Onsite screening and enhanced EAP counseling improves overall health, depression, and work outcomes: Four-wave longitudinal pilot study at a community health center in Vermont
Mark Attridge, Steven P. Dickens
Abstract
Over a 2-year period, patients at a rural community health center in Vermont were screened on-site for multiple behavioral health risk factors and, if found at risk, were offered no-cost counseling on-site at the health center. The treatment was delivered by two licensed employee assistance program (EAP) counselors highly proficient in an evidence-based motivational interviewing approach. Longitudinal data at four time points were examined: baseline; end of treatment (3 months); and 3 and 6 months post-treatment. Tests of paired data of baseline versus each later time point found significant improvement for global health (Patient-Reported Outcomes Measurement Information System [PROMIS]-10) in the total sample (N = 120); depression symptoms (Patient Health Questionnaire 9-item scale [PHQ-9]) among a subsample with depression as a clinical issue (n = 68); and work presenteeism and estimated hours of lost work time among the employed subsample (n = 46). Improvement in global health was significantly associated with improvement (reductions) in hours of lost work productivity at all later times (r = .33, .35, .50). Improvement in global health was moderated by level of household income (more improvement among patients with lower income levels), but not by clinical or demographic factors. Practical implications for behavioral health screening and intervention (BSI) in medical settings and onsite EAP counseling programs are discussed.