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.