Study: EAP Works Across Cultures and Borders

By David A. Sharar, PhD, Matthew Mollenhauer, MS, and Paul Heck, M.Ed


A recent study created by Chestnut Global Partners in partnership with DuPont demonstrated positive results from the Workplace Outcome Suite-5 (WOS-5) in more than 80 countries worldwide.

The WOS is short, precise, and well suited for pre- and post-test EAP studies. It uses a Likert-type rating scale that examines the effects of personal issues in relation to workplace functioning and overall life satisfaction.

The WOS uses five constructs: absenteeism, presenteeism, work engagement, work distress, and life satisfaction. The CGP/DuPont study found statistical evidence of improvement in each of these constructs in four world regions: Asia, Europe, Latin America, and the United States. The findings were presented at EAPA’s 2015 World EAP Conference in San Diego, California.

Study Origins
In 2014, DuPont and its EAP vendor partners, subcontractors, and affiliates in other nations focused on quantifying the impact of DuPont’s original claim for its EAP – that when employee personal concerns and employer performance issues overlap – and DuPont employees take advantage of their EAP, DuPont could expect positive workplace effects. Even though EAP has played a core role in DuPont’s benefits portfolio, process metrics and intuitive qualitative assessments alone were no longer sufficient to satisfy key decision-makers and executive leaders.

If improved productivity arises from providing quality EAP services, such findings would provide credible documentation to DuPont leadership regarding the productivity payback of its EAP. To the best of our knowledge, DuPont is the first multi-national corporation to systematically measure workplace outcomes for its global EAP.

The study examined self-report data from a large sample of 1,140 employee clients who used DuPont’s worldwide EAP services, as managed by its Integrated Health Services Department.

For non-English speaking countries, each primary DuPont regional EAP vendor used language-appropriate staff to translate the WOS short version in a “forward” and “backward” fashion. “Forward” means translating the English version into the target language. “Back” implies translating the target language back into English. After the forward and back translations, a different staff member from the various vendors compared the original English version with the back-translated copy for equivalence in meaning. Differences were noted and subsequently changed between the translators. 

Methods

*Study design. A repeated measures design was used to examine possible changes over time in the five WOS items from before to after the use of EAP services. The method of data collection was embedded into the routine EAP initial assessment and follow-up processes at each DuPont program. Employees were given the before (or pre-test) at the end of the initial intake call to set up an EAP appointment. The pre-test was administered by trained intake counselors at each regional or country-specific EAP call center.

*Follow-up period. A goal of the study was to determine if an improvement in work performance after use of the EAP persists over time, so the post-test measure was not assessed immediately after the final EAP session. Instead a three-month follow-up period was featured to see if the intervention had a sustained impact over this period. The various participating EAP vendors each conducted the follow-up at roughly 90 days after the last use of the EAP service. However, the actual number of days after the post-test was administered varied as some employee clients took longer to complete it than others.

*Participant recruitment and sample. Only the employee clients of DuPont’s EAP (and not family members or dependents) were included in the study. This was important to focus on the relationship between EAP intervention and work performance within DuPont. Employees who accessed EAP services from DuPont’s various global locations were invited to voluntarily complete the WOS evaluation. The final study sample included a total of 1,140 employee clients across the four world regions. This was a robust sample size.

*Data preparation. Each of the EAP providers submitted data from their organization to the authors with responses for each client listed separately on a single line in an Excel spreadsheet. The data was combined across all of the EAP vendors and then transferred as one aggregated dataset to a Statistical Package for the Social Sciences (SPSS) software program for statistical analysis. (SPSS is a widely used program for statistical analysis in social science.) Preliminary descriptive analyses revealed a range across participants in WOS scores at each time period.

*Statistical analyses. Frequencies for all five item responses were checked for bad or out-of-range data. Paired t-test analyses were performed to compare the Before EAP and After EAP mean scores to detect differences beyond chance levels for all items except absenteeism. The other four items: presenteeism, work engagement, workplace distress, and life satisfaction were more typically distributed. With a large sample size the study had a high level of statistical authority, which can make even a small difference between means to be found statistically “significant.” 

Results
Tests showed a statistically significant change for each item. Each of these changes was in the anticipated direction of improvement following use of EAP services. The results break out as follows:

* Absenteeism. Results revealed an average of nearly 7 (6.89 to be exact) fewer hours of missed work due to personal problems in the past 30 days after EAP use compared the previous 30 days before EAP use. The overall result was an 81.7% reduction in work absenteeism hours.

* Presenteeism. Employees also reported that their personal problems interfered less with their ability to concentrate at work after use of the EAP. This resulted in a nearly 30% (28.8%) decrease in the level of workplace presenteeism.

* Work engagement. After use of the EAP, employees on average reported feeling more eager to get to the job site. The overall result was a 15.53% increase in the level of work engagement.

* Work distress. Employees on average reported experiencing less dread about going to work. The result was a 20.6% decrease in the level of work distress.

* Life satisfaction. The change in level of life satisfaction was also positive, as more employees on average agreed that their life was going well after the EAP as opposed to before use of the EAP. The end result was a 26.7% increase in life satisfaction.

Size of Effects
Although all five of the WOS measures had significant changes, the size of the effects between the different items was not consistent. The largest sizes of improvements after EAP use were for work absenteeism, presenteeism, and life satisfaction. Consequently, the ability to be at work when scheduled, to be productive at work, and to have an improved subjective sense about one’s quality of life all represented large size changes among the users of EAP services.

Regional Differences
Even though the results from all four world regions moved in the right direction, several items were not statistically significant:

* In Europe, work engagement increased by 9% with a p-value of 0.089.
* In Latin America, workplace distress decreased by 11% with a p-value of 0.204. (This may be due to smaller sample sizes in these regions.)
* It is also worth noting that Asia had an 89% reduction in absenteeism, but the actual number that hours were reduced was small at 1.12 hours. This could be related to cultural differences in either missing work or the reporting of absent hours.

Summary
Even though the exact kinds of EAP services examined in this study were not specified, these outcomes suggest that EAP intervention in a general or generic way are associated with improvements in all four workplace outcome areas and also in overall life satisfaction.
Global EAP services in a cross-cultural context are highly heterogeneous and varied, along with the types and severities of problems that clients bring to the EAP. Thus, it seems that despite the generic nature of global EAP services there is sufficient intervention to produce a significant improvement in outcomes. To a global corporate purchaser who is invested in using EAP as a work productivity enhancement, these results lend credibility to the value proposition of a global EAP.
In the absence of a non-EAP user group, this study cannot prove that the use of an EAP alone caused these improvements among employees who used the EAP. However, it does demonstrate a statistically significant level of improvement after EAP use for all of the areas examined as well as a strong association with work improvements, with particularly large changes regarding absenteeism and presenteeism.
It is also important to note that these findings were obtained using a common and appropriately translated measurement tool with the data collected across many different countries and EAP providers, which was then combined into a large sample of employees from a single multi-national corporation. Consequently, the results are likely to be reliable and representative of what the majority of global or regional EAP providers can be expected to deliver as improvements in workplace outcomes.

Dave Sharar, PhD, is the Chief Clinical Officer of Chestnut Health Systems and a Research Scientist with Chestnut Global Partners Division of Commercial Science. He is co-developer of the widely adopted Workplace Outcome Suite, a free and validated tool to help EA providers measure the workplace effects of EA services. Matthew Mollenhauer, MS, LCPC, is Managing Director with CGP. Paul Heck, M.Ed., is an international business consultant, and former Global Manager, Employee Assistance & WorkLife Services with DuPont.