Comparing barriers to employee assistance program utilization in Canada and the United States using natural language...

Area of Science:

• Occupational Health
• Mental Health Services Research
• Computational Social Science

Background:

• Employee Assistance Programs (EAPs) offer vital mental health support but face low utilization rates in Canada and the United States.
• Existing research on EAP barriers is general, lacking country-specific comparative insights.
• Understanding these differences is crucial for improving EAP accessibility and effectiveness.

Purpose of the Study:

• To explore barriers to EAP usage among Canadian and American workers.
• To identify and compare country-specific perceptions influencing EAP utilization.
• To leverage natural language processing (NLP) for nuanced analysis of qualitative data.

Main Methods:

• A mixed-methods approach combining thematic analysis of 30 semi-structured interviews with EAP-eligible, non-users in Canada and the US.
• Qualitative data analyzed inductively following Braun and Clarke's Thematic Analysis guidelines.
• A BERT-based NLP model used to classify interview quotes by country, identifying key differentiating terms.

Main Results:

• Three core themes emerged: accessibility/coverage barriers, reluctance due to psychosocial/perceptual issues, and concerns about service quality/cultural relevance.
• US participants uniquely reported financial concerns.
• NLP analysis highlighted financial accessibility and diverse offerings for US quotes, and stigma/quality/cultural relevance for Canadian quotes.

Conclusions:

• While many EAP barriers are shared across Canada and the US, significant country-specific financial and perceptual differences exist.
• EAPs should consider tailored strategies: addressing stigma and quality in Canada, and cost and alternatives in the US.
• Future research should examine generalizability, sector-specific trends, and longitudinal perceptions.