Worksite cardiovascular wellness programs as a route to substance abuse prevention

This study addresses the question of worksites as an effective route to alcohol abuse prevention. Hypotheses tested include: (1) Cardiovascular disease risk reduction programs provide effective access for alcohol behavior change. (2) Proactive outreach and follow-up have more impact on health behavior change than health education classes. (3) Ongoing follow-up counseling produces the most behavior change. (4) Screening alone produces little change. The study population included 2000 employees, recruited through cardiovascular disease health screening, who were randomly assigned to individual outreach or classes interventions. Changes in the organization of work required more visible outreach, which produced demands for counseling services from many employees who were not in the original group targeted for outreach. After 3 years of intervention, rescreening results strongly supported hypotheses 1 and 2. Spill-over effects from counseling produced plant-wide improvements, so that hypotheses 3 and 4 were not confirmed. This demonstrates that highly visible outreach provides a cost-effective strategy for cardiovascular disease and alcohol prevention.