IMPORTANCE Investment in workplace wellness programs is increasing despite concerns about lack of clinical benefit and return on investment (ROI). In contrast, outcomes from workplace mental health programs, which treat mental health difficulties more directly, remain mostly unknown. OBJECTIVE To determine whether participation in an employer-sponsored mental health benefit was associated with improvements in depression and anxiety, workplace productivity, and ROI as well as to examine factors associated with clinical improvement. DESIGN, SETTING, AND PARTICIPANTS This cohort study included participants in a US workplace mental health program implemented by 66 employers across 40 states from January 1, 2018, to January 1, 2021. Participants were employees who enrolled in the mental health benefit program and had at least moderate anxiety or depression, at least 1 appointment, and at least 2 outcome assessments. INTERVENTION A digital platform that screened individuals for common mental health conditions and provided access to self-guided digital content, care navigation, and video and in-person psychotherapy and/or medication management. MAIN OUTCOMES AND MEASURES Primary outcomes were the Patient Health Questionnaire-9 for depression (range, 0-27) score and the Generalized Anxiety Disorder 7-item scale (range, 0-21) score. The ROI was calculated by comparing the cost of treatment to salary costs for time out of the workplace due to mental health symptoms, measured with the Sheehan Disability Scale. Data were collected through 6 months of follow-up and analyzed using mixed-effects regression. RESULTS A total of 1132 participants (520 of 724 who reported gender [71.8%] were female; mean [SD] age, 32.9 [8.8] years) were included. Participants reported improvements from pretreatment to posttreatment in depression (b = -6.34; 95% CI, -6.76 to -5.91; Cohen d = -1.11; 95% CI, -1.18 to -1.03) and anxiety (b = -6.28; 95% CI, -6.77 to -5.91; Cohen d = -1.21; 95% CI, -1.30 to -1.13). Symptom change per log-day of treatment was similar post-COVID-19 vs pre-COVID-19 for depression (b = 0.14; 95% CI, -0.10 to 0.38) and anxiety (b = 0.08; 95% CI, -0.22 to 0.38). Workplace salary savings at 6 months at the federal median wage was US $3440 (95% CI, $2730-$4151) with positive ROI across all wage groups. CONCLUSIONS AND RELEVANCE Results of this cohort study suggest that an employer-sponsored workplace mental health program was associated with large clinical effect sizes for employees and positive financial ROI for employers.
Estimates of species’ ranges can inform many aspects of biodiversity research and conservation-management decisions. Many practical applications need high-precision range estimates that are sufficiently reliable to use as input data in downstream applications. One solution has involved expert-generated maps that reflect on-the-ground field information and implicitly capture various processes that may limit a species’ geographic distribution. However, expert maps are often subjective and rarely reproducible. In contrast, species distribution models (SDMs) typically have finer resolution and are reproducible because of explicit links to data. Yet, SDMs can have higher uncertainty when data are sparse, which is an issue for most species. Also, SDMs often capture only a subset of the factors that determine species distributions (e.g., climate) and hence can require significant post-processing to better estimate species’ current realized distributions. Here, we demonstrate how expert knowledge, diverse data types, and SDMs can be used together in a transparent and reproducible modeling workflow. Specifically, we show how expert knowledge regarding species’ habitat use, elevation, biotic interactions, and environmental tolerances can be used to make and refine range estimates using SDMs and various data sources, including high-resolution remotely sensed products. This range-refinement approach is primed to use various data sources, including many with continuously improving spatial or temporal resolution. To facilitate such analyses, we compile a comprehensive suite of tools in a new R package, maskRangeR, and provide worked examples. These tools can facilitate a wide variety of basic and applied research that requires high-resolution maps of species’ current ranges, including quantifications of biodiversity and its change over time.
Life-history traits represent organisms' strategies to navigate the fitness trade-offs between survival and reproduction. Eric Charnov developed three dimensionless metrics to quantify fundamental life-history trade-offs. Lifetime reproductive effort (LRE), relative reproductive lifespan (RRL) and relative offspring size (ROS), together with body mass can be used to classify life-history strategies across the four major classes of tetrapods: amphibians, reptiles, mammals and birds. First, we investigate how the metrics have evolved in concert with body mass within tetrapod lineages. In most cases, we find evidence for correlated evolution among body mass and the three dimensionless metrics. Second, we compare life-history strategies across the four classes of tetrapods and find that LRE, RRL and ROS delineate a space in which the major tetrapod classes occupy mostly unique subspaces. These distinct combinations of life-history strategies provide us with a framework to understand the impact of major evolutionary transitions in energetics, physiology and ecology.
Hutchinson's n‐dimensional hypervolume concept underlies many applications in contemporary ecology and evolutionary biology. Estimating hypervolumes from sampled data has been an ongoing challenge due to conceptual and computational issues. We present new algorithms for delineating the boundaries and probability density within n‐dimensional hypervolumes. The methods produce smooth boundaries that can fit data either more loosely (Gaussian kernel density estimation) or more tightly (one‐classification via support vector machine). Further, the algorithms can accept abundance‐weighted data, and the resulting hypervolumes can be given a probabilistic interpretation and projected into geographic space. We demonstrate the properties of these methods on a large dataset that characterises the functional traits and geographic distribution of thousands of plants. The methods are available in version ≥2.0.7 of the hypervolume r package. These new algorithms provide: (i) a more robust approach for delineating the shape and density of n‐dimensional hypervolumes; (ii) more efficient performance on large and high‐dimensional datasets; and (iii) improved measures of functional diversity and environmental niche breadth.