In the U.S., the majority of adults who are at risk for alcohol problems and many who engage in risky sexual behavior are employed and spend a considerable amount of time in the workplace. In addition, alcohol abuse and outcomes related to high risk sexual behaviors such as unplanned pregnancies and STI infections are associated with job absenteeism, turnover, injury rates and increased medical care costs (Institute of Medicine, 1994; Martin, 1994), particularly among the working poor. Thus the workplace holds great potential as a venue for the identification of low wage workers who are at risk for, or engage in, these behaviors. In the proposed two year R21 study we seek to develop a workplace-linked intervention to reduce alcohol abuse/misuse and risky sexual behavior among low-wage employees in Alaska. Two theoretical frameworks guide this approach: 1) a Cultural Approach to Alcohol and Risky Sex the Workplace (adapted from Ames & Janes, 1992), and 2) the Theory of Planned Behavior (Ajzen & Madden, 1998). These two theories allow us to include both the organizational and cultural aspects of the work environment and individual level determinants of alcohol use/abuse and risky sexual behaviors of low-wage workers. We plan to base the proposed study in Alaska for several reasons: it is an underserved and under- researched state with high rates of alcohol abuse, STIs and unplanned pregnancies. We also have an existing research infrastructure in Anchorage and active collaborations with the research and substance abuse prevention communities there. In Year 1 we plan to develop collaborations with companies which employ low- wage service workers and conduct qualitative research with employees and employers to better understand the patterns of alcohol use/abuse, risky sexual behavior, STIs (including HIV) and unintended pregnancy; and the links among behaviors and outcomes and the workplace environment. During Year 2, we will conduct quantitative survey research with employers and employees to assess the prevalence of alcohol use/abuse, risky sexual behavior, STIs (including HIV) and unintended pregnancy and the relationships among these behaviors and the workplace environment and assess the acceptability of possible components of a workplace-linked program to reduce alcohol use/abuse and risky sexual behaviors. ? ? Based on these findings we will develop and pilot test an initial version of a workplace-linked prevention program to reduce alcohol use/abuse, risky sex, and STIs in low-wage service workers in Alaska in preparation for a larger R01 application. The proposed study will allow us to potentially affect risky behavior directly among low wage worker through programs as well as indirectly through the culture and environment of the workplace. The project will also enable us to propose a program less controversial than one focusing solely on risky sex, and capitalize on the links between alcohol and risky sex. ? ? ?
