The Role of Wellness Climate in Small Business Health Promotion and Employee Wellbeing.

Wellness involves physical, emotional, behavioral, social, and spiritual dimensions. A climate for wellness exists at both the psychological and organizational levels, consisting of individual and shared perceptions of policies, structures, and managerial behavior that support or promote employee wellbeing. This study explored the associations between psychological and organizational wellness climate and the effectiveness of a team health promotion training on employees' perceived physical and mental wellbeing and substance use. Employees from 45 small businesses completed self-report measures of wellness climate, wellbeing, positive unwinding behavior, work-family conflict, job stress, drug use, and alcohol use, assessed before, and one and six months after, attending either of two types of onsite health promotion training. Team Awareness training targeted improvements in the social climate at work. Healthy Choices training targeted individual health behavior. A control group did not receive training until after the study. Businesses were randomly assigned to conditions and data were analyzed using multi-level modeling. Models that included wellness climate as a mediator fit the data significantly better than models without climate as a mediator. Team Awareness participants showed greater improvements in wellness climate and wellbeing compared to the control group. Healthy Choices participants showed no changes in climate and no mediation effects of climate. Health promotion efforts may be enhanced by including wellness climate as a target in program design at multiple levels.

A Brief Measure of Organizational Wellness Climate: Initial Validation and Focus on Small Businesses and Substance Misuse.

OBJECTIVE: Organizations with fewer than 100 employees comprise most businesses in the United States. Since small businesses lack comparable resources, they may benefit from a simple valid tool for broadly assessing positive wellness climate, especially because climate contributes to employee wellbeing. METHODS: Using an ethnically and occupationally diverse sample of 45 businesses (n = 1512), the current study developed and tested a brief self-report measure of organizational wellness climate. RESULTS: Confirmatory factor analysis shows that a 9-item measure has good model fit (RMSEA = 0.06, CFI = 0.91), inter-item consistency of 0.74, and mean Rwg(j) of 0.87. The new measure is significantly positively correlated with physical health and wellbeing, and negatively correlated with substance use behavior. CONCLUSIONS: Findings indicate that a 9-item measure has good reliability, construct, and criterion validity. Implications for practical use of the measure are discussed.

A cluster randomized trial of alcohol prevention in small businesses: a cascade model of help seeking and risk reduction.

PURPOSE: The current study adapted two workplace substance abuse prevention programs and tested a conceptual model of workplace training effects on help seeking and alcohol consumption. DESIGN: Questionnaires were collected 1 month before, 1 month after, and 6 months within a cluster randomized field experiment. SETTING: Texas small businesses in construction, transportation, and service industries. SUBJECTS: A total of 1510 employees from 45 businesses were randomly assigned to receive no training or one of the interventions. INTERVENTION: The interventions were 4-hour on-the-job classroom trainings that encouraged healthy lifestyles and seeking professional help (e.g., from the Employee Assistance Program [EAP]). The Team Awareness Program focused on peer referral and team building. The Choices in Health Promotion Program delivered various health topics based on a needs assessment. MEASURES: Questionnaires measured help-seeking attitudes and behavior, frequency of drinking alcohol, and job-related incidents. ANALYSIS: Mixed-model repeated-measures analyses of covariance were computed. RESULTS: Relative to the control group, training was associated with significantly greater reductions in drinking frequency, willingness to seek help, and seeking help from the EAP. After including help-seeking attitudes as a covariate, the correlation between training and help seeking becomes nonsignificant. Help-seeking behavior was not correlated with drinking frequency. CONCLUSION: Training improved help-seeking attitudes and behaviors and decreased alcohol risks. The reductions in drinking alcohol were directly correlated with training and independent from help seeking.

Psychosocial correlates of the perceived stigma of problem drinking in the workplace.

The purpose of this study was to evaluate a questionnaire assessment of the perceived stigma of problem drinking that was designed for use in workplace substance abuse prevention research. Municipal employees from a mid-sized city (n = 315) and a large-sized city (n = 535) completed questionnaire measures of perceived coworker stigmatization of problem drinking, drinking levels, substance-use policy attitudes, workgroup stress and interdependence, alcohol-tolerance norms, and demographic variables. Inter-item correlation coefficients showed that the measure of the stigma of problem drinking had good internal consistency reliability (.76) in both samples. Hierarchical regression analyses showed that higher education, abstinence from alcohol, stress, and perceived temperance norms were all uniquely correlated with perceived stigma. Women and men perceived the same level of stigma from coworkers. Editors' Strategic Implications: This brief, validated measure provides organizations with a way to assess the level of stigma attached to alcohol abuse in their workplace culture, thereby enabling the organization to target and promote effective strategies to decrease the stigma attached to seeking help with the goal of reducing alcohol abuse.

Team awareness, problem drinking, and drinking climate: workplace social health promotion in a policy context.

PURPOSE: (1) To determine the effectiveness of classroom health promotion/prevention training designed to improve work climate and alcohol outcomes; (2) to assess whether such training contributes to improvements in problem drinking beyond standard workplace alcohol policies. DESIGN: A cross-sectional survey assessed employee problem drinking across three time periods. This was followed by a prevention intervention study; work groups were randomly assigned to an 8-hour training course in workplace social health promotion (Team Awareness), a 4-hour informational training course, or a control group. Surveys were administered 2 to 4 weeks before and after training and 6 months after posttest. SETTING AND SUBJECTS: Employees were surveyed from work departments in a large municipality of 3000 workers at three points in time (year, sample, and response rates are shown): (1) 1992, n = 1081, 95%; (2) 1995, n = 856, 97%; and (3) 1999, n = 587, 73%. Employees in the 1999 survey were recruited from safety-sensitive departments and were randomly assigned to receive the psychosocial (n = 201), informational (n = 192), or control (n = 194) condition. INTERVENTION: The psychosocial program (Team Awareness) provided skills training in peer referral, team building, and stress management. Informational training used a didactic review of policy, employee assistance, and drug testing. MEASURES: Self-reports measured alcohol use (frequency, drunkenness, hangovers, and problems) and work drinking climate (enabling, responsiveness, drinking norms, stigma, and drink with co-workers). RESULTS: Employees receiving Team Awareness reduced problem drinking from 20% to 11% and working with or missing work because of a hangover from 16% to 6%. Information-trained workers also reduced problem drinking from 18% to 10%. These rates of change contrast with changes in problem drinking seen from 1992 (24%) to 1999 (17%). Team Awareness improvements differed significantly from control subjects, which showed no change at 13%. Employees receiving Team Awareness also showed significant improvements in drinking climate. For example, scores on the measure of coworker enabling decreased from pretest (mean = 2.19) to posttest (mean = 2.05) and follow up (mean = 1.94). Posttest measures of drinking climate also predicted alcohol outcomes at 6 months. CONCLUSION: Employers should consider the use of prevention programming as an enhancement to standard drug-free workplace efforts. Team Awareness training targets work group social health, aligns with employee assistance efforts, and contributes to reductions in problem drinking.

Levels of substance use and willingness to use the Employee Assistance Program.

Individuals with drinking and drug problems may become particularly reluctant to seek help. To remove barriers to services, more needs to be understood about factors that influence help-seeking decisions. It was hypothesized that certain social psychological influences (attitudes, group cohesion, trust in management) might buffer a reluctance to use services provided by an external Employee Assistance Program (EAP). A random sampling of municipal employees (n = 793) completed anonymous questionnaires that assessed willingness to use the EAP, individual drinking and drug use, attitudes toward policy, work group cohesion, and trust in management. Data from the questionnaires were analyzed with multivariate regression analyses to examine the interacting effects of substance abuse and proposed moderators (gender, race, awareness of the EAP, perceptions of policy, cohesion) on willingness to use the EAP. The results demonstrated that although substance abusers were less willing to use the EAP than were nonusers, substance abusers who were aware of the EAP, who had favorable attitudes toward policy, and who did not tolerate coworker substance abuse were as willing to use the EAP as were nonusers. The results also showed that employees with greater awareness of the EAP, support for policy, and perceptions of work group cohesion reported significantly greater willingness to use the EAP than did employees with relatively less awareness of the EAP, policy support, and cohesion. Workplace prevention efforts that are designed to increase the use of EAP services should intentionally target the workplace environment and social context. Creating the awareness and favorability of the EAP, policy, and work group cohesion might buffer substance abusers' reluctance to seek help.