• Drug users are absent 1.5 times as often and make
  twice as many workers compensation claims
• U.S. Center for Substance Abuse Prevention,
  National Clearinghouse for Alcohol and Drug
  Information (NCADI)

8
The Need for S/A Prevention at Work

• Drugs
• Employed drug abusers cost their employers about
  twice as much in medical and workers
  compensation claims as their drug free co-workers
• NIDA Info Facts www.nida.nih.gov

9
What Can Every Employer Do?

• At the very least, every employer can do at least
  two things
• Develop and implement a drug free workplace
  policy Creating a supportive environment step
  in worksite wellness model
• Implement awareness and education programs -
  Intervention step in worksite wellness model

10
Where Does Worksite S/A Prevention Belong?

• Safety Programs
• Wellness Programs

11
Where Does Worksite S/A Prevention Belong?

• Safety Programs
• According to OSHA, between 10 and 20 percent of
  the nations workers who die on the job test
  positive for alcohol or other drugs....
• Industries with the highest rate of drug use are
  the same as those at a high risk for occupational
  injuries such as construction, mining,
  manufacturing and wholesale
• www.osha.gov/SLTC/substanceabuse/index.html

12
Where Does Worksite S/A Prevention Belong?

• Wellness Programs
• Initial worksite efforts focused on testing and
  EAP services....
• Currently there is seen a great potential for
  incorporating SA prevention efforts into
  successful worksite wellness initiatives and
  strategies which target other health concerns
• Northeast CAPT News Update, September 2006

13
Where Does Worksite S/A Prevention Belong?

• The safety vs. wellness question may become moot
  as NIOSH is promoting an initiative, the NIOSH
  WorkLife Initiative, designed to integrate safety
  and worksite wellness
• http//www.cdc.gov/niosh/worklife/steps/default.ht
  ml

14
Worksite Wellness Models

• Wellness Councils of America, WELCOA
• Maine Worksite Wellness Council
• American Journal of Health Promotion
• Health Canada
• National Quality Institute - Canada

15
WELCOA Model aka 7 Cs

• Capturing Senior Level Support
• Creating Cohesive Wellness Teams
• Collecting Data to Drive Program Efforts
• Crafting An Operating Plan
• Choosing Appropriate Interventions
• Creating A Supportive Environment
• Consistently Evaluating Your Program

16
1. Capturing Senior Level Support

• A difficult but necessary task to accomplish
• Major change initiatives must be actively led by
  senior management Drucker
• Senior level executives call the shots, control
  the finances and approve the policies
• Secure a senior level champion
• Link the wellness program to organizational and
  HR strategies or risk being seen as extraneous to
  the really important organizational activities
• Show how the wellness program can benefit the
  whole organization Under promise and over
  deliver
• Dont forget first line supervisors and mid-level
  managers

17
2. Creating Cohesive Wellness Teams

• Assembling the Wellness Team
• Wellness Teams Add
• Wellness Teams Do

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2. Creating Cohesive Wellness Teams continued

• Assembling the Wellness Team
• Use a Labor/Management Approach
• Appointments vs. Volunteers
• Leadership of the Team
• Team Size
• Meeting Frequency

19
2. Creating Cohesive Wellness Teams continued

• Wellness Teams Add
• Credibility and Importance
• Group Think Team Approach
• Stability
• Lighten the Load

20
2. Creating Cohesive Wellness Teams continued

• Wellness Teams Do
• Develop, Guide and Oversee
• Establish Vision, Goals, Objectives
• Communicate up, down and around the organization

21
3. Collecting Data to Drive Program Efforts

• Conduct A Needs Assessment
• Analyze the Data
• Communicate the Data
• Establish Baseline Data for Future Comparisons

22
3. Collecting Data to Drive Program Efforts -
continued

• Conduct A Needs Assessment
• Health Data Confidentiality
• Claims data or community data
• Workers compensation data
• STD and LTD data
• Safety Data
• Inspection results and program audit data
• Health Risk Appraisals/Assessments
• Worksite Health Screening Data

23
3. Collecting Data to Drive Program Efforts -
continued

• Conduct A Needs Assessment
• Organizational and Cultural Audit
• Attendance Data
• Performance Data including Presenteeism
• Employee Interest Data

24
3. Collecting Data to Drive Program Efforts -
continued

• Analyze the Data
• Communicate the Data
• Establish Baseline Data Where Possible for Future
  Comparisons

25
4. Crafting An Operating Plan

• Failing to plan is planning to fail
• Forces you to consider the big picture
• Needs and Priorities
• Legitimizes and communicates the program to
  senior management
• Provides for continuity through personnel changes
• Forces you to set specific goals and objectives
• Accountability
• Provides a means to measure progress - success

26
4. Crafting An Operating Plan - continued

• Seven Elements of An Operating Plan
• 1. Vision Statement
• 2. Goals
• 3. Objectives
• SMART Objectives Specific, Measurable,
  Achievable, Realistic and Time Specific

27
4. Crafting An Operating Plan - continued

• 4. Implementation and Timeline
• Implementation procedures
• Timeline
• Individual responsibility
• Methods of accountability
• 5. Marketing and Communication Plan
• 6. Budget
• 7. Evaluation Plan

28
5. Choosing Appropriate Interventions

• Programs should be results orientated and not
  activity centered
• Intervention Approaches
• Awareness Solutions
• Educational Solutions
• Behavioral Change Solutions
• Medical Solutions
• Prevention
• Disease Management
• Cultural Solutions

29
5. Choosing Appropriate Interventions - continued

• Targeting Risk Factors
• Keeping the low risk persons low risk
• Targeting Cost Factors
• 80 20 Rule
• Self Care
• Linkage between disease management and wellness

30
5. Choosing Appropriate Interventions - continued

• Targeting Senior Management Goals and
  Expectations
• Targeting Employee Wants
• Time and Money Issues
• Resources
• Good Work!
• Low Cost No Cost Resources

31
5. Choosing Appropriate Interventions - continued

• Match delivery methods to topic and audience
• Consider multiple delivery methods
• Consider Using Competition
• Consider Using Incentives
• Dont forget recognition

32
5. Choosing Appropriate Interventions - continued

• Worksite wellness programming must grow and
  change with the organization and culture

33
6. Creating A Supportive Environment

• Seeking to create an environment that supports
  healthy lifestyles
• Policies
• Environment
• Culture

34
6. Creating A Supportive Environment - continued

• Policies
• Use of proactive policies to influence behavior
• Vending machines
• Office parties/events
• Flex time

35
6. Creating A Supportive Environment - continued

• Environment
• The physical look and feel
• Use of existing assets stairwells
• CDC Stairwell Program see Web Resources Sheet
• Walking paths or trails
• Both indoor and outdoor
• Facilitate Partnering
• The Buddy System

36
6. Creating A Supportive Environment - continued

• Culture
• It is now more important than ever to define and
  measure corporate cultures for the sake of
  developing compatible business strategies.
• Reynolds and Murphy. The Power of Measuring
  Culture. Tom Peters Group, October, 2006

37
6. Creating A Supportive Environment - continued

• Culture
• Culture is the underlying norms, values and
  belief systems of the worksite
• Culture dictates how people will respond at the
  worksite
• Aligning interventions with the culture is
  imperative

38
6. Creating A Supportive Environment - continued

• If strategy and culture are not aligned, the
  culture encourages behaviors that conflict with
  what you are trying to achieve, blocking
  execution of or minimizing your strategy.
• Reynolds and Murphy. The Power of Measuring
  Culture. Tom Peters Group, October, 2006

39
6. Creating A Supportive Environment - continued

• The most important asset in every company is
  the spirit de corps the motivation and passion
  of each employee.
• Reynolds and Murphy. The Power of Measuring
  Culture. Tom Peters Group, October , 2006
• You need to identify what they are passionate
  about and what motivates them

40
6. Creating A Supportive Environment - continued

• Corporate cultures that focus on health are more
  likely to see a reduction in job turnover and
  workplace stress, and an increase in productivity
  and business results. Kenneth Mitchell,
  UnumProvident
• Kawczynski, Kelly. Obesity and the Rise of
  Health-Care Costs. WorldatJournal, Fourth
  Quarter 2006, Volume 15, Number 2,
  November-December 2006, pp. 68 76.

41
6. Creating A Supportive Environment - continued

• Celebrate Success
• Consistent rewards and recognition
• Attention
• Praise
• Rewards

42
7. Consistently Evaluating Your Program

• Evaluation determines the value of what you have
  done
• Benefits of Evaluation
• To determine if your intervention has worked
• Demonstrate the cost benefit of the intervention

43
7. Consistently Evaluating Your Program -
continued

• Benefits of Evaluation continued
• Determine ROI
• Compare different types of interventions
• Compare yourself with industry standards or
  another organizations results
• Provide valuable information about your program

44
7. Consistently Evaluating Your Program -
continued

• Four Standards in Evaluation
• Useful
• Feasible
• Proper
• Accurate
• CDC

45
7. Consistently Evaluating Your Program -
continued

• Evaluation Uses
• In addition to program self-evaluation,
  evaluation may be needed in other situations,
  such as
• Prioritizing activities and guiding resource
  allocation
• Informing funders about program effectiveness
• Informing community members and stakeholders
  about a projects value
• Providing information that can be useful in the
  design or improvement of similar projects
• CDC

46
7. Consistently Evaluating Your Program -
continued

• The Scope of Evaluations
• Different programs and situations require
  different evaluation strategies
• Program Development Stage
• Focus on the extent and severity of the issues to
  be addressed and designing effective
  interventions to address them
• On-going Program Stage
• Examination of program methods to improve
  effectiveness or decrease operational costs

47
7. Consistently Evaluating Your Program -
continued

• The Scope of Evaluations continued
• Program Expansion or Curtailment Stage
• Cost Benefit studies
• Cost Effectiveness studies
• Cost Benefit/Effectiveness study of alternative
  strategies
• CDC

48
7. Consistently Evaluating Your Program -
continued

• Types of Evaluations
• Process Based Evaluations
• Understanding how a program works
• Program outputs
• Outcomes Based Evaluations
• Is your program meeting its goals?
• What impact is your program having?
• Is the program doing the right activities to
  reach the outcomes that are believed to be
  needed?

49
7. Consistently Evaluating Your Program -
continued

• Continuous improvement is crucial for the
  survival of worksite wellness programs
• Evaluation strategies provide the mechanism to
  accomplish this

50
So Where Does Worksite S/A Prevention Best Fit in
the Worksite Wellness Model?

• Drug Free Workplace Policy
• Creating a Supportive Environment Element 6
• Training and Education
• Choosing Appropriate Interventions Element 5
• Awareness
• Education

51
Worksite Wellness Resources

• Low cost - No Cost Resources
• See Handouts
• Good Work! Kit

52
Good Work! Kit

• Binder Version
• Section 1 Worksite Wellness Framework
• Section 2 Success Stories and Resources
• Section 3 Appendices and Tools

53
Good Work! Kit - continued

• Additional On-line Materials
• Additional Success Stories
• A new section on Disease Prevention and
  Management
• A new section on Drug Free Workplaces
• Company profiles
• http//www.healthymainepartnerships.org/mcvhp/reso
  urce_good_work_manual.aspx

54
Worksite S/A Prevention Resources

• DOL Drug Free Workplace Program
• SAMHSA Model Programs

55
Worksite S/A Prevention Resources - continued

• DOL Drug Free Workplace Program
• Free Training/Education Materials
• Brochures
• Articles and Fact Sheets
• Supervisor Training
• Instructor Presentation PowerPoint
• Handouts
• Employee Education
• Instructor Presentation PowerPoint
• Handouts

56
Worksite S/A Prevention Resources - continued

• SAMHSAs Model, Effective, and Promising Programs
  Designed for Workplace Settings

57
Worksite S/A Prevention Resources - continued

• Model, Effective, and Promising Programs are
  defined as follows
• SAMHSA Model Programs are Effective Programs
  whose developers have the capacity and have
  coordinated and agreed with SAMHSA to provide
  quality materials, training, and technical
  assistance to practitioners who wish to adopt
  their programs.
• Effective Programs are prevention programs that
  produce a consistent positive pattern of results.
  
• Promising Programs provide useful, scientifically
  defensible information about what works in
  prevention but do not yet have sufficient
  scientific support to meet standards set for
  Effective/Model programs.

58
Worksite S/A Prevention Resources - continued

• SAMHSA Model Programs
• Coping with Work and Family Stress David
  L. Snow, Ph.D.
• Healthy Workplace Royer Cook, Ph.D.
• Team Awareness Joel Bennett, Ph.D.

59
Coping With Work and Family Stress

• Uses 16, 90 minute weekly group sessions of 15
  20 employees
• Techniques include lecture, group discussion,
  problem solving and use of personal experiences
• Teaches employees coping strategies to deal with
  stressors at work and home
• 2.5 4.5 hours per week of trainer prep time

60
Healthy Workplace

• Substance abuse prevention interventions cast in
  a health promotion framework
• Designed to defuse the SA stigma, to hopefully
  remove barriers to help seeking behavior
• Five interventions delivered in small group
  format of 10 20 employees

61
Healthy Workplace continued

• Five Interventions are
• Say Yes! Three 1 hour sessions
• Working People Four 30 minute sessions
• Make the Connection Three 45 minute sessions
• Power Tools Eight 45 minute sessions
• Prime Life 2000 -

62
Team Awareness

• Delivered in two, 4 hour sessions
• Uses a mixture of lecture, experiential and group
  related activities
• Content customizable regarding policies and EAP
• Six Modules
• Risk Identification
• Policies
• Reducing Stigma and Increasing Responsiveness
• Stress and Substance Use
• Improving Workplace Communication
• Encouragement and the NUDGE Model

63
Worksite S/A Prevention Resources - continued

• SAMHSA Effective Programs
• Wellness Outreach Program A Step-by-Step Guide
  Max Heirich, Ph.D.

64
Wellness Outreach At Work

• Comprehensive health risk reduction strategies
  including S/A within a health promotion framework
• Annual cost of 200 per employee

65
Worksite S/A Prevention Resources - continued

• SAMHSA Promising Program
• Parenting Partnership Robert
  Feiner, Ph.D.

66
Parenting Partnership

• Collaborative initiative between worksites and
  human service providers focusing on parenting
  skills, knowledge and attitudes while
  facilitating the creation of support networks at
  the worksite
• Enhances family based protective factors

67
Worksite S/A Prevention Resources - continued

• SAMHSA Upcoming Workplace Programs
• Effective
• Rockford Enhanced EAP Jeremy Bray, Ph.D.

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Rockford Enhanced EAP

• Designed to deliver comprehensive EAP outreach
  services to all employees with an enhanced focus
  on women and minorities
• Supervisory training materials enhanced to
  increase awareness of discriminatory practices
  and attitudes.

69
Worksite S/A Prevention Resources - continued

• Other SAMHSA Evaluated Worksite Programs
• GetFit.SAMSHA.gov
• Peer Care Ted Miller, Ph.D.

70
GetFit.SAMHSA.gov

• http//www.GetFit.Samhsa.gov/
• Free research based Web site
• Provides information on physical health, mental
  health, drugs and alcohol
• Provides substance abuse prevention within a
  health, wellness and safety strategy

71
Peer Care

• Developed for a union management environment
• Uses peer groups to stop the acceptance and
  support of working under the influence
• Peer volunteers educate, intervene and refer
  co-workers to services without fear of
  disciplinary action

72
For Further Information and Consultation

• William McPeck, MSW, CHPD
• Director, Employee Health and Safety
• Maine State Government
• 114 State House Station
• Augusta, ME 04333
• 207-287-6783
• william.c.mcpeck_at_maine.gov