Employee assistance programs (EAPs) have gained increasing popularity in all types of employment settings recently, but few studies have estimated the costs and effectiveness of these programs or the individual services they deliver. In general, evaluation studies of health services are extremely important in today's economy given the rising costs of health care, the extra demands on the health care market caused by substance abuse and HIV/AIDS, and the public pressure to reform the national health care system. EAPs have the potential to significantly influence the use of health care resources through their ability to prevent and treat alcohol misuse among employees and their dependents. Given the shortage of evaluation studies and the important role of EAPs in the health care market, the proposed study will design and evaluate a specialized workplace alcohol program (SWAP) targeted to women and ethnic minority workers at three large worksites in a midwestern community. The SWAP protocol will include new and enhanced outreach materials designed especially for woman and ethnic minorities, the addition of two new EAP counselors who specialize in issues that are particularly pertinent for women and minorities, revised supervisor, employee, and counselor training, and several other service components. We will integrate the SWAP protocol into the existing EAP at each worksite to ensure that all employees have access to at least the standard level of services and to facilitate continuation of the protocol at the end of the evaluation study if we find it to be effective. The primary objectives of the proposed study are to: (l) develop and implement a SWAP protocol at three worksites; (2) estimate the effectiveness of the SWAP protocol in terms of EAP utilization, absenteeism, turnover, job performance ratings, health care expenditures, days of heavy drinking, and alcohol-related problems; and (3) estimate the cost and cost-effectiveness of the SWAP protocol. The proposed study has a high degree of significance because EAPs have rarely been evaluated, the target populations are understudied in alcohol research, and EAP utilization for alcohol-related problems is extremely low at the participating worksites. Our findings will provide a richer understanding of the costs and benefits of standard and enhanced EAP services. The results will also help employers, policy makers, and EAP practitioners to design more efficient and effective workplace alcohol programs.
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