Workplace SBI Product Development Work Group

1
Workplace SBI Product Development Work Group

• Funded through a Cooperative Agreement with the
  National Highway Traffic Safety Administration
  (NHTSA).

2
Agenda

• Briefly Review Workplace SBI Project
• Review Results of Promotion/Outreach and
  Screening Delphi
• What are the most highly rated SBI components?
• Was there consensus?
• Enlist Volunteers to Share SBI Materials and
  Resources
• Discuss Brief Intervention Approaches
• Enlist Volunteers to Review SBI Materials
• Schedule Next Call

3
Work Plan

• Delphi Assessments and Conference Calls
• Delphi Process
• Send out Delphi on specific SBI components
• Summarize feedback
• Report back to the group prior to next conference
  call
• Conference Calls
• Discuss results of previous Delphi
• Discussion of other components of the SBI model
• Tentative Schedule for Discussion of SBI
  Components (2-3 more calls)
• April/May Discussing Promotion/Outreach
  Screening and Brief Intervention/Referral/Follow-u
  p, Workplace Policy
• June/July Discussing Training/Credentialing/Compe
  tency Process Evaluation (Quality Monitoring,
  Fidelity)
• August Discuss Organizational Factors and
  Outcome Evaluation

4
Brief Project Review

• Held workplace SBI Product Development Workgroup
  kick-off meeting, January 2007.
• Detailed discussion on the Components of the
  Workplace SBI Conceptual Model developed in Year
  1
• Summarized feedback from kick-off.
• Revised the SBI conceptual model.
• Disseminated meeting summary and revised model.
• Collecting materials for the implementation and
  training guidance.
• Developed SBI project web site.
• www.ensuringsolutions.org/solutions/solutions_show
  .htm?doc_id450551
• Conducted Delphi on Promotion/Outreach
  Screening

5
Promotion/Outreach Screening Delphi Results

• Rating of Components (avg ratings)
• Rated Most Essential
• Health education about alcohol misuse and related
  issues (e.g., stress, impaired driving)
• Assessment of suspected alcohol use with signs
  symptoms recognition approach
• Inclusion of alcohol as part of addressing issues
  such as depression, anxiety, or stress
• Alcohol/drug testing of specific employee groups
  (e.g., DOT regulated, safety sensitive)
• EAP/MBHO service promotion/marketing to
  supervisors
• EAP/MBHO service promotion/marketing to employees
• 14 of 15 Rated Important to Essential
• Rated Least Essential
• Alcohol/drug testing for all employees

6
Results of Delphi (cont.)

• Some Recommended Changes/Added Items
• Alcohol screening and education for employees and
  their families
• HRA with embedded scientific alcohol screening
  tool
• Use of web-based health education
• Alcohol information should be routine part of
  health education programs to enable regular
  exposure to messages
• Overall health education programming should
  include all of these things- alcohol, drug,
  mental health and medical screenings
• Use of social marketing tools showing drinking
  norms through posters, emails, websites, mailings
  - outreach to employees and their families
• Other recommended items to be considered in
  future Delphi assessments were related to
  training, brief intervention, referral, policy

7
Results of Delphi (cont.)

• Ranking of Components
• Some consensus on which were among the 5 most
  important (also rated as most essential)
• Health education about alcohol misuse and related
  issues (e.g., stress, impaired driving)
• EAP/MBHO service promotion/marketing to
  supervisors
• EAP/MBHO service promotion/marketing to
  employees
• Inclusion of alcohol screening as part of
  addressing issues, such as depression, anxiety,
  and stress
• Routine alcohol screening by EAP/MBHO provider
• Less consensus on the order of importance
• Some consensus on which were not among 5 most
  important
• Alcohol/drug testing for all employees
• Indirect alcohol screening as part of life
  coaching

8
Results of Delphi (cont.)

• Key Messages
• Alcohol education, outreach, and screening should
  be part of addressing other mental health,
  medical, and life issues of the employee and
  their family.
• Alcohol education should convey the relationship
  between alcohol use and other health issues
• Alcohol misuse can affect health
• Dealing with health and life issues may result in
  alcohol misuse
• Supervisors play a key role in identifying
  workers through signs and symptoms recognition
• Service promotion/marketing to both employees and
  supervisors is important

9

• Wanted Materials for Posting to the Website
• Materials may include, brochures, newsletters,
  email communications, paycheck stuffers, posters,
  flyers, videos, websites, web-based health
  promotion programs, etc. Screening tools could be
  self-report, interviews, web-based, telephonic,
  etc. Materials and tools in different languages
  would be interesting.
• Health Education about alcohol misuse and related
  mental health, substance use, medical and life
  issues
• Service promotion/outreach to employees and their
  families
• Service promotion/outreach to employers
  (supervisors, HR, HP/wellness professionals,
  occupational health/safety staff)
• Supervisor assessment of suspected alcohol use
  with signs symptoms recognition
• Workplace policies (alcohol use policies, Drug
  Free Workplace Policies, etc.)- less punitive,
  less criminalizing, more proactive, prevention
  and treatment-oriented
• Alcohol screening tools
• Alcohol screening as part of screening for mental
  health, substance use, medical/health and life
  issues
• Depression, anxiety, drug use, stress, family
  problems or other health conditions such as
  diabetes

10
Brief Intervention Approaches for Workplace
Settings

• What techniques have you found useful/effective
  for addressing alcohol use and other health
  issues (e.g., MI/MET)?
• Are different techniques more useful/effective
  with certain issues or target groups?
• What are the best methods to deliver BI
  (face-to-face, telephonic, web, email)?
• What are the advantages/disadvantages of one
  method over the other?
• Is engagement or completion of BI more likely
  with certain methods?
• Any lessons learned? Challenges in implementing
  BI?
• Other important considerations issues we should
  consider around implementing BI in workplace
  settings?

11
Next Steps

• Conduct Delphi on Brief Intervention (May)
• Volunteers help develop BI statements for Delphi?
• Need Volunteers to Participate in Review of
  Materials for SBI Components (e.g., health
  education, screening, BI, training, evaluation)
• Send out sign up sheet.
• Schedule Next Call (late May- early June)
• Will send out RSVP for date/time (TBD).
• Discuss results of Delphi on Brief Intervention.
• Discuss SBI Training.

12
Workplace SBI Model
Outcomes
Activities
Initiating Events
Long
Short
Medium

• Outreach
• Service Promotion (EAP, MBHO, OHW, HP/W, DM)
• Health Education

Alcohol Drug Testing (Mandatory Referral)
Increased Utilization
Increased Identification

• Increased Prevention/ Early Intervention
• Changed Organizational Culture
• Improved Employee Clinical/Health Outcomes
• Improved Business Outcomes (productivity metrics,
  economic outcomes)

• EAP/MBHO Process
• Routine Screening
• Brief Intervention/ multi-session MI
• Treatment Referral
• Follow-up

Job Performance Evaluation/ Signs Symptoms
Recognition (Mandatory Recommended Referral)
Increased Screening
Increased Initiation in Brief Intervention

• Life Coaching Process
• Non-directive coaching, screening integrated in
  sessions (not routine)
• Treatment Referral
• Follow-up

Increased Engagement in Brief Intervention
Health Promotion/Wellness (HRA, automated
screening, screening days, health fairs,
biometric screening, health promotion
programs) (Recommended Referral)

• OHW Process
• Annual exam screening
• Brief Intervention/one MI session
• Referral to EAP/Treatment/DM
• Follow-up

Decreased Treatment Referral for Alcohol Misuse
Disease Management (case management, disease
management programs) (Recommended Referral)

• Staff Training
• EAP/MBHO Staff
• OHW Staff
• HP/W Staff
• DM Staff
• Supervisors
• (CEUs/Certifications)

• Disease Mgt Process
• Routine Screening
• Brief Intervention/multi-session MI
• Treatment Referral
• Follow-up

Increased Treatment Referral for Alcohol Use
Disorders (abuse or dependence)
Critical Variables Processes
Infrastructure (adaptation/adoption/integration
of data collection software, systems, telephonic
and web capabilities data warehousing, 3rd party
vendor capabilities)
Quality Fidelity (adaptation/adoption/integrati
on of mechanisms for monitoring and providing
feedback, continuous improvement process
employer demand for quality in vendor staffing
and service delivery)
Organizational Factors (mission, leadership buy
in and support, policies, culture, climate,
trust, champions, contracts, data sharing
agreement, employer performance expectations)