A cluster randomized trial of alcohol prevention in small businesses: a cascade model of help seeking and risk reduction.

Purpose: The current study adapted two workplace substance abuse prevention programs and tested a conceptual model of workplace training effects on help seeking and alcohol consumption.

Design: Questionnaires were collected 1 month before, 1 month after, and 6 months within a cluster randomized field experiment.

Setting: Texas small businesses in construction, transportation, and service industries.

Subjects: A total of 1510 employees from 45 businesses were randomly assigned to receive no training or one of the interventions.

Intervention: The interventions were 4-hour on-the-job classroom trainings that encouraged healthy lifestyles and seeking professional help (e.g., from the Employee Assistance Program [EAP]). The Team Awareness Program focused on peer referral and team building. The Choices in Health Promotion Program delivered various health topics based on a needs assessment.

Measures: Questionnaires measured help-seeking attitudes and behavior, frequency of drinking alcohol, and job-related incidents.

Analysis: Mixed-model repeated-measures analyses of covariance were computed.

Results: Relative to the control group, training was associated with significantly greater reductions in drinking frequency, willingness to seek help, and seeking help from the EAP. After including help-seeking attitudes as a covariate, the correlation between training and help seeking becomes nonsignificant. Help-seeking behavior was not correlated with drinking frequency.

Conclusion: Training improved help-seeking attitudes and behaviors and decreased alcohol risks. The reductions in drinking alcohol were directly correlated with training and independent from help seeking.