Data_Sheet_1_An Ecological Study of a Universal Employee Depression Awareness and Stigma Reduction Intervention: “Right Direction”.xlsx

Objective: Right Direction (RD) was a component of a universal employee wellness program implemented in 2014 at Kent State University (KSU) to increase employees' awareness of depression, reduce mental health stigma, and encourage help-seeking behaviors to promote mental health. We explored changes in mental health care utilization before and after implementation of RD.
Methods: KSU Human Resources census and service use data were used to identify the study cohort and examine the study objectives. A pre-post design was used to explore changes in mental health utilization among KSU employees before and after RD. Three post-intervention periods were examined. A generalized linear mixed model approach was used for logistic regression analysis between each outcome of interest and intervention period, adjusted by age and sex. Logit differences were calculated for post-intervention periods compared to the pre-intervention period.
Results: Compared to the pre-intervention period, the predicted proportion of employees seeking treatment for depression and anxiety increased in the first post-intervention period (OR = 2.14, 95% Confidence Interval [CI] = 1.37–3.34), then declined. Outpatient psychiatric treatment utilization increased significantly in the first two post-intervention periods (OR =1.89, 95% CI = 1.23–2.89; OR = 1.75, 95% CI = 1.11–2.76). No difference was noted in inpatient psychiatric treatment utilization across post-intervention periods. Unlike prescription for anxiolytic prescriptions, receipt of antidepressant prescriptions increased in the second (OR = 2.25, 95% CI = 1.56–3.27) and third (OR = 2.16, 95% CI = 1.46–3.20) post-intervention periods.
Conclusions: Effects of RD may be realized over the long-term with follow-up enhancements such as workshops/informational sessions on mindfulness, stress management, resiliency training, and self-acceptance.

研究目标：正向指引（Right Direction, RD）是肯特州立大学（Kent State University, KSU）于2014年推出的全员员工健康计划的组成模块，旨在提升员工对抑郁症的认知水平、降低心理健康污名化程度，并鼓励求助行为以促进心理健康。本研究旨在探究RD推行前后心理健康服务使用情况的变化。
研究方法：本研究使用肯特州立大学人力资源普查数据与服务使用数据确定研究队列并验证研究目标。采用前后对照设计，探究RD推行前后该校员工的心理健康服务使用变化情况，共设置三个干预后观测周期。采用广义线性混合模型（generalized linear mixed model）开展逻辑回归分析，以探究各关注结局与干预周期的关联，并以年龄、性别作为混杂因素进行调整。同时计算各干预后周期相较于干预前周期的对数差值。
研究结果：相较于干预前周期，干预后首个观测周期内，因抑郁与焦虑寻求治疗的员工预测占比有所上升（优势比（Odds Ratio, OR）= 2.14，95%置信区间（Confidence Interval, CI）= 1.37–3.34），随后出现下降。干预后前两个观测周期内，精神科门诊服务使用率显著上升（OR=1.89，95%CI=1.23–2.89；OR=1.75，95%CI=1.11–2.76）。各干预后观测周期的精神科住院服务使用率无显著差异。与抗焦虑处方获取情况不同，干预后第二、第三个观测周期内，抗抑郁处方的获取量均有所上升（OR=2.25，95%CI=1.56–3.27；OR=2.16，95%CI=1.46–3.20）。
研究结论：若后续辅以正念、压力管理、韧性训练及自我接纳相关的工作坊/信息讲座等强化措施，RD的干预效果可在长期内得以体现。