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

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

16. INTEGRAL
PREVENTION

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.

27. https://youtu.be/M3W5E44V9Zc

28. CONTACT INFORMATION
Joel Bennett
Organizational Wellness & Learning Systems
3200 Riverfront (Suite 102)
Fort Worth, Texas, 76107
817.921.4260
owls@organizationalwellness.com