Substance Misuse Programs in Commercial Aviation Safety First (2023) / Chapter Skim
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5 Outcomes of the Human Intervention and Motivational Study and the Flight Attendant Drug and Alcohol Program: Analysis of the Available Evidence
5 Outcomes of the Human Intervention and Motivational Study and the Flight Attendant Drug and Alcohol Program: Analysis of the Available Evidence
Pages 99-114
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From page 99... ...
S econd, however, this chapter presents these data because it is important to describe what is and is not known. For example, the substantial amount of missing data due to low survey response rates are itself an important finding.
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From page 100... ...
, which assesses a flight attendant's admission and discharge dates, whether the flight attendant completed the full course of treatment, the flight attendant's presenting problem (e.g., alcohol, drugs, mental health) , whether social supports participated in treatment, details of medication-assisted therapy (e.g., whether it was offered, accepted)
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From page 101... ...
To be counted as a unique treatment episode by the analyst, treatment providers must have returned the "Primary Treatment Summary" survey with non-missing admission and discharge dates, and repeat treatment episodes had to be separated by at least 28 days. Completeness of the FADAP Database Survey response rates are important because they affect interpretation of the findings.
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From page 102... ...
N (%) P value Treatment-provider-reported broad treatment issue .37 Alcohol and mental health 329 (50.8)
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From page 103... ...
. Treatment episodes that were lost to follow-up generally did not differ from treatment episodes that were not lost to follow-up in terms of treatment-provider-reported treatment characteristics, offers of medication-assisted treatment, length of treatment, or treatment completion, and flight attendant reports from the "Initial Selfreport Survey" (see Table 5-1)
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From page 104... ...
Only 10 Airline 10 flight attendants took part in FADAP, which represents 0.01 percent of all Airline 10's full-time employees and 0.84 percent of the 1,196 flight attendants in the FADAP database.3 FADAP Treatment Episode Details Table 5-3 shows treatment episode details as reported by treatment providers in the "Primary Treatment Summary" survey. Notably, the unit of analysis is now treatment episodes (N = 1,172)
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From page 105... ...
31 (29, 43) NOTES: aDue to missing data, Ns ranged from 884 to 1,172 treatment episodes.
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From page 106... ...
Approximately half of treatment episodes involved treatment for alcohol and mental health problems (51.7%, N = 574 of 1,110 treatment episodes)
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From page 107... ...
NOTES: aThe analyses are limited to 990 treatment episodes that were eligible for the one-year follow-up survey based on discharge date by October 31, 2021. Due to high rates of nonresponse among flight attendants with eligible treatment episodes, analytic Ns ranged from 211 to 243, with the exception of the analysis of return to work.
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From page 108... ...
Additionally, the committee enlisted the help of FADAP, HIMS, the Air Line Pilots Association, International, and other contacts within aviation to directly invite flight attendants and pilots to complete the "Call for Perspectives." The committee recognizes this could have introduced selection bias into the results, but to ensure anonymity of the respondents, the link was not tracked. The "Call for Perspectives" asked about substance use and its relationship to airline industry culture, treatment initiation and recovery, and perspectives and recommendations on FADAP and HIMS.
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From page 109... ...
were not personally in recovery and not reporting substance misuse but had knowledge of a colleague or relative with a substance use disorder. Of 26 interviewees who had experience with substance misuse, all were in recovery; one had taken part in FADAP, six obtained treatment before FADAP existed, six sought treatment through the company or union Employee Assistance Program program, and the others sought treatment through other means (N = 10)
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From page 110... ...
, and the financial costs of treatment. Suggested ways to improve FADAP included increasing promotion of FADAP to increase awareness of the program, dispelling misinformation to promote voluntary enrollment, enacting more rigorous substance testing requirements, and strengthening aftercare programs.
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From page 111... ...
In addition to the HIMS executive summary, claims about HIMS effectiveness were made in the HIMS 2021 Advanced Topics Seminar. The 2021 Advanced Topics Seminar data are shown in Tables 5-5, 5-6, and 5-7 and are reproduced exactly.
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From page 112... ...
. SOURCE: Committee generated from the 2021 HIMS Advanced Topics Seminar (September 13–14, 2021, Denver, CO)
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From page 113... ...
. Unlike FADAP, the committee never received indications that HIMS and its administering organization, Air Line Pilots Association, International, ever distributed the link or sought pilot participation.
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