Exploring the Impact of Promotion on the Use of …...2018/06/02 · utilized program. Promotion of EAP Programs Research indicates that the successful marketing of EAP services leads

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ExploringtheImpactofPromotionontheUseofEAPCounseling:

ARetrospectiveAnalysisofPostcardsandWorksiteEventsfor82EmployersatKGA

____________________________________________________________________________________________________________

Hallie Shepps, MPH1 and Kathleen Greer, LMHC2

1 Tufts University School of Medicine. Currently at Marsh & McLennan Agency.

2 KGA, Inc.

____________________________________________________________________________________________________________

Copyright Ó2018 Employee Assistance Society of North America (EASNA) with other rights of use retained by the authors. Contact EASNA at: Phone: (703) 370-7435

Website: www.easna.org Address: 3337 Duke Street, Alexandria, VA 22314 ____________________________________________________________________________________________________________

ABSTRACT.ThisstudyretrospectivelyexamineddatafromKGA,Inc.-anEAPvendorlocatedintheUnitedStates-toexploretheimpactofdifferentkindsofpromotionalactivitiesonincreasingordecreasingtheuseofEAPservices.WestartedbyconductinginterviewsabouttheEAPpromotionalpracticeswithhumanresourceandwellnesscontactsfortheEAPatfiveclientcompanieswithstrongEAPactivity.Themesfromtheseinterviewsfocusedonthemanychallengestopromotionandpotentialtacticsthatcouldbeeffective.Next,wereviewedtheutilizationrecordsoveratwo-yearperiodfor82employerswithalmost150,000totalcoveredemployees.Analysisof5,985EAPcasesfoundthat“promotionalmaterials”werethenumberonesourceofreferralintotheEAP,with1in3casescitingit.Thus,promotionswerefrequentlymentionedasakeypartofuseoftheEAP.Thenextpartofthestudyinvolvedcomparingvariouskindsofpromotionalactivities(mailedpostcardsandfivekindsofeventsprovidedattheworksite)ontheusageratesfornewEAPcounselingcasesinthetwo-weeksafterthe

promotionversusthetwo-weeksbefore.Usingthisrestrictedoutcomeperiod,theimpactofpromotionaleventswasextremelysmall–atlessthanonepercentincreaseinaddingnewcasesimmediatelyafterthepromotion.However,whencontrollingforthedifferencesinthelevelofexposuretodifferentkindsofworksiteevents,presentationtoemployeesontheOrientationtoEAPwereover10timesmoreeffectivethanotherkindsofworksiteevents.Limitationsofthestudydesignanddatacollectioncontextarediscussedalongwithideasforfurtherresearch.GeneralrecommendationforeffectivepromotionalpracticesofEAParealsopresented.Introduction

About1in5ofallworkersintheUnitedStatesmetcriteriaforhavingbehavioralhealthproblemseachyear.1Typically,onlyabouthalfoftheseat-riskpeoplewillgetanyprofessionalhelpfortheseproblems(i.e.,anxiety,depression,adjustment/stress,occupational

EASNARESEARCHNOTESVolume7,Number2,June2018

EASNA Research Notes, 2018, Vol. 7, No. 2 Shepps & Greer

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distress,substanceabuse,otheraddictions).Thishighrateofincidenceofbehavioralhealthproblemsillustratestheimportanceofimplementingworkplace-basedservicesthattargetemployeesatriskformentalandemotionalhealthissues.Giventhepersonalconsequencesandthedirectandindirectcostburdensassociatedwithlackoftreatment,itmakesgoodbusinesssensetotrytohelppreventandproperlytreatemployeeswiththeseissues.2,3RecentnationalsurveysofemployersintheUnitedStatesfoundthatthemajorityofmedium-andlarge-sizecompaniessponsoremployeeassistanceservices.4,5Thus,mostemployersintheU.S.nowhaveEAPservices,eventhoughonlyabout1in4smallemployers(under200employees)haveanEAP.5Havingtheserviceavailableisagoodstartbutgettingthebenefitsfromtheservicerequiresittobeusedbythoseinneed.TheutilizationratesofEAPsareoftenakeycomponentinhowpurchasersjudgethesuccessoftheseservices.6,7ManyemployerspreferhighutilizationratesoftheEAPinordertoobtainthecorrespondingdecreasesinthebehavioralhealthandwork/lifeissuesaffectingtheemployeeswhousetheservices.Thus,akeyquestionforthepurchasersofEAPconcernsiftheseprogramsbeingusedenoughamongthoserelevanttotheservicesandhowtomosteffectivelydriveupprogramutilization.8EmployeeawarenessofEAPprogramsisanessentialcomponenttotheutilizationofEAPservices.However,EAPprogramscangounnoticedandunder-utilizediftheyarenotpromotedadequatelyintheworkplaceandalsothroughpromotionalmailingstothehomesofemployees.PromotionalmethodsareakeycomponenttoincreasingtheutilizationrateofEAPs.9OurexperienceasanEAPproviderindicatesthatavarietyofregularandongoingpromotionalactivitieshelpstocreateawell-utilizedprogram.

PromotionofEAPProgramsResearchindicatesthatthesuccessfulmarketingofEAPservicesleadstoanincreaseintheemployee’suseofEAPservices,andthatthemostimportantfactorinthesuccessofEAPsiswhetheremployeesareevenawareoftheservices.10GreaterprogrampromotionandknowledgeofservicesbyemployeeshasbeenassociatedwithhigherEAPutilizationrates.11AstudyconductedbyMazloffanalyzedemployeeawarenessofEAPservicesandfoundthatcommunicationshouldbehighlyvisiblethroughmarketingandeducation.9ThisresearchalsoindicatedthatnewsletterswerenoteffectiveandsuggestedthemainsourcesofinformationaboutEAPforemployeeswerethroughwordofmouthandpeer-referral–thusinformalandnaturallyoccurringtypesofpromotion. OtherresearchcitedbytheU.S.OfficeofDisabilityEmployment,suggestsusingmoretechnologytopromotetheEAPandtomakeEAPservicesmoreaccessiblethroughtechnologytoolsonlineorviatext,e-mail,orwebinars.12ItiscustomaryforEAPstoberesponsibleforpresentingvariouscampaignsandpromotionalmaterialstocreatevisibilityfortheprograms.SometimestheEAPcustomerorganizationswillrequestspecificpiecesofpromotionalmaterial;however,mostoftentheEAPwillmakethesesuggestions.EAPsaregenerallynotgivendirectaccesstoemployeeeligibilityfiles.Withoutemployeenamesandcontactinformation,thismeansthatEAPsarecompletelydependentonpartnersatthehumanresourcesorbenefitsdepartmentstohelppromotetheEAP.Ifthesepartnersdonotdotheirparttogetpromotionalmaterialstoeligibleemployees,thentheemployeeassistanceprogramscanbeunderutilized.


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PreliminaryInterviewswithCustomersAboutPromotionofTheirEAPPrograms KGAisaHumanResourcesservicesfirmthathelpsorganizationscreateandsustainahealthy,engagedandproductiveworkforce.QualitativeinterviewswereconductedwithsomeofourcustomersinordertogainafurtherunderstandingofthevalueplacedontheEAPswithinlarge,dynamicorganizations.Theinterviewswereintendedtohelpus,astheEAPprovider,tobetterunderstandthereasoningbehindtheirchoicesofwhichpromotionalmethodstouseandwhattoexploreinourstudyofpromotionalpractices.TheinterviewswereconductedwithHRrepresentativesorwithwellnesscoordinatorsatfivedifferentlargersizeorganizations.Theseorganizationsincludedthreehospitals(headcountsrangedfrom3,200to4,576)andtwouniversities(headcountsof1,088and1,355).ThesecustomerswereselectedbecausetheyrepresentedthelargersizeorganizationsservedbyKGAandhadallbeenactivepartnerswiththeEAPinthepromotionoftheprogram.Questionswereaskedabouttheiremployeedemographicprofile,EAPpromotiontechniquesused,challengestodoingpromotions,potentialforuseoftechnologyandsocialmediaforpromotion,andreasonsforthemostsuccessfulpromotions.Theinterviewslastedabout30minutesandwereconductedinperson.Theinterviewswereaudiorecordedandthentranscribed.Afterouranalyseswerecompletedtherecordingsweredeleted.Morespecifically,thequestionsincluded:

• Canyounamethreebehaviors/issuesyouwanttoaddresswithinyouremployeepopulationbyprovidingEAPservices?

• HereiswhatKGAhasonrecordofthe

differentmethods/techniquesyou’veusedandthefrequencyatwhichtheywere

implemented(sharecompanyspecificresults).Doesthislookaccuratetoyou?Isthereanythingmissing?Whydidyouusethesemethods?

• Istheresomeelementoftheemployee

demographicthatyouviewasmostimportantinbeingawareoftheEAPservices?Pleasechoosetwoofthefollowingvariablesthatyoubelievetobemostimportant-age,seniority,gender,ethnicity,diseasestatus.

• Inwhatwayshaveyouremployee

demographicsinfluencedwhatyouhavedoneforpromotion?

• Howisnewtechnologyhelpingyouto

promoteanyofyourhealthandwellbeingprograms?

• Wouldanyofthenewtechnologythat

you’reusingbehelpfulwiththepromotionofEAPservices?

• Haveyouusedanyformofsocialmedia

forpromotionofeitherwellnessprogramsoremployeeresourcegroups?

• Didyoureceiveanyfeedbackaboutthe

EAPpromotionsthatweredoneinyourorganization?Ifso,whattypeoffeedback?

Theinterviewdatawasanalyzedusingthematiccodinginordertoidentifykeythemesandtrendsamongalloftheinterviews.Someofthemostconsistentfindingsarepresentedbelow.Amongallfiveorganizations,stressreductionwasakeyissuetargetedbyimplementingEAPs,althoughthetypesofstressorsvariedamongthedifferentorganizations.Importantstressorsinthework/lifeareaincludedemployeefinancialandlegalissuesandtheneedforchildcareandeldercare.


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Ingeneral,achievingsufficientemployeeawarenessofalloftheservicesavailablethroughtheEAPwasachallengefacedbyeachoftheorganizationsweinterviewed.

Worksiteevents,especiallywhenattendedbyarepresentativeoftheEAP–suchaspromotionofEAPaftercrisiseventsandwellnesspromotionsonpopulartopics(e.g.,managingfinances)aregenerallyconsideredtobeeffectiveformsofpromotionoftheEAP.ManyoftheclientsinterviewedsupportedthisideaandmentionedthatworksiteeventswereagreatplacetopromotetheEAPandtoremindpeoplethattheserviceisavailable.Forexample,oneorganizationfocusedonmanagertrainingstoenhancemanagerreferralsintotheEAP.Allofthefiveorganizationshadusede-mailstopromotetheEAP,butmanyalsodiscussedbarrierstotheireffectivenessandcomputeraccesslimitationsforsomeworkerstogete-mails.

NoneofthefiveorganizationshadusedsocialmediatopromotetheEAPservices.Thiswasmainlyduetothedemographicsoftheiremployeepopulations,whotendedtolackaccesstoorinterestinsocialmedia.

Theresultsfromtheseinterviewswereusedtoinformthekindsofpromotionsselectedforreviewinthequantitativedatapartofthestudy.

ResearchQuestionsThegoalofthestudywastouseourowndatatobetterunderstandhowtoengageemployeesandtheirhouseholdmembersintheuseoftheEAP.WedecidedtoexaminetherelationshipbetweendifferentkindsofpromotionaltacticsandtheirimpactonutilizationofcounselingservicesbytheEAPimmediatelyfollowingthepromotion(i.e.,inthenexttwoweeks).RQ1:AmongcaseswhousetheEAPforcounselingservices,howoftenarepromotions

mentionedasasourceofreferralintousingtheEAP?RQ2:DoesthepromotionalactionofsendingpostcardsabouttheEAPresultinincreaseduseoftheEAPforcounselingservices?RQ3:DoesthepromotionalactionofhavingEAP-relatedonsiteeventsintheworkplaceresultinincreaseduseoftheEAPforcounselingservices?Methods SampleThestudysamplefeatured82employersdrawnfromthecustomersofKGA,whichisanexternalproviderofEAPandWork-LifevendorbasedintheeasternregionoftheUnitedStates.Intotal,KGAhas116differentemployerorganizationsandsupportsover300,000employeesandfamilymembers.Ofthese,34employerorganizationswerenotincludedinthestudy,eitherbecauseofbeingtoosmallinsize(i.e.,employeecount)tohavemeaningfuldataorbecauseofnothavingheldatleastoneEAPpromotionalworksite“event”intheyears2015and2016.Thetotalnumberofcoveredemployeesforthe82employerswas147,902.Thus,weexamineddatarepresentingmorethanhalfofthetotalemployeepopulationcoveredbyKGA.Althoughtheaveragecompanysizewasabout1,800employees,thissetofemployersrangedinsize,asfollows:<499totalemployees(n=30employers;37%),500-999employees(n=21;26%),1,000-4,999employees(n=24;29%),5,000-9,999(n=5;6%),and>10,000employees(n=2;2%).Theseorganizationsrepresented17differentindustries,including:Technology(n=21organizations);Biotech(n=12);Healthcare(n=9);ProfessionalServicesorConsulting(n=6);HigherEducation(n=5);Manufacturing(n=5);


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Insurance(n=4);ConsumerGoods(n=3);Non-profit(n=3);Retail(n=3);Financial(n=2);Construction(n=2);Legal(n=2);Municipality(n=2);ConsumerService(n=1);Union(n=1);andUtilities(n=1).Fortheseemployers,therewere5,985EAPcounselingcasestotalduringthestudyperiodofyears2015and2016combined.ArchivalDataSourcesThequantitativedatawasextractedfromtwodatabases:onethatstoreddataaboutpromotionalactivitiesandanotherwithclientdata.Utilizationdatawasanalyzedtoexaminehowpromotionalactionsimpactedtheutilizationoftheprogram.Thedatabasesystemcontainedrecordsonthecounselingintakeassessmentofclinicalcases.Thedataexaminedincludedthenamesandheadcountsoforganizationsthatreceivedapromotionaswellastheage,gender,referralsourceforeachindividualpersoncontactingtheEAPandwhethertheywereanemployeeorfamilymember.Fortheworksiteevents,itcontainedinformationregardingthetypeofevent,thedateoftheevent,thenumberofparticipantsattheevent,andthetotalintakenumberforeachcompanythatheldaneventoverthepasttwoyears.AmailingprogramwasusedtotrackpostcardsthatweresentthroughtheU.S.Mail.Fore-mails,itcontainedinformationonwhattypeofe-mailwassentandthedateitwassent.DefiningEAPUtilizationRatesAccordingtoEASNA,therearethreekindsofwaystomeasureutilizationrates.4TheClinicalCaseUseRateisperhapsthemostcommonlycomparedutilizationrate,butitisalsothemostconservativenumber.Thismetriccountsthenumberofpeople(employeesandfamilymembers)whobecomea“case”oftheEAPbyreceivingaclinicalassessmentandthenhaveoneormorecounselingsessionsfromtheEAPand/orreferraltoadditionalresourcesandtreatment.ThiscountofEAPcasesisdividedby

thetotalnumberofemployeesattheorganizationwithaccesstotheEAPbenefit.Forexample,50clinicalEAPcasesoutofapopulationof1,000employeesyieldsarateof5.0%.Clinicalcaseutilizationratescanrangefrombetween<1to10percentorhigher.Forexample,onenationaldatawarehousewithdatafromovertwodozendifferentEAPprovidershadabenchmarkaverageof3.9%fortheannualutilizationrateforclinicalcasesopened.13TheEAPindustryaveragehasbeencalculatedat4.5%(andmedianof3.6%),basedondatafortheyear2011from48differentEAPvendorsasreportedinthestudybytheNationalBehavioralConsortium(NBC).14However,notallEAPsmeasureuseoftheirservicesinthissamemannerandtherecanbewidevariationinlevelofuseacrossdifferentcompanycustomerswithinoneEAPvendorandbetweendifferentEAPproviders.15IntheNBCvendorstudy,therangeintheaveragecaserateforvendorsoftheirentirebookofbusiness(i.e.,allcustomerorganizationscombined)fortheyearwasverywide:from0.1%atthelowestEAPvendorto15.6%atthehighestEAPvendor.14

ThePeopleUseRateisthesecondbasicutilizationmetriccountsthetotalnumberofpeoplewhousedtheEAPforanyreason–notjustforassistancewithclinicalproblems.16Thismeasureaddsupalloftheuniquepeople(employeesandfamily)whousedtheEAP,eitherforclinicalcounseling,informationandreferral,managementororganizationalservices,attendeesofworksitetrainings,crisismanagementeventsandsoon.

TheTotalActivityUseRatemeasuresalloftheactivitythattookplacefortheEAPinthereportingperiod.16ThisrateisthemostinclusiveofalloftheservicesofferedbytheEAPandthusisthehighestlevelofthethreeutilizationmeasures.Itaddsupallofthecontacteventsanddiscreteservicesprovided


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bytheEAP,includingallcalls,websitehits,attendeesatworksitetrainings,managementconsultations,sessionswithclinicalcounselors,sessionswiththeEAP’slegalorfinancialconsultants,andsoon.ThismetricisthebestreflectionofthetotalityoftheEAPbenefitandwhatisdeliveredfromthebudgetfortheEAP.

Inthisstudy,weusedonlythefirsttypeofutilizationmetric(clinicalcaserate).Thus,weusedthemostconservativemeasureofprogramutilization.Thisisimportanttoconsider,giventhatthevariouspromotionaltacticsthatwereusedweresometimesrelevantnotonlytoindividualclinicalissuesservedbythementalhealthcounselorsattheEAPbutalsotoraisingawarenessofthemanyotheraspectsoftheEAPservicesportfolio(i.e.,well-being,legal,financial,managerial,prevention,andsoon).TheimplicationisthatthelargerimpactofthevariouspromotionaltacticsonthefulluseofalloftheEAPservicesthatoccurredafterwardswasnotfullytested.Inthisway,ourfocusononlythecaserateutilizationmetricdilutedthetrueimpactofthepromotions.

CalculationofChangein2-WeekCounselorCaseUseRateasPrimaryOutcomeMeasureTheprimaryareaofinquirywastoexplorethesuccessofvariouskindsofpromotionalmethodscommonlyusedinEAPfield.Tofocusontheimmediateimpactsoonafterapromotionalactivity,wedecidedtoonlyconsiderusedatafromthetimeperiodsoftwoweeksbeforeandtwoweeksafterapromotionoccurred.Thismeasurewascreatedbytakingthenumberofcounselorcasesinthetwo-weekperiodsbeforeandafterthepromotionalactivityofinterestanddividingitbythetotalnumberofcoveredemployeesatthatcompanyforthatyear.Next,thedifferenceinthebeforeuserateandafteruseratewascalculatedandthatabsolutechangewasusedtocalculatetherelativechangeinthetwoutilizationratesasapercentage.Thesameprocesswasrepeatedaroundthedatesforeachkindofintervention

(mailedpostcardsandworksiteevents)ateachemployer.Therefore,thecounselorcaseutilizationrateswerecalculatedateachemployerforeachkindofpromotionaltacticthathappenedoverthetwo-yearstudytimeframe.Toillustrateourbasicmathematicalapproach,hereisanexample.Let’sassumeaheadcountof2,000employeesforacompanyandanannualEAPcaseuserateof5.0%.Thisscenarioyields100EAPcounselingcasesperyearforthissizepopulation.However,thiscountbecomesonly3.85cases(onaverage)pereverytwo-weekperiodoftheyear(i.e.,100casestotalforyeardividedbythe26two-weektimeperiods).Ifwerounduptogetawholeperson,thisis4casespereverytwo-weekperiodoftheyear.Takingthe4casesdividedinto2,000employeepopulationisa2-weekspecificEAPuseratethatisverysmall–at0.002%.Ifapromotionresultedinjust1morecasethanthetypicallevelofuse,thiscasecountwouldbecome5casesintwoweeksandthepostpromotionperioduseratewouldbe0.0025%.Todividethedifferenceinthetworatesbythebeforerate,yieldtherelativechangeintheuseratesfrombeforetoafterthepromotion.Thischangepercentageisourkeyoutcomeinthestudy.Inthisexample,themathisasfollows:• Beforepromotionuserate=0.002%• Afterpromotionuserate=0.0025%• Difference(After–Before)=+0.0005%• RelativeChangeinRate=25.0%increase

Thenumberofcasesinatwo-weekperiodmayevenhavebeenlowerthanthe4casesinthisexampleinsomeofthedatapointstestedwhenconsideringthatthemajority(52of82)organizationshadlessthan1,000employees.Notethatthisanalyticalmethodishighlyinfluencedbydifferencesbetweenthe82employerswestudiedintheirbaselineuserateseachyear–suchthatanemployerwithaverylow(orzero)two-weekuserateforaparticular


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promotionataparticularwindowintimewassubjecttomuchgreaterrelativechangeresultpostpromotion.Butanotheremployerwithaveryhighuseratebeforethepromotionactivitydatewouldshowonlyasmallrelativechangepostpromotion.Inanattempttolessenthisproblem,theaveragerelativechangeinthetwo-weekutilizationratewascalculatedacrossallpromotionaleventsofthesamekindthatoccurredacrossallofthedifferentemployerswiththatsametypeofpromotion“intervention”overthetwoyearsincludedinthestudytimeframe.Thus,weusedallavailabledatatocalculatetheaverageofthechangeinuseratepercentages.Inthisapproach,thegreaterthenumberofpromotionaleventsofeachtypethatoccurred,thenthemorereliabletheprimaryoutcomemetricbecame.Consideringthatwehad19mailedpostcardcampaignsand838totalworksiteeventsthatoccurredoverthetwo-yearspan,resultsweremostreliablefortheworksiteeventstypeofpromotionalactivity.Results Theresultsarepresentedinthreepartscorrespondingtothethreeresearchquestions.FindingsfortheroleofpromotionsamongthedifferentreferralsourcesintotheEAParepresentedfirst.Thisisfollowedbytheresultsformailingpostcardsandthenfordifferentkindsofeventsattheworksite.ResultsPart1:TheRoleofPromotionsasaReferralSourceIntoEAPOurfirstresearchquestionconcernedtheroleofthevariouspromotional“interventions”inwhypeoplechosetousetheEAP.ThiswastestedwithdatacollectedroutinelyduringeachEAPintakecall,whentheclientisaskedtoindicatetheirreferralsource.Atotalof13kindsofreferralsourceswerecodedfromtheclientintakesduringthe2015and2016period(SeeTable1).

Thisdatarevealedthatabout1inevery3casesreported“promotionalmaterial”asthereasonleadingtotheiruseoftheEAP.Thiswasthemostcommonlyreportedtypeofthe13referralsources.ThisfindingprovidessomemeasureofconfidencethatpostcardsmayhavehadsomeroleintheuseoftheEAP.However,thespecifickindofpromotionalmaterials(e.g.,e-mails,postcards,wallposters,newsletters,webinars,andsoon)wasnotdefinedinmoredetailinthismeasure.Table1:ReferralSourcesforEAPCasesReferralSource Percentage

ofEAPCasesPromotionalMaterials 32.5%UsedServiceBefore 24.7%HumanResources 9.1%Family 9.0%BenefitsWebsite 5.8%Co-worker 3.8%Manager 3.7%NewHireOrientation 2.4%HealthFair 1.8%HealthServices 1.0%Other 0.9%KGAOnsite 0.9%Vendor 0.6%Missing/Unclassified 3.8%Note:N=5,985casesovertwoyears.AscanbeseeninTable1,thesecondmostcommonreferralservicewas“usedservicebefore,”withabout1inevery4counselingcasesreportingthattheyhadusedtheEAPinthepast.ThishighrateofrepeatuserssuggeststhatpeopleseethevalueofEAPandhadreturnedtouseadditionalservices.ReferralsfromHRstaffwasnextat9.1%ofcases.Orientationsfornewhiresatthecompanywereanother2.4%-andtheseareusuallyalsoassociatedwithHRstaff.Thus,trainingsabouttheEAPtohumanresourcesstaffappearstobesuccessfulasonewaytopromotetheEAP.


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Referralsfromafamilymemberwereat9.0%.Referralsfromotheremployeeswerereportedby3.8%ofallcases.Only3.7%ofreferralswerefromthemanagersofemployees.Lessthan1%ofcasesreportedaKGAonsiteeventasthereferralsourcefortheircalltostartcounseling.ThissuggeststhattheemployeeorientationsorotherEAPonsiteeventswererarelymentionedasthereferralsource(andthusperhapswouldhavelittleimpactonuseratesinourmorespecifictests).Similarly,only1.8%ofcasesnoted“healthfairs”asthereferralsource.Thus,havinganEAPattheemployeehealthbenefitsfairhadasmallroleinreferralintoEAP.However,bothoftheselowerratescouldalsobeduetotherelativeinfrequencywithwhichthesekindsononsiteeventsareprovidedovera12-monthperiod.Benefitsfairsaretypicallyonlydoneonceayearduringtheannualbenefitsenrollmentperiod.SomeoftheinterpersonaltypesofreferralsourceswerealsoverylikelytohavebeeninfluencedbeforehandbythegeneralpromotionalactivitiesthatincreasedawarenessoftheEAPamongHRstaff,managers,otherco-workersandfamilymembersofemployees.Whencombined,thesemorepersonalrelationship-orientedtypesofreferralsaccountedfor1in4cases.ThisdataindicatestheimportanceofsecondarypromotionsuchthatinitialawarenessoftheEAPisthensharedwithotherswhoareperceivedasrelevanttouseoftheEAP.ResultsPart2:PromotionofEAPbyPostcardsMailedtoHomeOverthetwoyears,wetracked19mailingcampaignsthatsentatotalof32,256postcardsabouttheEAPtoemployeehouseholds.Forthepostcards,wealteredouroperationalmethodologyslightlybyaddingtwodaystothecut-offdateforthetwo-weekposteventperiodtoaccountfordeliverytimefrompostofficetothehome.Thus,thebeforeperiodwas14daysandtheafterperiodwas16dayswhen

collectingusedataaroundthedateofmailingapostcard.WhenapostcardtypeofpromotionfortheEAPissenttothehomeofemployeesthereisthepotentialofreachingeligibleadditionalfamilymemberstoalsomakethemawareofEAPservices(atleastfortheemployeeswhodonotlivealone).Forthepasttwoyears,theoperationaldatashowsthatanaverageof10%ofallEAPcounselingcasestoKGAwerefamilymembersofemployees.Becauseofthisfact,thepostcardpromotionalpracticesmayhaveaslightlyhigherchancetoimproveEAPutilizationastheyarealsoreachingfamilymembers,whereastheworksiteeventsaremostlyattendedbyemployees.ThepostcardspresentedabriefdescriptiontheEAP’servicesandeligibilitytoemployeesandadultfamilymembers.Examplesofthemessagesonpostcardsvariedandincludedseveralimagesofindividualsorfamiliesorsimplegraphics.Themesofkeyphrasesonthefrontofpostcardsincluded:• Lifecanbedifficult.YourEAPcanhelp.• ConnectingwithyourEAPiseasierthanever

(usesmartphoneApp–KGAMobile)• (CompanyName)EAPandWork-Life

Programcanhelpwithmorethanyouthink.Theresultsshowedthatsendingpostcardsresultedinanaverageof0.20%increaseinthetwo-weekEAPcounselingutilizationrateacrossthe19tests.Thisisasmalleffectasitislessthanonepercentofanincrease.Duetothissmalleffectsize,possibledifferencesinchangeintheEAPuseratebetweenthespecificthemesinthepromotionalmessagesandimagesfeaturedinthe19postcardcampaignswerenotanalyzed.


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ResultsPart3:PromotionofEAPbyEventsProvidedattheWorksiteTherewere838totalworksiteeventsincludedinthestudyovertwoyearsand59,700employeesintotalwhoattendedthedifferentevents.Othereventsthathadmissingdataforthenumberofparticipantsattheeventwereexcludedfromthisanalysis.Althoughsomeemployershadmoreeventsthanothers,therewasanaverageofroughly5eventsperyearperemployer.Wellnessprogrammingeventswerethemostcommontypeofonsitepromotionwith278totaleventsoverthetwoyears.Therewasanaverageof1.7wellnesseventspereachemployerperyear.Populartopicsforthewellnesstrainingsincluded:Resiliency;StressManagement;TimeManagement;HealthyEating;andBetterSleep.HavingtheEAPatbenefitsfairswerethesecondmostcommontypeofonsitepromotionwith225eventsoverthetwoyears.Forthebenefitsfairs,KGAhadarepresentativefortheEAPpresentduringthefairasoneofmanyboothsthatarethereonavarietyofdifferentemployeebenefits.Printedmaterialsareprovided(brochures,educationalbriefs)andrepresentativesanswerquestionsabouttheEAPandhowitcanhelp.Therewasanaverageof1.4wellnesseventspereachemployerperyear;butastheseareusuallydoneonlyonceayearatthebenefitsenrollmentperiod,thisratereflectsthatlargersizeemployersheldbenefitsfairsatmultipleworksites.OrientationstoemployeesabouttheEAPwereroutinepresentationsfromKGAthatfocusedonwhattheEAPcanoffer,howandwhenitshouldbeused,andraisingawarenessofallofthedifferentservices.Weprovided147oftheseeventsintotalovertwoyearsforanaverageof0.9pereachemployerperyear.Thecrisiseventresponsesaresomewhatdifferentfromtheotherevents.Therewere143

oftheseeventsfollowingacriticalincident(suchasrobbery,accident,employeedeath,naturaldisaster,andsoon.Therewasanaverageof0.9pereachemployerperyear.Theseinvolvedbothgroup-levelsupportprovidedshortlyaftertheincidentandalsosometimeshavinganEAPcounseloravailableonsiteforbriefperiod(i.e.,oneortwoweeks)toprovidecounselingorpost-traumasupportifneededtoindividualemployeesbeyondthegroupde-briefing.OtherdataatKGArevealsthattheseonsitecounselorsarenotactuallyusedthatoftenaftercriticalincidents.TrainingsforHRstaffontheEAPweredonetheleastoftenandonlytookplaceforthe30smallersizeemployers.Therewere45eventsovertwoyearsforanaverageof0.8pereachemployerperyear.ThesetrainingsdescribedtheroleoftheEAP,bestpracticesformakingreferralsandraisingawarenessofallofthedifferentservices.Wedefinedaparticipationrateforaneventasthenumberofemployeesattendingtheeventdivedbythetotalemployeeheadcountatsameemployeratthattime.Participationratesasapercentageofallemployeeswerethenaveragedacrossalloftherelevantemployersthatprovidedthatsametypeofevent.DescriptivefindingsfortheaverageparticipationratesforthefivedifferenttypesofeventsarelistedbelowinTable2.Table2:RatesofEmployee“Participation”inEAP-relatedEventsatWorksiteTypeofEvent Event

ParticipationRateas%ofAll

Employees

Changein2-weekEAPCaseUseRateAfter

PromotionEAPatBenefitFairs 8.27% 1in12WellnessTrainings 3.88% 1in26EAPCrisisResponse 1.09% 1in92TrainingtoHRStaff 0.71% 1in141EAPOrientations 0.17% 1in588


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Theseratesshowthatthenumberofemployeeswhoattendedaparticulareventtype,rangedonaveragefrombetween0.2%and8.3%ofallemployees.Contrastthistothe100.0%exposurerateforsendingpostcardsabouttheEAP(i.e.,everyemployeegetsthepostcard).Participationwashighestforbenefitsfairs(1inevery12employees)andforwellnesseventsprovidebytheEAP(1inevery26employees).Incontrast,orientationsabouttheEAPdoneonsiteintheworkplacehadthelowestparticipationlevel,reachingonly1inevery588employees,onaverage.OneexplanationastowhytheHRparticipationratewassolow(at0.7%ofallemployeesor1inevery141employees)isbecausetheattendancecountwasbeingcomparedagainsttotalemployeecounts.HRbriefingsactuallyonlyincludedmembersoftheHRgroupatanorganization.Typically,thereisaboutoneHRpersonperevery100employees.Whenadjustedinthisway,theparticipationrateforHReventsamongonlytheHRstaffpopulationwasactuallymuchhigherat70.1%(or7outof10HRstaff).ButwhatisunknownishowmanyemployeeswerereferredbytheHRstaffinthetwo-weekperiodimmediatelyfollowingthesetrainingsaboutEAPservicestoHR.Thefulltwo-yeardatapresentedinTable1indicatedthatabout1in10ofallEAPcasesoverthefulltwo-yearstudyperiodhadbeenreferredbytheirHRrepresentative(allofwhompresumablyhadanorientationabouttheEAPatsometimeinthepastduringtheirtenureatthecompany).ThisdataonparticipationlevelsshowsthelimitedpotentialtoraiseawarenessoftheEAPsatthesekindsofworksiteeventscomparedtothemuchgreaterreachofmassdistributiontypesofpromotions(suchaspostcardsandsendinge-mails)whicharetypicallyaresenttoallemployees.Thus,worksiteeventsreachedfarfeweremployeesoutofthetotalpossibleemployeepopulationscomparedtosendingpostcards.Yet,theemployeeswhovoluntarily

attendaworksiteeventrelatedtoEAParemakingachoicetodoso.Thus,theymaybefarmoreinterestedinlearningabouttheEAP,comparedtotheemployeewhorandomlygetspostcardthatpromotestheEAPwhentheymayormaynotbeinterestedinsuchissues.Thisdynamiccouldmakeadifferenceintheresults.ResultsforOnsiteEventsResultsshowedthatonsiteeventsinvolvingpromotionofEAPwereassociatedwithanaverageincreaseofonly0.10%intherateofutilizationforEAPcounselinginthetwo-weeksfollowingtheevent.Thisfindingwashalfasbigaswhatwasfoundforpostcards,whichhad0.20%averageincrease.However,substantialdifferencesinoutcomewereobtainedbetweenthetypesofworksitepromotionalevents(SeeTable3onnextpage).Ofthefivetypesofevents,EAPorientationsdeliveredattheworksitehadthebiggestimpactonutilization,witha0.20%increaseinthetwo-weekrateofEAPuse.HavingtheEAPatemployeebenefitsfairsattheworksitehada0.19%increaseinthetwo-weekrateofEAPuse.Incontrast,eachoftheotherthreekindsofworksiteeventshadmuchlessimpact.Acrisiseventresponseattheworksiteresultedina0.06%increaseinuse.BothtrainingstoHRstaffandwellnessprogrammingeventsattheworksitehadvirtuallyzeroeffectsontherateofEAPuse.Deeperanalysesalsorevealedthattheseeffectsforworksiteeventsweredrivenalmostentirelybytheresultsobtainedamongthesmallestsizeorganizations(i.e.,withaheadcountwithlessthan500totalemployees).Amongthissetof30smallemployers,EAPorientations(0.45%)andbenefitsfairs(0.32%)hadthebiggestchangeinEAPuserateinthefollowingtwoweeks.Thesefindingssuggestthatworksiteeventsaremoreeffectiveforsmallercompaniesthanlargerorganizations.Theonlyothersimilarsizeeffect(0.22%)wasforbenefitsfairseventsatorganizationswith500to999employees.


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Table3:Changein2-WeekUtilizationRateforEAPCounselingCasesAfterPromotionalEventsatWorksite:BySizeoftheOrganizationandCombined

SizeofOrganization*

#Org.

EAPOrientations

BenefitsFairs

CrisisEvents

WellnessTrainings

HRStaffTraining

AverageforAllEvents

<500 30 0.45% 0.32% 0.12% 0.06% 0.01% 0.19%500-1,000 21 0.09% 0.22% 0.00% -0.10% NA 0.03%1,000-4,999 24 0.03% 0.06% 0.04% 0.01% NA 0.04%5,000-9,999 5 -0.01% -0.06% 0.00% 0.04% NA 0.01%10,000+ 2 0.05% 0.02% 0.00% 0.00% NA 0.02%TotalSample 82 0.20% 0.19% 0.06% 0.00% 0.01% 0.10%*Countofallemployeesatorganization

UnderstandingtheRoleofExposureRatetotheOnsitePromotionTheresultspresentedsofaroftheimpactofdifferentkindsofpromotionalactivitiesonchangesinthetwo-weekEAPcaserateareaccurate.Butitisdifficulttoproperlycomparetheresultsbetweenthedifferentpracticeswhentheyvarydramaticallyinhowmanyoftheemployeesinthetotalpopulationwereexposedtoor“participated”inthedifferentpromotions.Forexample,incomparingtheresultsfortheEAPorientationpresentationsandthebenefitsfairs,althoughtheyhavealmostthesamesizepositive(albeitverysmall)boosttotherateofcounselinguse,thebenefitfaireventsreachedalmost50timesasmanyemployeesasdidtheEAPorientations.AnotherwaytounderstandthiswidediscrepancyinexposurelevelsforthesetwoworksiteeventsisthatanorganizationwouldneedtohavetheEAPat50benefitsfairstogetthesamenetresultinincreaseduseoftheEAPforcounselingservicesashavingjustoneorientationabouttheEAP.Whatifeachtypehadreachedthesamepercentageoftheworkforce,thenwhatwouldtheresultbe?Toanswerthisquestion,eachofthefivekindsofworksitepromotionswerestandardizedtoallhavethesamelevelofexposureat10%ofthetotalemployeepopulation.TheresultsareshowninTable4.

Giventhat1in5employeeshavebehavioralhealthrisks,gettingevenhalfofthistargetgrouptobeparticipantswouldbeagoodtargetforthesepromotions.Theresultsrevealedadramaticdifferencebetweenthetypesofevents.ProvidingEAPorientationsincreasedthetwo-weekuserateby11.67%.Thisismuchhigherthanallfouroftheotherkindsofevents,whichrangedfromanincreaseof0.09%to0.23%.Thus,assumingthelevelofparticipationisequivalent,thebasicEAPorientationisbyfarthemosteffectivetypeofonsitepromotionaltactic.Table4:EstimatedOutcomesWhenRatesofEmployee“Participation”inWorksiteEventsAreStandardizedTypeofEvent Adjusted

EventParticipationRateas%ofAllEmployees

EstimatedChangein2-weekEAPCaseUseRateAfter

PromotionEAPatBenefitFairs 10% 0.23%WellnessTrainings 10% 0.03%EAPCrisisResponse 10% 0.09%TrainingtoHRStaff 10% 0.14%EAPOrientations 10% 11.76%ThisestimationexerciseindicatedthatsomethingaboutEAPorientationsisdifferentandmoreeffectiveasawaytopromotetheEAP


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(atleastforshort-termimpactinthenexttwoweeks).OnepossibilityisthatthechoiceofanemployeetoattendapresentationabouttheEAPmayindicateagreaterreadinessinthatemployeetothentakeactionandseekassistancefromacounselor.Atanorientationsession,anemployeecanalsoaskquestionsabouttheEAPandhaveachanceforamorepersonalexchangewiththeEAPrepresentativeaboutoptionsattheEAPtopossiblyhelpwiththeirissue.Theself-selectionofcertainemployees(perhapsthoseat-riskforbehavioralhealthissues)toattendanorientationontheEAPappearstobeakeyissuetoconsiderinplanningopportunitiesforpromotionofEAP.SUMMARYInreviewofthequantitativefindings,wediscoveredthatabout1in3usersoftheEAPforcounselingreportstheinfluenceofpromotionsasasourceofreferralintotheEAP.ThetraditionalapproachofsendingpostcardsabouttheEAPtothehomesofemployeeswassomewhateffectiveonimmediateuse.Fortheonsiteevents,wefoundthatprovidingEAPorientationsandhavinganEAPrepresentativeatbenefitfairshadthemostimpactonthetwo-weekutilizationrate.Thesetwokindsofworksiteeventswereparticularlyimpactfulatsmallersizeorganizationswithlessthan500employees.Incontrast,thethreeotherkindsofworksiteeventshadlittleeffectonyieldingnewEAPcounselingcasesintheperiodrightafterapromotionhappened.Furthermore,whenholdingtherateofexposureorparticipationconstantacrossthetypesofworksiteevents,EAPorientationsweremuchmoreeffectivethananyoftheotherkindsofevents.LimitationsThefirstlimitationofthisstudyisthatnotalloftheinformationwascollectedinthesamedatabase.Thismadeitimpossiblelinktogethersomedataelements.Forexample,informationaboutpostcardsandspecialpromotionwasnotkeptinthesamesystemastheworksiteevents

(orsendinge-mails).Inordertoensuretheinformationiscompletelyaccurateandorganized,inthefutureitwouldbemoresuccessfultotrackallofthedifferenttypesofpromotionsinthesamedatabase.Eventhoughthechangeinutilizationwascalculatedfromtwoweeksbeforetotwoweeksafterthepromotionalmethodtookplace,itwasdifficulttodetermineifthenewEAPcaseswereduetothatpromotionortosomethingelse.WhenthecallertotheEAPindicatedageneralcategoryof“promotionalmaterial”butnotwhichspecifictypeofpromotion.Inaddition,itwasnotpossibletocollectinformationonpostersabouttheEAPdisplayedattheworksitesbecausetherewasnopropertrackingofposters.Thisresultedinlimitedinformationonhardcopypromotionssuchasposters.FutureresearchshouldbeconductedonpostersandthepotentialimpactonEAPutilizationrates.Whenevaluatingtheeffectofahomemailedpostcardmailing,itisimportanttokeepinmindthatthepercentincreasespossiblyincludesomeofthefamilymembersofemployeeswithfamilymemberswhomayhaverespondingtothepostcard.Recallthatourdatashowsthetypicaloverallcasesmixincludesabout10%familymembersand90%employees.Notethattheanalysisofchangesinutilizationafterworksiteeventsalsomayincludesomefamilymembersintheutilizationcountsandthusacttoskewthoseresultssomewhathigherthanexpectedifonlyemployeeuserswereincludedincalculatingthebeforeandafterpromotionutilizationrates.Lastly,asthisstudywasnotanexperimentalresearchdesignwithacontrolgroupthathadnopromotion.Itwasaretrospectiveappliedanalysisofarchivaldatawithnaturallyoccurring“interventions”consistingofthedifferentpromotionalactivities.Therefore,wecouldnotdefinitivelydetermineifthechanges


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inutilizationwemeasuredwerecausedbythepromotionalmaterialsoriftheywerecausedbyotherunknownanduncontrolledfactors.UseoftheEAPsurelyinvolvemultipleinfluences.SuggestionsforFurtherResearchFurtherstudyisneededtodetermineifourresultscanbereplicatedinotherEAPsettings.Inthislight,therearesomeaspectsofthestudydesignthatcouldbeimprovedifthiskindofappliedresearchstudywastobedoneagain.ReferralIntoEAP.WeanalyzedforthereasonoftheuseoftheEAPreportedatcaseintakeasasummaryacrossallofthecasesinthetwo-yearperiod.Thisprovidesalargesampleandreliableresult.Alternatively,wecouldhavere-codedthisdataintosmallerunitsoftimebasedonthedatethatcorrespondedtothetwo-weeksaftereachofthepromotionaleventsexaminedthatoccurred.Thistime-linkedapproachtoexaminingthereportedreferralsourcedata–althoughmoredifficulttodooperationally–wouldhaveyieldedresultsonreasonforthereferralintoEAPthatmatchedthetimeframeofthevariouspromotionalactivities.AdesignofthisnaturewouldprovideastrongerempiricallinkbetweenthekindsofpromotionsdeliveredanduseoftheEAP.EAPPromotionbyE-mails.WecouldalsotesttheimpactonutilizationofpromotionoftheEAPthroughcompanydistributionofe-mails.Almostallofourcustomerorganizationsdosendoute-mailstoallemployees–oftendoingsoonamonthlyorbi-monthlyfrequency.Forexample,themostcommontypesofe-mailsusedforpromotionarebriefone-pagedigitalmessagescalled“WellnessNotes.”TheyusuallyfeatureaKGAEAPSpotlightsectionontopicssuchas“BacktoSchoolBlues,”“SavingforYourChild’sEducation,”and“HowDoIDealwithMyChild’sSeparationAnxiety?”TheyalsousuallyincludelistingsofdatesandtopicsofupcomingonlinewebinarsofferedbytheEAP.Othertypesofe-mailsarenewsletterssentbytheHRDepartmentatthecompanytoallemployees,

newslettersjustformanagers,specialpromotions,andnoticesofupcomingworksiteevents.Weactuallydidcollectthedatafor68separatee-mailscampaignsinvolvingatotalof147,902employeesoverthetwoyearsforthesame82employers.Weusedthesametwo-weekpreandpostmeasurementperiodsforcounselorcaseuseratesasinthetestsofpostcardsandworksiteevents.Theresultsshowedthatsendingane-mailaspromotionofEAPhadvirtuallynoeffect(<0.01%change)intherateofutilizationforEAPcounselinginthetwo-weeksfollowingthee-mail.Furthermore,thislackofimpactwasfoundforallfivetypesofe-mailmessagesweexamined.However,wedonotbelievethatthisdataaccuratelyreflectsthetrueimpactofe-mailsasapromotionaltactic.Ourtestingprocedurejustwasnotagoodfitbecauseofthehighfrequencyandregularityofsendingdifferenttypesofe-mails.Sendingmonthlyandbi-monthlye-mailpromotionsmayhavecontributedtothelackofeffectswefoundfortheparticulare-mailcampaignstestedbecausethebaselineor“beforepromotion”two-weekperiodverylikelyalreadybeeninfluencedbyadifferentpriore-mailabouttheEAP.Wherethishappened,itwouldhaveresultedinverylittlechangefromthebeforetoafterperiodsiftheEAPuseduringthebeforeperiodwasalreadyslightlyelevated.Ineffect,wehadnorealbaselineinthesetests.Forthisreason,ourfindingsone-mailswerenotfeaturedinthestudy.Reflectingonourmethodologyinretrospect,weshouldhaveusedadifferentstudydesignwithamoreappropriatetestconditionthathasacleanerbeforeperiodoftimeinwhichnoothere-mailswerehappening.OutcomeTimeFrame.Morefundamentally,itisalsopossiblethatourchoicetostudyanimpactperiodoftwoweeksissimplytooshortofatimeframe.Howreasonableisittoexpectthenaturallyoccurringexperienceofwhatisoftenanacutepersonalorworkproblemtohappento


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coincidewiththe14daysafterthedateofthepostcardoranonsiteeventpromotingtheavailabilityofEAP?Otherresearchcouldexamineperiodsofimpactlongerthantwo-weeks.Usinganannualperiodoftimewithactualfull-yearutilizationdataisamorerealisticperiodforunderstandingtheoverallinfluenceofpromotions.CumulativeImpactofMultiplePromotions.Itisalsoofinteresttoexploreatacompanylevel,thecumulativeimpactofmultipledifferentkindsofpromotionaleventsthatoccurduringeachquarterorthefullyearoftime.Forexample,onecouldcountupallofthedifferentpromotionaleventsthathappenedateachemployercustomerinafullyearperiod(i.e.,numberofe-mailcampaigns,numberofpostcardcampaigns,numberofdifferentworksiteeventsofkeytypes).ThenalsocollecttheEAPclinicalcaseutilizationratefortheyearforeachemployer(andalsomaybeamoregeneralallpeopleorallactivityuseratestoo–seenextpoint).ThenwecouldseeifmoretotalpromotionalactivityduringtheyearisassociatedwithmoreuseoftheEAPoverthefullyear.TypesofEAPUtilization.OurchoicetoexamineEAPutilizationbasedonlyonclinicalcasesalsomayhavelimitedourtestofthefullimpactofthepromotions.Totheextentthatthemessaginginthepromotionalpostcards,e-mailsandworksiteeventswasrelevanttomanagerialconsultations,towork/lifeissuesupport,tolegalissues,tofinancialissues,ortoothereducationalaspectsincludedinthefullrangeofEAPservices,thenpotentialincreasesintheseotherkindsofnon-clinicalserviceswentuntested.Addinganoverallprogramutilizationmetricsthatcombinealloftheemployeeassistanceprogram,Work-Lifeprogram,andrelatedwellnessusagetothestudydesign(asdescribedinthemethodologysection)wouldtestthebroaderimpactofpromotionsbeyondonlythecounselingservices.

Conclusions ManyEAPandWork-Lifecompaniesproactivelysuggestpromotionalactivitiestoengageemployeesandfamilymemberstousetheservicesthroughavarietyofhealthpromotionactivities.Successinpromotionisdependentonacollaborationwiththeorganizationandismorechallenginginlargercompaniesthanforsmallerones.Thisstudysuggeststhatassessingthetrueimpactofpromotionisacomplicatedendeavor.Oneimplicationofourfindingsisthatwhenresourcesarelimited,theallocationofpromotionaldollarsshouldgotoprovidingorientationsabouttheEAPonsite(possiblyatmultipletimesthroughouttheyear)andalsoforexecutinghomepostcardmailings,astheincreaseinutilizationofthecounselingpartofEAPserviceswashighestamongthesetwotypesofpromotions. General Recommendations Recommendation1:Toconductaneedsassessmentofanorganizationbeforeimplementingpromotionalmethod.• Thiscanincludecollectingthe

demographicsfortheorganization,theirdesiredbehaviorchange,andiftheyaremorelikelytoviewonlinetoolsorphysicalmaterials(i.e.,brochures,postcards,posters).

• Understandingmoreaboutthecultureofthe

companywouldhelptodevelopapromotioncampaignthatismorespecifictotheorganization.

Recommendation2:Tofocusonworksitetypesofpromotionsforsmallerorganizations,specificallyforofferingEAPorientationsandbenefitsfairs.• Utilizationrateswerehighestfor

organizationswithlessthan500employeeswhencategorizedbytypeofevent.


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• OrientationsaboutEAPhadthehighest

standardizedimpactonuseandthisshouldbefeaturedineverypromotionalplan.

• Benefitsfairsalsoanimpactonutilization

andmanyclientsinterviewedstatedthattheyfoundtheseeventsverysuccessful,especiallywitharepresentativeoftheEAPpresent.

Recommendation3:Tofocuseffortonpostcardsandotherkindsofphysicalpromotionalmaterials.• Postcardswerefoundtohavesomeimpact.• Postcardsarealsoabletoreachfamily

members,ensuringthatspousesandfamilymembersarealsoviewingthepromotion.

Recommendation4:Tosuggestthatthehostorganizationcollectallofthedatainonesystemandtobettertrackpromotionalmethods.• Trackingalldatainthesamesystemwould

resultinamoreorganizedandaccuratedatacollectionandwouldprovideconsistencywhenevaluatingdata.

• Informationonpostersandphysical

promotionsshouldbetrackedinthesystem,whichwouldallowforbettercomparisonofphysicalpromotions.

• OnlineresourcesatEAPwebsiteandrelated

digitalmediapromotionscouldbetracked.Althoughnotbasedontheempiricalfindings,thefollowingrecommendationsconcernotherwaystoimprovepromotionsthatweresuggestedintheinterviewswedid.Recommendation5:Toincreasemanagerbuy-inforwhyandwhentousetheEAP.

• IfmanagersviewtheEAPasimportantandrefertheiremployees,theemployeeswillbemorelikelytoseeitsimportanceandutilizetheservice.

• Managerawarenesstrainingisoneofthe

mosteffectivewaystoaccomplishthisgoal.Recommendation6:TosuggestthatHRrepresentativesandwellnesscoordinatorspartnerwiththeirmarketingdepartmenttoaddtheEAPstothesocialmediachannelsfortheorganization(ifavailable).• Socialmediaisanunder-utilizedresource

andimplementingitcouldhelptoreachnewdemographicsandpotentiallyincreaseutilization.

• Ifcertainemployeesweregatheredintoan

onlineinterestgroupfocusedon“companywellbeing,”itmightbeeasiertoreachcertainemployeeswithonlineandmobiletypesofhealthpromotions.

Recommendation7:CreatedtargetedpromotionsofEAPbasedonemployeedemographicsandlifestageevents.• Directingpromotionalmethodstowardsthe

demographicsoftheemployeepopulationcouldbeanimportantcomponenttoincreasingEAPutilizationrates.Forexample,“millennial,”individualsbornbetween1981and1997,areskilledintechnology,tendtoworkontheirownschedule,andreceivemostoftheirhealthinformationfromtechnologyandsocialmedia.Somemillennialsactuallyprefertousetechnologyandsmartphoneappsfortheirhealth.

• Toensurehighutilizationratesfor

companieswithmanyyoungeremployees,EAPproviderscouldtargetsegmentoftheworkforcethroughmobileaccessandsocialmedia.Socialmediaispotentiallyan


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importantcomponentasitcanhelpbuildrelationshipsandimprovecommunicationforthisyoungerpopulation.17

• Otherimportanttargetgroupscouldbe

basedonstageoflifeevents,suchasnewparents,employeesapproachingretirementage,firsttimehomebuyers,andemployeescaringforagingparents.

Author Commentary WehopethesefindingsandrecommendationscancontributetoabetterunderstandingofhowtoraiseawarenessoftheEAPandengageat-riskemployeesandtheirhouseholdfamilymembersintheuseoftheEAPwhenneeded.

AsFounderandChairmanofKGA,Iwanttosharesomebackgroundonwhyweattemptedthisappliedresearchprojectandtoaddsomeinsightintowhythiskindofdata-informedanalysiseffortisneededintheEAPindustry.

Ihaveoftensaid,“EAPsareonlyasvaluableastheyarevisible.”Ifemployeesandhouseholdmembersaren’tawareoftheEAPserviceswhentheyneedassistance,wehavenohopeofhelpingthemnavigateasomewhatoverburdenedandconfusingmentalhealthsystem.Thisresearchwasanopportunitytogobeyondourday-to-dayfocusonservicedeliveryandlearnmoreaboutwhichpromotionalmethodsreallyworkbestforoptimalengagement.

TheEAPindustryhasfacedanumberofchallengesinthelastdecadesuchasmassiveconsolidationofvendors,aninfluxof“free”orbundledinsuranceproducts,anddeflatedprices.Duringthissameperiod,theneedforqualityEAPserviceshasgrownexponentiallyalongwiththepublichealthcrisesofincreasedsuicides,opioidepidemics,workplaceshootings,harassmentcomplaints,familyfinancialdistressandmore.EAPsaretoovaluabletobehiddenbehindaninsuranceproductwithlimitedaccessandwhichstripsawaykeyEAPservicestoHRandmanagers

thatsupporttheorganization(suchasactiveandongoingworksite-basedpromotions).

Onecriticalfactorthatdidn’tcomeoutinthisresearchstudywasthenecessityofdevelopingapartnershipandongoingpatternofcollaborationofeffortbetweentheEAPandthecustomerorganization.AhighqualitypartnershipinvolvesanactiveprocessofanalyzingbothEAPandorganizationaldataandthenjointlycomingupwithstrategicplanforpromotionalactivitiesandevents.ItisalsocriticalthattheEAPbecomesintegratedintothefullrangeofotherwellbeing-relatedbenefitsinordertosuccessfullycross-referbetweenalliedprogramswhenneeded.

Forexample,severalofourmostactivecustomershavehostedwellnessintegrationmeetingswhereweareabletosharetheEAPdatawithotherbenefitvendors-suchasthehealthplan,wellnessprogram,disabilityvendorandbroker.Atthesemeetings,weshareinformationaboututilizationtrendsanddecideasagroupwhichserviceswillbepromoted.Italsoservestoeducateotherserviceprovidersandhelpsustosetmutual(andrealistic)goalsforEAPutilization.Thisintegrationcomponentwasmissingfromthestatisticalkindsofanalyseswedidinthepaper,asthequalityofthecustomerrelationshipismoreofaworkculturevariableandhardtomeasureasaspecificnumber.

Inclosing,Iamfortunatetohavespentmycareerinanoccupationthathelpsindividualsnegotiatelifewhentimesgettough.MyhopeisthatthisappliedresearchwillhelptoeducatetheHRandEAPcommunitiesaboutwhatittakestomakeourprogrammorevisibleandvaluabletoemployeesandhouseholdmembers.Employeeassistanceprogramsaremorerelevantthaneverbeforeandneedtobepromotedassuch.

KathyGreer

References [1]Karg,R.S.,Bose,J..Batts,K.R.,Forman-Hoffman,V.L.,Liao,D.,Hirsch,E,Pemberton,M.R.,Colpe,L.J.,&Hedden,S.L.(2014,October).PastyearmentaldisordersamongadultsintheUnitedStates:Resultsfromthe2008–2012MentalHealthSurveillanceStudy.


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CBHSQDataReview.PublishedbytheCenterforBehavioralHealthStatisticsandQuality.Washington,DC:SAMHSA.Availablefrom:http://www.samhsa.gov/data/sites/default/files/NSDUH-DR-N2MentalDis-2014-1/Web/NSDUH-DR-N2MentalDis-2014.pdf

[2]Hilton,M.,Schuffham,P.,SheridanK.,Clearly,C.,Vecchio,N.,&Whiteford,H.(2009).Theassociationbetweenmentaldisordersandproductivityintreatedanduntreatedemployees.JournalofOccupationalandEnvironmentalMedicine,51(9),996-1003.[3]Gurchiek,K.(2015).Copingwithemployees’mentalillnessescanbechallenging.HRNews.Retrievedfrom:https://www.shrm.org/resourcesandtools/hr-topics/risk-management/pages/coping-employees-mental-illnesses.aspx[4]Mercer.(2012).Mercer2012nationalsurveyofemployer-sponsoredhealthplans.NewYork,NY:Author[5]KaiserFamilyFoundation.(2014).Kaiser/HRETsurveyofemployer-sponsoredhealthbenefits.SanFrancisco,CA:Author.Availablefrom:http://files.kff.org/attachment/2014-employer-health-benefits-survey-full-report[6]Sandys,J.(2015).TheevolutionofemployeeassistanceprogramsintheUnitedStates:A20-yearretrospectivefrom26EAPvendors.EASNAResearchNotes,5(1).[7]Heathfield,S.M.(2017).DoEAPsworkorjustmakeemployersfeelgood?TheBalance.Retrievedfrom:https://www.thebalancecareers.com/do-eaps-work-or-just-make-employers-feel-good-1917971[8]Taranowski,C.J.,&Mahieu,K.M.(2013).Trendsinemployeeassistanceprogramimplementation,structure,andutilization,2009to2010.JournalofWorkplaceBehavioralHealth,28(3),172–191.[9]Mazloff,D.(2008).TheImportanceofstrategicworksitepromotion.EmployeeAssistanceQuarterly,14(2),47–65.[10]Lashley-Giancola,W.,&Richardson,R.(1996).Promotingemployeeassistanceprogramservicestoemployees.EmployeeAssistanceQuarterly,12(2),33–46.

[11]Azzone,V.,McCann,B.,Merrick,E.,Hiatt,D.,Hodgkin,D.,Horgan,C.(2009).Workplacestress,organizationalfactorsandEAPutilization.JournalofWorkplaceBehavioralHealth24(3),344–356.[12]OfficeofDisabilityEmploymentPolicy.(2009).Programsforanewgenerationofemployeesdefiningthenextgeneration.Washington,DC:DepartmentofLabor.Retrievedfrom:https://www.dol.gov/odep/documents/employeeassistance.pdf[13]Amaral,T.,Sharar,D.,&Attridge,M.(2013).AdvancingtheEAPfieldbyapplyinginnovationintechnologyandpredictiveanalytics.PresentedattheEASNAAnnualInstitute,Chicago,IL.Retrievedfrom:http://hdl.handle.net/10713/6516[14]Attridge,M.,Cahill,T.,Granberry,S.,&Herlihy,P.(2013).TheNationalBehavioralConsortiumindustryprofileofexternalEAPvendors.JournalofWorkplaceBehavioralHealth,28(4),251-324.[15]Caffo,S.,&Greer,K.(2015).Improvingutilizationreports.JournalofEmployeeAssistance,45(1),8-11.[16]Attridge,M.,Amaral,T.,Bjornson,T.,Goplerud,E.,Herlihy,P.,McPherson,T.,Paul,R.,Routledge,S.,Sharar,D.,Stephenson,D.,&Teems,L.(2009).UtilizationofEAPServices.EASNAResearchNotes,1(5),1-5.[17]McCann,B.(2017).Reachingmillennial:Respondingtogenerationaldiversityintheworkplace.TheJournalofEmployeeAssistance,47(1),16-19.Acknowledgement:TheauthorswishtothankandacknowledgethemanyhoursofsupportreceivedbyTysonPuetz,VP,InformationSystems,KGAandthere-analysisworkandfinaleditingofthispaperprovidedbyDr.MarkAttridge,AttridgeConsulting/EditorofEASNAResearchNotes.Suggested Citation: Shepps, H., & Greer, K. (2018). Exploring the Impact of Promotion on the Use of EAP Counseling: A Retrospective Analysis of Postcards and Worksite Events for 82 Employers at KGA. EASNA Research Notes, Vol. 7, No. 2 Available from: http://www.easna.org/publications

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Exploring the Impact of Promotion on the Use of …...2018/06/02 · utilized program. Promotion of EAP Programs Research indicates that the successful marketing of EAP services leads