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Article: A Novel Stress and Coping Workplace Program Reduces Illness and Healthcare Utilization

Psychosomatic Medicine 64:278-286 (2002)

Richard H. Rahe, MD, C. Barr Taylor, MD, Robbyn L. Tolles, MAT, Lynn M. Newhall, MS, RN, Tracy L. Veach, EdD and Susan Bryson, MA, MS

From the Nevada Stress Center (R.H.R., R.L.T.), VA Sierra Nevada Health Care System, Reno, NV; Department of Psychiatry (R.H.R.), Päijät-Häme Central Hospital, Lahti, Finland; Department of Psychiatry and Behavioral Sciences (C.B.T., S.B.), Stanford University School of Medicine, Stanford, CA; and Office of Medical Education (L.M.N., T.L.V.), University of Nevada School of Medicine, Reno, NV.

Correspondence: Address reprint requests to: Richard H. Rahe, MD, Nevada Stress Center, Code 151-C, VA Sierra Nevada Health Care System, 1000 Locust Street, Reno, NV 89502-2597. Email: rahe@equinox.unr.edu

OBJECTIVE: The purpose of this study was to determine if a novel workplace stress management program, delivered either face-to-face or by self-help, would reduce illness and health services utilization among participants.

METHODS: Five hundred one volunteers were randomly allocated to one of three groups: full intervention, which received assessment and personalized self-study feedback and was offered six face-to-face, small-group sessions; partial intervention, a self-help group that received assessment and personalized feedback by mail; and a wait-list control group. All participants completed questionnaires for stress, anxiety, and coping at the start of the study and 6 and 12 months later. Health reports were completed at 0, 3, 6, 9, and 12 months. A subsample of subjects who subscribed to a single health maintenance organization provided objectively recorded doctor visit data across the study year.

RESULTS: All three groups reported significant improvement in their stress, anxiety, and coping across the year. Full intervention participants showed a more rapid reduction in negative responses to stress than did participants from the other groups. Full-intervention subjects also reported fewer days of illness than subjects in the other groups. Objectively measured physician visits showed a large (34%) reduction in healthcare utilization for full intervention subjects in the HMO subsample.

CONCLUSIONS: These results indicated that a work-site program that focuses on stress, anxiety, and coping measurement along with small-group educational intervention can significantly reduce illness and healthcare utilization.

Key Words: stress, * coping, * stress management, * healthcare utilization, * illness reporting, * work site.

Abbreviations: ANOVA = analysis of variance; * HMO = health maintenance organization; * QHRQ = Quarterly Health Report Questionnaire; * ROC = relative operating curve; * SCI = Stress and Coping Inventory; * STAI = State-Trait Anxiety Inventory.

Source: http://www.psychosomaticmedicine.org/cgi/content/abstract/64/2/278