David L Snow PhD
Professor Emeritus of Psychiatry and Professor in the Child Study Center and of Epidemiology (Chronic Diseases)
Prevention; Health promotion; Workplace interventions; Stress; Coping; Social support; Intimate partner violence
- Further testing of the efficacy of the Coping with Work and Family Stress intervention on behavioral and physical health outcomes with new populations and within a broader spectrum of settings (e.g., medical students in university settings).
- Testing modifications of the Coping with Work and Family Stress intervention with selected, high-risk populations (e.g., family caregivers in the workplace or women in community settings at risk for AIDS and substance abuse).
- Conducting longitudinal, risk and protective factor research to identify individual and organizational factors predictive of behavioral and physical health outcomes in the general population as well as among an aging workforce.
- Continued collaboration in examining the precursors, correlates, and outcomes of intimate partner violence (both victimization and perpetration) for women and men.
Research is focused in two areas: (1) studies to identify risk and protective factors (e.g., stressors, traumatic events, coping, social support) that are predictive of psychological symptoms, substance abuse, intimate partner violence, and other behavioral and health outcomes; and (2) studies to examine the effectiveness of interventions implemented in the workplace and other community-based settings at modifying key risk and protective factors and preventing psychiatric disorders, substance abuse, and other negative behavioral and health outcomes.
Extensive Research Description
There is increasing interest in the development of workplace preventive interventions as a means of reaching large segments of the adult population to address the potentially adverse effects of work, family, work-family, and other stressors. The spectrum of documented stress-related problems among workers is extensive, ranging from psychological symptoms, including depression, anxiety, and somatic complaints to substance abuse to physical health problems such as heart disease, hypertension, and obesity. These problems are costly to employers, employees and their families as well as to society at large. It is estimated that in the workplace, billions of dollars are lost each year in diminished productivity, high rates of absenteeism, and reduced performance resulting from these types of stress-related problems.
The Yale Work and Family Stress Program was initially established through two grants funded by NIDA and NIAAA (David L. Snow, PI). Based on a risk and protective factor model, these investigations assessed whether an intervention, Coping with Work and Family Stress, aimed at increasing individuals’ use of active coping strategies and social support, reducing stressors and avoidance coping, and enhancing effective stress management approaches led to the prevention or reduction of alcohol and drug use and psychological symptoms. Essential components of the research included: 1) identifying risk and protective factors that are predictive of substance use and psychological symptoms and that can be targeted in subsequent interventions; and 2) assessing the effectiveness of randomized controlled interventions implemented in the workplace. Significant effects of these efficacy trials have been shown in reducing work, family, and work-family stressors, increasing social support from supervisors and coworkers, enhancing the use active coping and decreasing the use of avoidance coping strategies, and in reducing alcohol consumption, smoking and other substance use, and psychological symptoms of anxiety, depression, and somatic complaints. Based on these research findings, Coping with Work and Family Stress was designated by SAMHSA in 2003 as a Model Prevention Program and, more recently (2007), was listed as an evidence-based program by the National Registry of Effective Programs and Practices (NREPP). Building on this phase of research, effectiveness trials are currently underway with new populations and settings, most notably with medical residents in training at university medical schools. In addition to this ongoing research, the program is now in a stage of active dissemination nationally and internationally. Future intervention research will involve: (1) efforts to change risk and protective factors at multiple levels of the organization (individual employee, work group or department, overall organization) in order to achieve even greater effect sizes, (2) to test the efficacy of modified, but related, interventions designed specifically for family caregivers in the workplace, in one instance, and, in another, for women in community settings at risk for HIV/AIDS and substance abuse disorders, (3) to disseminate science-based workplace interventions to military personnel and their families; and 4) to collaborate on a study of the effects of changes in Time and Place Management (TPM) policies (i.e. workplace flexibility) on employee health, well being, and productivity in a large U.S. corporation