A wealth of research demonstrates that depression places a substantial burden on employees and the firms in which they work. This project's long-term goal is to develop an effective, efficient and sustainable intervention that will reduce depression's adverse impact on the employee's ability to function at work. This project's main innovation will be a multi-modal, work-focused intervention program delivered by employee assistance program (EAP) counselors who companies already employ. Named the Work and Health Initiative (WHI), it will offer employees: 1) depression screening; 2) coordination of care activities; 3) work-focused cognitive behavioral therapy (CBT) strategies; and 4) work modifications to reduce impairments secondary to depression. General Aim 1 is to evaluate alternative strategies for implementing the WHI. This project will include: 1) a randomized controlled trial (RCT), using a crossover design, to test the effectiveness of two different EAR counselor training methods; 2) an RCT comparing two different strategies for recruiting employees into a workplace depression screening survey; 3) employer interviews, which will identify standards for reporting back meaningful information about the impact of the WHI while protecting employee privacy.
Aim 1 will generate several products that can contribute to the success of future workplace mental health promotion programs. These products will also be integrated into this project's WHI trial. General Aim 2 is to evaluate the effectiveness of the WHI using an RCT design. At least 14,000 employees of the Lockheed Martin Corporation, representing a wide range of occupations, will be eligible to complete a private, web-based depression and work problem screening. Employees with depression and work problems will be identified from the screening and, following an in-person interview and consent, half will be randomly assigned to the usual care group and half will be assigned to the experimental WHI group (total n=230). Subjects will be surveyed at baseline and four months later. The primary outcomes to be evaluated are employee work performance and productivity using the validated Work Limitations Questionnaire (WLQ) and its work absence module. An intent-to-treat analysis will quantify the impact of the WHI on employee ability to function at work, work productivity, and depression symptoms. The WHI potentially will help employees with depression to function more effectively at work. In addition, it may decrease the burden of productivity loss on employers. Thus, this project will generate important information for key health care system stakeholders including consumers, purchasers, providers, and policymakers.
