This application proposes to continue a program of research into the epidemiology and consequences of drug use in the workplace. It addresses the needs to improve methodologies for assessing drug use and associated factors in employment settings, and how these relate to organization structure and remedial policies such as those involving urine testing and EAPs. There are three specific aims: (1) to examine employee survey alternatives for improving prevalence estimates based on self-report data (which generally represent low-end estimates) for drug use and other problem behaviors by examining various surrogate measures involving nominative techniques, attitude prototypes, and least preferred co-workers; (2) to develop survey instruments for assessing company policies and procedures dealing with drug abuse which have good psychometric properties and which will be readily applicable to a wide variety of employment settings -- especially those with smaller numbers of employees and limited resources; and (3) to replicate the survey instrument components across time and different employment settings for studying stability of estimates as well as changes in drug use prevalence and employee attitudes that are related to shifts in organizational structure and policies. An earlier 2-year NIDA grant was used to pilot-test survey techniques in a large municipal setting, based on a stratified sample of almost 2000 city employees in San Antonio, Texas. The proposed 5-year continuation will expand the research program to include another large city (Fort Worth) as well as several smaller suburban or rural municipalities and private companies. Replicated surveys on a stratified sample of 1000 city employees in Fort Worth will be conducted in Years 1 and 4, 1000 city employees in San Antonio will be resurveyed in Year 2, and several smaller organizations with be surveyed in Year 3. Year 5 will be used to finish data analyses involving comparisons of results across time and across sites, and publication of findings. Based on procedures successfully used in the previous San Antonio survey, intact employee workgroups will be selected randomly and represent a cross-section of management, skilled technical, clerical, and services job categories. Participation will be voluntary, but careful efforts will be made to maximize cooperation by using advisory groups of management and employee representatives in a coordinated strategy to inform workgroups of the purpose, timing, and confidentiality of the survey. In San Antonio, 75% of employees responded cooperatively to this strategy (and the same percentage agreed to provide urine specimens after the survey for urinalyses). Self- report data will be compared with results of random urine testing and EAP referrals being conducted by the City of Fort Worth, and a 50% sample of the San Antonio respondents will be targeted for urine testing following the survey administration. Survey results will be given as feedback to participating sites and their employees, as well as be presented at professional meetings and in the professional literature.
