Developing a Workplace Program to Reduce Alcohol Abuse and Risky Sex in Alaska

描述(申请人提供)：在美国，大多数有酒精问题风险的成年人和许多从事危险性行为的人都是有工作的，并在工作场所度过了相当长的时间。此外，酗酒以及与计划外怀孕和性传播感染等高风险性行为有关的后果与缺勤、流失率、伤害率和医疗费用增加有关(医学研究所，1994年；马丁，1994年)，特别是在贫困劳动者中。因此，工作场所具有巨大的潜力，可以用来识别处于这些行为风险中或从事这些行为的低薪工人。在拟议的为期两年的R21研究中，我们试图开发一种与工作场所相关的干预措施，以减少阿拉斯加低工资员工中的酒精滥用/误用和危险的性行为。指导这一方法的两个理论框架：1)酒精和工作场所危险性行为的文化方法(改编自Ames&Janes，1992)和2)计划行为理论(Ajzen&Madden，1998)。这两个理论使我们能够包括工作环境的组织和文化方面，以及低薪工人酗酒/滥用和危险性行为的个人决定因素。我们计划将这项拟议的研究设在阿拉斯加，原因有几个：这是一个服务不足、研究不足的州，酗酒、性传播感染和意外怀孕的比率很高。我们在安克雷奇也有现有的研究基础设施，并与那里的研究和药物滥用预防社区积极合作。在第一年，我们计划与雇用低薪服务人员的公司发展合作，并与雇员和雇主进行定性研究，以更好地了解酒精使用/滥用、危险性行为、性传播感染(包括艾滋病毒)和意外怀孕的模式；以及行为和结果与工作环境之间的联系。在第二年，我们将与雇主和雇员进行定量调查研究，以评估酒精使用/滥用、危险性行为、性传播感染(包括艾滋病毒)和意外怀孕的流行率，以及这些行为与工作场所环境之间的关系，并评估与工作场所相关的计划的可能组成部分的可接受性，以减少酒精使用/滥用和危险性行为。 基于这些发现，我们将开发和试行工作场所相关预防计划的初始版本，以减少阿拉斯加低薪服务工作者的酒精使用/滥用、危险性行为和性传播感染，为更大规模的R01应用做准备。这项拟议的研究将使我们能够通过项目直接影响低薪工人的危险行为，并通过工作场所的文化和环境间接影响危险行为。该项目还将使我们能够提出一个争议较少的项目，而不是一个只关注危险性行为的项目，并利用酒精和危险性行为之间的联系。

DESCRIPTION (provided by applicant): In the U.S., the majority of adults who are at risk for alcohol problems and many who engage in risky sexual behavior are employed and spend a considerable amount of time in the workplace. In addition, alcohol abuse and outcomes related to high risk sexual behaviors such as unplanned pregnancies and STI infections are associated with job absenteeism, turnover, injury rates and increased medical care costs (Institute of Medicine, 1994; Martin, 1994), particularly among the working poor. Thus the workplace holds great potential as a venue for the identification of low wage workers who are at risk for, or engage in, these behaviors. In the proposed two year R21 study we seek to develop a workplace-linked intervention to reduce alcohol abuse/misuse and risky sexual behavior among low-wage employees in Alaska. Two theoretical frameworks guide this approach: 1) a Cultural Approach to Alcohol and Risky Sex the Workplace (adapted from Ames & Janes, 1992), and 2) the Theory of Planned Behavior (Ajzen & Madden, 1998). These two theories allow us to include both the organizational and cultural aspects of the work environment and individual level determinants of alcohol use/abuse and risky sexual behaviors of low-wage workers. We plan to base the proposed study in Alaska for several reasons: it is an underserved and under- researched state with high rates of alcohol abuse, STIs and unplanned pregnancies. We also have an existing research infrastructure in Anchorage and active collaborations with the research and substance abuse prevention communities there. In Year 1 we plan to develop collaborations with companies which employ low- wage service workers and conduct qualitative research with employees and employers to better understand the patterns of alcohol use/abuse, risky sexual behavior, STIs (including HIV) and unintended pregnancy; and the links among behaviors and outcomes and the workplace environment. During Year 2, we will conduct quantitative survey research with employers and employees to assess the prevalence of alcohol use/abuse, risky sexual behavior, STIs (including HIV) and unintended pregnancy and the relationships among these behaviors and the workplace environment and assess the acceptability of possible components of a workplace-linked program to reduce alcohol use/abuse and risky sexual behaviors. Based on these findings we will develop and pilot test an initial version of a workplace-linked prevention program to reduce alcohol use/abuse, risky sex, and STIs in low-wage service workers in Alaska in preparation for a larger R01 application. The proposed study will allow us to potentially affect risky behavior directly among low wage worker through programs as well as indirectly through the culture and environment of the workplace. The project will also enable us to propose a program less controversial than one focusing solely on risky sex, and capitalize on the links between alcohol and risky sex.