2121 k street, nw, suite 210 washington, dc 20006 center for integrated behavioral health policy...

2121 K Street, NW, Suite 210Washington, DC 20006

Center for Integrated Behavioral Health Policy

Department of Health Policy, George Washington University Medical Center

Implementing Alcohol Screening and Brief

Intervention in Your EAP

Chesapeake EAPAJanuary 6, 2011

Eric Goplerud PhDTracy L. McPherson, PhD

Presenters Eric Goplerud, PhD

Research Professor and DirectorCenter for Integrated Behavioral Health PolicyEnsuring Solutions to Alcohol ProblemsDepartment of Health PolicyGeorge Washington University Medical CenterWashington, [email protected]

Tracy L. McPherson, PhDAssistant Research Professor

Center for Integrated Behavioral Health PolicyEnsuring Solutions to Alcohol ProblemsDepartment of Health PolicyGeorge Washington University Medical CenterWashington, [email protected]

Learn about and receive a copy of the World Health Organization’s AUDIT-C/AUDIT – a brief, validated alcohol screening tools that can be integrated into routine EAP practice to identify risky alcohol use.

Learn to relate appropriate levels of brief intervention to level of alcohol use risk.

Today’s Objectives:

Learn to use SBIRT protocols informed by Motivational Interviewing (MI) to assist clients in behavioral change.

Learn about NIAAA’s alcohol education and self-management resources (e.g., “Rethinking Drinking”) for clients.

Today’s Objectives:

Learn about the “BIG” Initiative EAP learning collaborative and how you can benefit

Learn about (and take-away) “BIG” materials and resources to help you integrate alcohol SBIRT in your EAP practice.

Learn about research findings and implementation tips from EAP pilot tests.

Bonus Elements:

Agenda

Background and Rationale Workplace SBIRT Project The BIG Initiative

What is SBIRT?Alcohol Screening ToolsComponents of Brief InterventionMotivational Interviewing StrategiesSBIRT Protocols Using AUDIT (with/without MI)

Bonus Elements

Implementation Tips from PilotsEAP Pilot Test FindingsMore “BIG” ResourcesDemonstrating Impact and Value

Easy-to-Use Outcome Measures

Seed Funding: NHTSA CSAT SAMHSA NETS Alkermes

Corporate Sponsors

Pilot Sites: Aetna OptumHealth ValueOptions

Trainer: Denise Ernst PhD, Training and

Consultation http://www.deniseernst.com

Workplace Alcohol SBI Project Partners: The BIG Initiative

Overall Aim:

Adapt alcohol SBIRT approaches developed in medical settings for work-related settings:

EAP Occupational health & safety Health promotion and wellness Disease management

NHTSA/CSAT Workplace SBI Project (2006-2010)

Conducted extensive literature review, surveys, interviews, convened advisory panel.

Developed a conceptual model (a feasible approach) of workplace SBI.

cont…

A Feasible EAP Approach(telephonic or face-to-face)

Developed protocols that could be seamlessly integrated into existing EAP practice.

Conducted “proof of concept” studies to pilot test approaches and protocols in EAPs.

Launched “BIG Initiative” to facilitate EAP adoption of alcohol SBIRT through dissemination of materials and pilot test findings, and training.

cont…

EAP industry-wide initiative kicked-off in Dallas at EAPA to adopt alcohol SBIRT as routine practice by 2011.

Learning collaborative facilitated by GW which brings together 80+ organizations in the SBIRT “supply chain”.

What is “BIG”?

EAPs/MBHOs

Employers

Professional Associations

Clinicians

SBIRT/MI Experts

Researchers and Consultants

Pharmaceutical Companies

Federal Agencies

“BIG” Members

National Highway Traffic Safety AdministrationSubstance Abuse and Mental Health Services AdministrationNetwork of Employers for Traffic SafetyAetna Behavioral Health/EAPOptumHealth/UBHValueOptionsOffice of Drug and Alcohol Policy and Compliance, Department

of Labor Office of Demand Reduction, Office of National Drug Control

Policy, Executive Office of the PresidentU.S. Nuclear Regulatory CommissionDepartment of DefenseMaine State Government Federal Occupational Health (FOH)University of Maryland School of Social Work Chestnut Behavioral HealthFirst Sun EAPSELECT, IncCIGNAMagellanAnthem/WellPointMasi ConsultingBurke Consulting

Caterpillar Northrup Grumman Johns Hopkins University and Hospital JP Morgan ChaseHawaii Business Health CouncilNational Business Group on HealthUPSAmtrakContinental Airlines RAND CorporationBaltimore Gas & ElectricHalliburton 3MEAPAEASNACenter for Clinical Social WorkNAADACAssociation of Flight AttendantsAONSt John’s MercyFirst AdvantageThe Rainier GroupReckitt-Benckiser

Brief Intervention Group (“BIG”)

Four Committees

Board of Directors – thought leaders, industry decision-makers provide direction of BIG strategy

Clinical – change EAP provider and network affiliate practice

Systems and Operations – change call center and internal EAP practice

Quality Improvement – identify common metrics (program performance, client outcomes)

What does “BIG” do?

www.EAPBIG.org

FREE SBIRT Training Materials and Resources

Connect with BIG members on LinkedIn

Earn CE/PDHs by participating in BIG events

EAPA chapter meetings; regional and national conference events

EASNA annual meeting

How can you benefit from “BIG”?

Heavy drinking (5+ drinks on one occasion) increases risk of depression, sleep problems, hypertension, and cancer

3 in 10 adults drink at levels that increase risk of physical, mental health, and social problems (NIAAA)

So…Why Should EAP Providers Care About Alcohol SBIRT and

BIG?

Alcohol Problems Nearly as Prevalent as Diabetes

Alcohol Abuse & Dependence

Diabetes

17.6 million1

18.2 million2

A

References:

1. Grant BF, et al. Alcohol Res. and Health. 2006; 29:77.

2. National Center for Chronic Disease and Prevention and Health Promotion. National Diabetes Fact Sheet. http://www.cdc.gov/diabetes/pubs/estimates.htm. Accessed June 25, 2008.

How Many Get identified?

~ 8% of U.S. adults has a diagnosable alcohol use disorder (NSDUH, 2005)

92%

8%

How Many Get Identified?

Health plans identify <1% of members (NCQA, 2007)

Office of Applied Studies. (2004). Results from the 2003 National Survey on Drug Use and Health: National findings. Rockville, MD: Substance Abuse and Mental Health Services Administration.

Alcohol problems have a profound impact on the workplace, its employees and their families:

80% of problem drinkers are employed

60% of alcohol-related absenteeism, tardiness, and poor work quality are caused by at-risk drinkers

20% of employees have covered for a coworker, required to work harder, or injured due to coworkers drinking

more reasons…

Economic Costs of Alcohol Problems

Greater than High Blood Pressure, Asthma and Diabetes…

…Combined$185 billion1,2

$40 billion2

$11 billion2

$98.1 billion2

Alcohol Abuse & Dependence

High Blood Pressure

Asthma

Diabetes

References:1. National Institute on Alcohol Abuse and Alcoholism. Updating Estimates of the Economic Costs of Alcohol Abuse in the United

States: Estimates, Update Methods, and Data. http://pubs.niaaa.nih.gov/publications/economic-2000. Accessed June 25, 2008.2. The George Washington University Medical Center. Ensuring Solutions to Alcohol Problems. Primer 1: Treating Alcoholism as a

Chronic Disease. http://www.ensuringsolutions.org/usr_doc/PDF_Version_of_Primer.pdf. Accessed June 18, 2008.

EAPs play a vital role to employers and workers

Millions of workers rely on EAP for confidential help for mental health, substance use, work stress and family issues.

Employers see EAP as a crucial resource.

EAPs are uniquely positioned to “case find” (alcohol misuse is not a common presenting problem).

more reasons…

Brief, evidence-based approaches exist for EAP providers to enhance existing practice and increase value of services.

“BIG” provides EAP providers with materials and resources to do SBIRT.

Making the right thing to do, the easy thing to do.

More reasons…

Alcohol identification rates by EAP providers remain abysmal!

~ 160,000 EAP alcohol cases each year (Amaral 2009)

Baseline identification <1 to 5% (GW pilot studies)

Historically EAP providers have focused on workers with alcohol addiction.

EAP providers have not focused on early intervention to identify at-risk drinkers but don’t meet diagnostic criteria.

“BIG” Challenges

Who Are We Trying to Reach?

5% (6.25 million)

Daily HarmfulDrinking or dependence

behavior

20% (26.25 Million)At Risk

Exceed daily limits

70 % ( 87.5 Million)Occasional or non drinkers, seldom

exceed daily limits for alcohol consumption

1% Historical EAP focus

25% engaged in risky, harmful or hazardous drinking

32.5 million people could benefit from brief intervention

1%(1.25)Addicted

Spectrum ofAlcohol Use

How do we identify workers at risk?

“Case Finding” through SBIRT

What is SBIRT?

S: Screening using a validated tool

BI: Brief Intervention using an evidence-based framework

RT: Referral to Treatment

SBIRT: Screening, Brief Intervention and Referral to Treatment

Follow-up: administrative, clinical, outcomes

MI: Motivational Interviewing

Approach developed in the medical setting (trauma, ED), backed by scientific evidence of effectiveness.

Recent efforts to adapt for EAP and other behavioral settings (e.g., community health centers).

What is SBIRT?

Increase early identification of clients at risk for alcohol problems.

Build awareness and educate clients on U.S. guidelines and risks associated with alcohol use.

Motivate at-risk clients to reduce unhealthy, risky alcohol use; adopt health promoting practices.

Motivate clients to seek help for alcohol use.

Aim of SBIRT

http://pubs.niaaa.nih.gov/publications/arh28-1/toc28-

1.htm

http://pubs.niaaa.nih.gov/publications/arh28-2/toc28-

2.htm

Evidence behind SBIRT

Identification Rates at 5 months approached U.S. population estimates

18.5% using AUDIT screening tool

6% based on “presenting problem”

At baseline: < 1% (prior vendor data)

Aetna Pilot Findings

McPherson, T.L., Goplerud, E., Derr, D., Mickenberg, J., Courtemanche, S. (in press, 2010). Telephonic Screening and Brief Intervention for Alcohol Misuse Among Workers Contacting the Employee Assistance Program: A Feasibility Study. Drug and Alcohol Review.

78% agreement to follow-up by EAP clinician

72% set an appointment for face-to-face counseling

Findings at 5 Months


Pre-SBI

Time Period(n=68

1)

Post-SBI Time

Period(n=383

)

p-value

EAP Alcohol Identification

Hazardous alcohol use

7.5% (51)

20.1% (77)

<0.0001

Alcohol abuse/dependence

7.1% (48)

10.4% (40)

0.0536

OptumHealth EAPReplicated Findings

Greenwood, G., Goplerud, E., McPherson, T.L., Azocar, F., Baker, E., & Dybdahl, S. (in press, 2010). Alcohol Screening & Brief Intervention (SBI) in Telephonic EAP. Journal of Workplace Behavioral Health.

51.5

36.531.7

18.4

Alcohol Illegal Drugs

% Intake

% Follow-up

Alcohol use to intoxication (5+ drinks) declined 38.4%

Use of any illegal drugs decreased 49.6%

Nearly 50% of those who received a BI changed patterns of misuse

N = 11 States

Federal SBIRT DemonstrationFindings

Adapted from Tom Stegbauer, DHHS, 2008

QUESTIONS?

Components ofSBIRT

SBIRT Core Components

ScreeningIdentification of

behavioral problems/risk

(alcohol, tobacco,drugs,

depression)

Brief InterventionRaises awareness

of risks and reinforces staying

at low risk

Referral to TX Referral of those with

more serious or complicated mental or substance use

conditions

Brief Intervention/ Brief Treatment

Cognitive behavioral, medications with

clients who acknowledge risks

and are seeking help

High

Moderate

Low

Adapted from Tom Stegbauer, DHHS, 2008

Heterogeneity of Alcohol Use

Never exceedsdaily limits

•Exceedsdaily limits

•No distressor harm

•Exceedsdaily limits

•Harmful

•Daily or neardaily heavydrinking

•Impairedcontrol

•3-5 criteria

•Daily or neardaily heavydrinking

•Chronic orrelapsing

•6-7 criteria•Functionalimpairment

None Mild(“At-risk”)

Moderate(Harmful use)

Severe(Dependence)

Chronicdependence

70% ~21% ~5% ~3% ~1%

DSM-IV Abuse/Dependence

EAP and Workplace BH Programs

NIDA Single-Item Drug Use

"How many times in the past year have you used an illegal drug or used a

prescription medication for non-medical reasons?”

Identifies overall drug usePositive screen = 1 or moreProvide BI /RT

Barclay, Laurie (2010). Single Screening Question May Identify Drug Use in Primary

Care. Arch Intern Med. 2010;170:1155-1160

NIAAA Single-Item Alcohol Use

"How many times in the past year have you had X or more

drinks in a day?"

X = 5 for men, 4 for women Identifies unhealthy alcohol use Positive screen = 1 or more (provide

BI)

Barclay, Laura (2009). Single Screening Question May Accurately Identify

Unhealthy Alcohol Use. J Gen Intern Med.

Alcohol Screening(handout)

AUDIT-C

AUDIT

4747

AUDITAlcohol Use Disorder Alcohol Use Disorder

Identification TestIdentification Test

Developed by WHODeveloped by WHOEnglish:http://whqlibdoc.who.int/

hq/2001/WHO_MSD_MSB_01.6a.pdf

Spanish:http://www.who.int/substance_abuse/activities/en/

AUDITmanualSpanish.pdf

Detects Alcohol Detects Alcohol Problems in the Last Problems in the Last

YearYear

AUDIT-C <2 minAUDIT-C <2 minAUDIT <5 minAUDIT <5 min

AUDIT Domains

AUDIT-C Hazardous Use (AUDIT Items

1-3)

AUDIT-C ScoringItems # 1-3 scored 0-4 points

Add up points

Positive prescreen = 4+ men 3+ women and adults over age 65

Administer remaining AUDIT items # 4-10

Provide BI, if using only AUDIT-C

Dependence Symptoms (Items 4-6)

Harmful Use (Items 7-10)

AUDIT Scoring

Add up points Items # 1-8 scored 0-4 points Items 9-10 scored 0, 2 or 4 points

8+ indicates at-risk, harmful or hazardous drinking

World Health Organization (WHO) Recommended

Levels of Brief Intervention (4 Zones)

Adaptations of WHO for EAP

3 Risk Level Intervention

AUDIT InterpretationLevels of Brief Intervention

“BIG” Adapted – 3 levels

AUDIT Online

http://rethinkingdrinking.niaaa.nih.gov/

QUESTIONS?

What is Brief Intervention?

….IT’S NOT THIS!

BI: Definition & Implications

Short, non-confrontational health counseling technique.

A practice to identify a real or potential alcohol use problem, and

to motivate an individual to do something about it.

Effective with other conditions (e.g., tobacco and drug use, depression, diabetes).

BI: Definition & Implications

Not a quick fix treatment.

Persons with addiction or a mental health disorder require specialist care or other treatment modalities beyond BI.

May help identify persons with a disorder and facilitate referral.

Elements of BI Screening score feedback Education (risks, guidelines) Normative feedback Simple advice Enhance motivation Assist with action plan Give encouragement Provide resources Close on good terms Ask for permission Provide Referral

Screening Score Feedback

Low risk

“From your responses, your drinking is in a healthy range which puts you at lower risk for many health and emotional concerns than those who drink at higher ranges.”

Screening Score Feedback

Moderate and High Risk

"From your responses, your drinking puts you at higher risk for many health and emotional concerns than those who drink at lower ranges. These questions have been given to thousands of people, so you can compare your drinking to others. Your score was [#]…on a scale of 0-40 which places you in the category of [moderate or high] risk.

Education

Discuss health risks of alcohol and other substances

“Unhealthy alcohol use can put you at risk for injury, accidents, and health problems such as depression, diabetes, cancer, insomnia, high blood pressure, stroke, heart and gastrointestinal problems, and other conditions.”

Education

Review drinking guidelines

“The recommended guidelines for healthy adults are no more than 1 drink per day (or 7 drinks per week) for women and adults over age 65, and no more than 2 drinks per day (or 14 drinks per week) for men.”

Normative Feedback

Provide feedback on how client’s use compares to others (i.e., men, women, adolescents, general population)

“Your alcohol consumption is similar to [different from/higher than] most people (about 72% of adults) in the U.S. who never exceed the recommended guidelines.”

“Reducing your consumption to safer drinking levels can decrease your risk.”

“Cutting back on the number of drinks you typically have each day can decrease your risk of health problems.”

“I advise you to Cut Back your alcohol consumption.”

Simple Advice

“Cut Back”/Moderation

Recommend drinking or using at “moderate levels” which are safe/within guidelines.

Not a request to Abstain/STOP.Alcohol: (m) 2-14-5, (w) 1-7-4

(Adapted from NIAAA, 10th Report to Congress 2000)

“Based on my assessment, you are at-risk for future health problems…I advise you to cut back/quit.”

Non-judgmental feedback and appraisal of risks by a practitioner….

10-30% patients will significantly reduce (alcohol/tobacco/diabetic) risky

behavior.(WHO, 1996; CSAT TIP 24, 1997)

Non-Judgmental Tone

Exploring Motivation using MI Strategies

Explore Ambivalence Pros and Cons of Alcohol Use

Explore Readiness Importance and Confidence Rulers

Explore Goals quit, cut down, make no change?

Elicit Change Talk – Use your OARS “I really want to cut-back on drinking with

the guys after work.”

Using Your OARS

O = Open Questions

A = Affirmations

R = Reflections

S = Summary

Source: Mary Velasquez, HOT EAPA Motivational Interviewing Training, September 1, 2010

What are the good things about your ____?

What are some of the less good things?

What concerns do you have about your ____?

If you were to change, what would it be like?

Where does this leave you now?


Exploring Pros/Cons

0 10

Importance Ruler

“How important is it to you to ____ ( e.g., quit using, begin treatment)?

If 0 was “not important,” and 10 was “very important,” what number would

you give yourself ?”


Exploring Importance

Why are you at x and not y? (always start with the higher number)

What would have to happen for it to become much more important for you to change?


Confidence Ruler

“If you decided right now to ___ (e.g., stop drinking, using drugs, enter treatment), how confident do you feel about succeeding with this?

If 0 was ‘not confident’ and 10 was

‘very confident’, what number would you give yourself?”

0

10Source: Mary Velasquez, HOT EAPA Motivational Interviewing Training, September 1, 2010

Building Confidence

What would make you more confident about making these changes?

Why have you given yourself such a high score on confidence?

How could you move up higher, so that your score goes from x to y?

How can I help you succeed?


Assist with Action Plan

If you were to decide to change, what might your options be?

What is your next step?

How will you do that?

Are there any ways you know about that have worked for other people?

Is there anything you found helpful in any previous attempts to change?


Assist with Action Plan

Who will you ask to help you?

What might get in the way?

What have you learned from the things that went wrong last time you tried?

How will you deal with those challenges?


Give Encouragement

“I believe you can take that next step to…”

“I believe you’ll be able to implement that plan when you have those challenges.”

Provide Resources

Rethinking Drinking (booklet, online)


Tips for Cutting Down on Your Drinking

Mixing Alcohol and Medication

http://pubs.niaaa.nih.gov/publications/tips/tips.pdf

http://pubs.niaaa.nih.gov/publications/Medicine/Harmful_Interactions.pdf

Close on Good Terms

Say “Thank You”

“Thank you for taking a few minutes to talk with me about your alcohol use. I appreciate your openness and sharing your experiences/thoughts with me today.”

Ask for Permission

“I would like to see how things are going for you over the next few months. Would you mind if I followed up with you?”

Provide ReferralHigh Risk Cases: Referral to Specialist/Treatmente.g.,

addiction specialist behavioral health provider alcohol disease management chemical dependency program community resource (e.g., mutual help)

other referral sources

Moderate Risk Cases (as appropriate)

Provide Referral

“Based on the information you provided, I would encourage you to consider getting additional help for dealing with issues related to alcohol.”

“I would like to refer you/put you in touch with a provider on your health plan.”

“What do you think about this?”

It’s SBIRT using MI strategies(It’s not MI)

Sample Protocols “SBIRT Basic” (no MI) “SBIRT MI-Informed”

How does it all fit together?

Sample Protocols(handouts)

QUESTIONS?

BONUSELEMENTS

Bonus Element:

Implementation Tips

Tips

Normalize screening (and outcomes measurement) procedures

“We ask all clients who contact the EAP these questions.”

Give a reason for asking“We are trying to understand the impact

of EAP counseling in the workplace.”

Stress the need to follow-up“It’s important that I follow-up with you

to see how you’re doing, what is the best way to reach you?”

Adapted from: CGP’s Workplace Outcomes Suite: Overview, Rationale, and Implementation. Rik Lennox, Chestnut Global Partners

More Tips

Ask permission to follow-up “May I follow-up with you in X

(days/months)?”

Get good “locater” information “What is the best way to reach you?”

Stress confidentiality“Answering these questions is

completely voluntary and confidential, we will not share it with your employer.”


Integrate Screening and Outcome Measures at Intake

before EAP consultation, counseling

embed in existing intake assessment

often called “baseline” or “pre-test”


Recommendations

Integrate Screening and Outcome Measures at Follow-up

After EAP consultation, counseling embed in existing follow-up procedure often referred to as “post-test” time period varies

(30, 45, 60, 90 days; 6, 12, 24 months) consider instrument recommendations

when selecting time period (e.g., 90 days for “Workplace Outcomes Suite”)


Recommendations

Bonus Element:

EAP Pilot Tests

Aetna EAP Approach

BI, Referral, & Follow-up

Aetna EAP Pilot

Site Characteristics: large U.S. employer (financial services) 147,000 employees non-emergent, self-referral cases dedicated EAP team

Evaluation Design: compared baseline to post-SBIRT

implementation at 5-months

Participation

93% completed the AUDIT-C 87% completed the AUDIT

AUDIT-C prescreen

40% positive, asked remaining 7 items 60% negative, stopped at item #3


AUDIT screen

Identification approached U.S. population estimates

18.5% using AUDIT screening tool

6% based on “presenting problem”

At baseline: < 1% (prior vendor data)


78% agreement to follow-up by EAP clinician

72% set an appointment for face-to-face counseling



Pre-SBI

Time Period(n=68

1)

Post-SBI Time

Period(n=383

)

p-value

EAP Alcohol Identification

Hazardous alcohol use

7.5% (51)

20.1% (77)

<0.0001

Alcohol abuse/dependence

7.1% (48)

10.4% (40)

0.0536

OptumHealth EAPReplicated Findings

Greenwood, G., Goplerud, E., McPherson, T.L., Azocar, F., Baker, E., & Dybdahl, S. (in press, 2010). Alcohol Screening & Brief Intervention (SBI) in Telephonic EAP. Journal of Workplace Behavioral Health.

Bonus Element:

More “BIG” Resources(handout)

World Health Organization (WHO)

SBIRT ManualsEnglish: AUDIT http://whqlibdoc.who.int/hq/2001/WHO_MSD_MSB_01.6a.pdf

BI Manual http://whqlibdoc.who.int/hq/2001/WHO_MSD_MSB_01.6b.pdf

Spanish: AUDIT http://www.who.int/substance_abuse/activities/en/AUDITmanualSpanish.pdf

BI Manualhttp://www.who.int/substance_abuse/activities/en/

BImanualSpanish.pdf

AUDIT Online

117117

NIAAA 2005 Guidelines

http://pubs.niaaa.nih.gov/publications/Practitioner/CliniciansGuide2005/clinicians_guide.htm

• Free Online Training

• Video Cases: Helping Patients Who Drink Too Much

• Free CME/CE credit for physicians or nurses

http://www.niaaa.nih.gov/Publications/EducationTrainingMaterials/CME_CE.htm

119

AMA Approved Billing Codes

Providers can be reimbursed for SBI

http://www.ensuringsolutions.org/resources/resources_show.htm?doc_id=385233&cat_id=2005

Reimbursement for SBIReimbursement for SBI

Payer Code DescriptionFee

Schedule

Commercial

Insurance

CPT

99408

Alcohol and/or substance abuse structured screening and brief intervention services; 15 to 30min

$33.41

CPT

99409

Alcohol and/or substance abuse structured screening and brief intervention services; greater than 30min

$65.51

Medicare

G0396Alcohol and/or substance abuse structured screening and brief intervention services; 15 to 30min

$29.42

G0397

Alcohol and/or substance abuse structured screening and brief intervention services; greater than 30min

$57.69

MedicaidH0049 Alcohol and/or drug screening $24.00

H0050Alcohol and/or drug service, brief intervention, per 15 min $48.00

Bonus Element:

Measuring Performance and Client Outcomes –

Demonstrating Impact and Value

Outcome Measures

WOS

WLQ

Chestnut Global PartnersWorkplace Outcomes Suite

(WOS)

WOS Developed by Rik Lennox, Dave Sharar et

al., Chestnut Global Partners

Free, with licensing agreement

20 items, 5 scales (5 items each)

Scales used stand-alone or together

Workplace focus (not clinical outcomes)

Short, sensitive to change

Administered at EAP Intake and at 90 days

WOS ScalesAbsenteeism

# hours away from work in past 30 days, can be monetized

Presenteeism proxy for productivity, extent to which

problems inhibit work

Work Engagement measure of "over" involvement with the

job

Life Satisfaction gauges importance of job to "life“

Workplace Distress looks at "distress at work" across all

problems

WOSRead more: Sharar and Lennox (2009). A New

Measure of EAP Success. Society of Human Resource Management.http://www.chestnutglobalpartners.org/LinkClick.aspx?fileticket=oE7rAAU5GMM%3D&tabid=364

Lennox, R.D., Sharar, D., Schmitz, E. , Goehner, D.B. (2010). Development and Validation of the Chestnut Global Partners Workplace Outcome Suite. JWBH, 25, 107-131. http://www.informaworld.com/smpp/content~content=a922042152~db=all~jumptype=rss

WLQ(Work Limitations

Questionnaire)

WLQDeveloped by Debra Lerner, Tufts Medical Centerhttp://160.109.101.132/icrhps/resprog/thi/wlq.asp

Available with licensing agreement

8 item (WLQ-Short Form) “presenteeism” or “on-the-job disability” measure

Four scales, used together

Designed for assessing groups of individuals currently employed

Indicates the degree health problems interfere with the ability to perform job roles, and productivity impact of these work limitations.

WLQ ScalesTime Management Scale

Difficulty performing a job easily at the beginning of the workday and starting the job soon after arriving at work.

Physical Demands Scale Ability to perform job tasks that involve

sitting and standing in one position and repeating the same motion repeatedly.

Mental-Interpersonal Demands Scale Difficulty concentrating on work and ability

to interact with people on-the-job.

Output Demands Scale Ability to complete work.

WLQ Productivity Loss Score

Estimates percent difference in an employee’s at-work

productivity compared to employees who do not have health-related work limitations (a healthy benchmark group).

Read more: Lerner, D., Amick, B.C., Rogers,

W.H., Malspeis, S., Bungay, K., Cynn, D. (2001). The work limitations questionnaire. Medical Care. 39, 72-85. http://www.ncbi.nlm.nih.gov/pubmed/11176545

WLQ website: http://160.109.101.132/icrhps/resprog/thi/wlq.asp

THANKYOU

Tracy L. McPherson, PhD

Assistant Research [email protected]

202-994-4307

Center for Integrated Behavioral Health Policy

Department of Health Policy, George Washington University Medical Center

Eric Goplerud, PhDResearch [email protected]

202-994-4307

2121 k street, nw, suite 210 washington, dc 20006 center for integrated behavioral health policy...

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