Health Services Insights · Published 2026-07-01 · DOI 10.1177/11786329261471267
Hong Ki Chloe Lau, Javier Mencia-Ledo, Kishana Balakrishnar, Sana Siddiqui, Raihana Premji, Paula Allen, Marilyn Grand'Maison, Allison Kelly, Ali Bani-Fatemi, Behdin Nowrouzi-Kia
Background Research on Employee Assistance Program (EAP) effectiveness has expanded in recent years, but comparative research across countries on people who have never used these services remains limited. Also, few studies have examined how low EAP usage relates to broader workplace factors and well-being. Objectives The present study aims to examine cross-national differences in health, well-being, and work conditions among working adults in Canada and the U.S. who have never used EAPs. Specifically, it explores (1) satisfaction with healthcare, work ability, and job demands; (2) quality of life; (3) self-reported happiness; and (4) key demographic and occupational factors. Methods This study employed a cross-sectional quantitative design, with adaptation from the international classification of function (ICF) framework. Data were collected through an 87-item online survey, including questions regarding demographic information and validated measures of psychological well-being (OHQ), quality of life (WHOQOL-BREF), and work ability (WAI). Participants included 179 employed adults (Canada: n = 78; U.S.: n = 101) with no prior experience of using EAP services. Data were analyzed using descriptive statistics, standardized between-country comparisons, exploratory subgroup analyses, and linear regression models. Results No significant national differences were found in overall quality of life or happiness. U.S. participants reported significantly higher overtime hours, while other between-country differences in income, work ability, physical health, and environmental quality of life were generally small or non-significant at the overall country level. Subgroup analyses revealed that socioeconomic factors (e.g., income, education) were stronger predictors of well-being in the U.S. while occupational factors (e.g., work ability, job demands) were more influential in Canada. Conclusion Cultural, economic, and structural differences between Canada and the U.S. shape how work and well-being interact across populations. Although overall well-being scores were similar between the two countries, differences emerged in predictors of well-being. These findings highlight the need for EAPs to adopt tailored strategies that address the specific needs of vulnerable subgroups within each national context.
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Lau, H., Mencia-Ledo, J., Balakrishnar, K., et al. (2026). Health, Well-Being, Work Ability and Work Conditions Among EAP Non-Users in Canada and the U.S.: A Quantitative Cross-National Comparison Study. Health Services Insights. https://doi.org/10.1177/11786329261471267