The Small Business Wellness Initiative (SBWI) is a wellness-outreach model to small businesses that builds a strategic partnership between three types of agencies in any local community: small business development centers, non-profit prevention agencies, and organizational/research consultancy. The SBWI was developed through a research grant (USDHHS) to three such organizations in North Texas. This project adapted for small businesses two 'Model' programs recognized by the National Registry of Effective Programs. You can learn about NREPP at www.nrepp.samhsa.gov (Search "Team Awareness").

The two programs have been shown to improve health-related attitudes, increase help-seeking behaviors and EAP utilization, reduce stress and stress-related drinking and problem drinking and, in some instances, illicit drug use. The primary goal of the SBWI is to provide these programs to the high-risk small businesses, which typically do not have access to such programs, and encounter many barriers to implementation.

Methods: The SBWI was implemented as a randomized research trial with psychometrically valid self-report measures assessing several health indicators. Businesses within three industries were randomly assigned to either of the interventions or a control condition. The SBWI successfully recruited 40 businesses (N = 1,352), all of which received surveys at base-line, two weeks, and six months. There were 14 businesses in construction, 10 in transportation/utilities, and 16 in hospitality/service. Of these, 13 received Team Awareness, 12 received Choices, and 15 were assigned to the no-training control group. Businesses ranged in size from 8 to 360 employees and averaged about 34 workers per businesses (54% White; 25% Hispanic/Latino; 19% Black); 16% of all participants used Spanish as their primary language so all survey and training materials were translated. Employee retention rate from pre-to-training was 88% and from pre-to- six months was 69%.

Results: Experimental results for Team Awareness include improvements in organizational climate, use of positive coping skills, and help-seeking and reductions in alcohol dependence. Key findings for Choices include improvements in exercise habits, and reductions in several substance use outcomes (alcohol use, problem drinking, and tobacco use). Qualitative findings include positive reactions from business owners and improved use of drug free workplace policies.

Conclusions or Significance: To our knowledge, the SBWI is the first evidence-based approach to bring wellness to the underserved small business population. A replication manual may be found at www.sbwi.org, including downloadable training materials, research summaries, and a list of free wellness tools. Over 50 professionals around the United States have accessed materials for replication and the SBWI has been featured in several insurance magazines.