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Markkanen PK, Gore RJ, Sama SR, Lindberg JE, Galligan CJ, Quinn MM. Coaching Home Care Clients to Prepare Their Homes for Safe Care Visits: A Mixed-Methods Study to Evaluate a Nurse-Led Educational Intervention Process. Int J Environ Res Public Health 2024; 21:360. [PMID: 38541359 PMCID: PMC10970455 DOI: 10.3390/ijerph21030360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 03/10/2024] [Accepted: 03/14/2024] [Indexed: 04/11/2024]
Abstract
Assuring home care (HC) workers' safety is challenging because the work environment is a private home. This paper presents the process evaluation for a proof-of-concept safety intervention study to assess whether nurse-led safety coaching, using motivational interviewing and a safety handbook, could enable HC clients to improve safety in their homes. The process evaluation objectives were to (i) document the intervention's implementation progress and (ii) assess the intervention's dose delivery, dose reception, and fidelity. Five agencies employing liaisons (n = 5) and nurse managers (NMs, n = 8) implemented this study's intervention and control arms. NMs assigned to the intervention arm (n = 6) coached 34 clients. Process evaluation metrics were assessed with mixed-methods data from (i) surveys completed by NMs during the intervention, (ii) postintervention audio-recorded and transcribed interviews (n = 6) with NMs and liaisons, and (iii) study progress tracking tools. The delivered dose efficiency was 85%, measured by the distribution of safety handbook copies to clients. About 94% of clients (n = 32) were considered "engaged" or "maybe engaged" during the safety coaching. Most coached clients (n = 30) were reachable for follow-up by NMs to assess intervention progress. Despite challenges, the intervention was implemented with good fidelity. Safety coaching can be applied in many HC contexts in larger populations.
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Affiliation(s)
- Pia K. Markkanen
- Safe Home Care Project, Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell (UMASS Lowell), Lowell, MA 01854, USA; (R.J.G.); (S.R.S.); (J.E.L.); (C.J.G.); (M.M.Q.)
| | - Rebecca J. Gore
- Safe Home Care Project, Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell (UMASS Lowell), Lowell, MA 01854, USA; (R.J.G.); (S.R.S.); (J.E.L.); (C.J.G.); (M.M.Q.)
- Department of Biomedical Engineering, Francis College of Engineering, University of Massachusetts Lowell (UMASS Lowell), Lowell, MA 01854, USA
| | - Susan R. Sama
- Safe Home Care Project, Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell (UMASS Lowell), Lowell, MA 01854, USA; (R.J.G.); (S.R.S.); (J.E.L.); (C.J.G.); (M.M.Q.)
| | - John E. Lindberg
- Safe Home Care Project, Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell (UMASS Lowell), Lowell, MA 01854, USA; (R.J.G.); (S.R.S.); (J.E.L.); (C.J.G.); (M.M.Q.)
| | - Catherine J. Galligan
- Safe Home Care Project, Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell (UMASS Lowell), Lowell, MA 01854, USA; (R.J.G.); (S.R.S.); (J.E.L.); (C.J.G.); (M.M.Q.)
| | - Margaret M. Quinn
- Safe Home Care Project, Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell (UMASS Lowell), Lowell, MA 01854, USA; (R.J.G.); (S.R.S.); (J.E.L.); (C.J.G.); (M.M.Q.)
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Cho J, Toffey B, Silva AF, Shalev A, Safford MM, Phillips E, Lee A, Wiggins F, Kozlov E, Tsui EK, Dell N, Avgar AC, Andreae SJ, Sterling MR. To care for them, we need to take care of ourselves: A qualitative study on the health of home health aides. Health Serv Res 2023; 58:697-704. [PMID: 36815290 PMCID: PMC10154157 DOI: 10.1111/1475-6773.14147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVE To understand the perspectives of home health aides (HHAs) toward their own health and health behaviors, and how their job impacts both. DATA SOURCES AND STUDY SETTING Interviews were conducted with 28 HHAs from 16 unique home care agencies from August 2021 to January 2022. The study was conducted in partnership with the 1199SEIU Training and Employment Fund, a labor-management fund of the largest health care union in the US. STUDY DESIGN A qualitative study with English and Spanish-speaking HHAs. Interviews were conducted using a semi-structured topic guide, informed by Pender's Health Promotion Model and the National Institute for Occupational Safety and Health's Total Worker Health Model. To be eligible, HHAs had to be currently employed by a home care agency in New York, NY. DATA COLLECTION/EXTRACTION METHODS Interviews were recorded, professionally transcribed, and analyzed thematically. PRINCIPAL FINDINGS The 28 HHAs had a mean age of 47.6 years (SD 11.1), 39% were non-Hispanic Black, 43% were Hispanic, and they had a mean of 14.1 years (SD 7.8) of job experience. Five themes emerged; HHAs were: (1) Healthy enough to work, but were managing their own chronic conditions while working; (2) Motivated to be healthy, in part driven by their desire to care for others; (3) Worked closely with sick patients, which influenced their perceptions of health; (4) Experienced occupational and patient-level barriers to practicing healthy behaviors; (5) Sought support and resources to improve their health and wellbeing. CONCLUSIONS HHAs have numerous health challenges, many of which are influenced by their job. Culturally and occupationally tailored interventions may mitigate the barriers that HHAs experience to achieve optimal health.
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Affiliation(s)
- Jacklyn Cho
- Renaissance School of Medicine at Stony Brook UniversityStony BrookNew YorkUSA
| | - Brittany Toffey
- New York Presbyterian Hospital, Weill Cornell MedicineNew YorkNew YorkUSA
| | - Ariel F. Silva
- Division of General Internal Medicine, Department of MedicineWeill Cornell MedicineNew YorkNew YorkUSA
| | - Ariel Shalev
- New York Presbyterian Hospital, Weill Cornell MedicineNew YorkNew YorkUSA
| | - Monika M. Safford
- Division of General Internal Medicine, Department of MedicineWeill Cornell MedicineNew YorkNew YorkUSA
| | - Erica Phillips
- Division of General Internal Medicine, Department of MedicineWeill Cornell MedicineNew YorkNew YorkUSA
| | - Ann Lee
- 1199SEIU Training and Employment FundsNew YorkNew YorkUSA
| | - Faith Wiggins
- 1199SEIU Training and Employment FundsNew YorkNew YorkUSA
| | - Elissa Kozlov
- School of Public HealthRutgers UniversityNew BrunswickNew YorkUSA
| | - Emma K. Tsui
- School of Public HealthCity University of New YorkNew YorkNew YorkUSA
| | | | - Ariel C. Avgar
- School of Industrial Labor RelationsCornell UniversityIthacaNew YorkUSA
| | | | - Madeline R. Sterling
- Division of General Internal Medicine, Department of MedicineWeill Cornell MedicineNew YorkNew YorkUSA
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Olson R, Hess JA, Turk D, Marino M, Greenspan L, Alley L, Donovan C, Rice SPM. COMMunity of Practice And Safety Support for Navigating Pain (COMPASS-NP): study protocol for a randomized controlled trial with home care workers. Trials 2023; 24:264. [PMID: 37038235 PMCID: PMC10088173 DOI: 10.1186/s13063-023-07149-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 02/08/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND Chronic pain is a prevalent and costly problem that often has occupational origins. Home care workers (HCWs) are at high risk for work-related injuries, pain, and disability. Current treatments for chronic pain emphasize medications, which are an inadequate stand-alone treatment and can produce significant adverse effects. METHODS In this translational study, we will adapt an established work-based injury prevention and health promotion program (COMmunity of Practice And Safety Support: COMPASS) to address the needs of HCWs experiencing chronic pain. COMPASS employs peer-led, scripted group meetings that include educational content, activities, goal setting, and structured social support. The translated intervention, named COMPASS for Navigating Pain (COMPASS-NP), will be delivered in an online group format. Safety protections will be strengthened through an ergonomic self-assessment and vouchers for purchasing ergonomic tools. Educational content will integrate a self-management approach to chronic pain using proven cognitive-behavioral therapy (CBT) principles. We will use a mixed-methods hybrid type 2 evaluation approach to assess effectiveness and implementation. A cluster-randomized waitlist control design will involve 14 groups of 10 HCWs (n = 140) recruited from Washington, Oregon, and Idaho. Half of the groups will be randomly selected to complete the intervention during the first 10 weeks, while the waitlist groups serve as controls. During weeks 10-20, the waitlist groups will complete the intervention while the original intervention groups complete a follow-up period without further intervention. Our primary hypothesis is that COMPASS-NP will reduce pain interference with work and life. Secondary outcomes include injury and pain prevention behaviors, pain severity, changes in medication use, risk for opioid misuse, well-being, physical activity, and sleep. Qualitative data, including phone interviews with group facilitators and organizational partners, will evaluate the implementation and guide dissemination. DISCUSSION The results will advance the use and knowledge of secondary prevention interventions such as ergonomic tools and cognitive behavior therapy, to reduce injury, pain, and disability and to encourage appropriate uses of analgesic medications among HCWs. TRIAL REGISTRATION ClinicalTrials.gov NCT05492903. Registered on 08 August 2022.
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Affiliation(s)
- Ryan Olson
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, 3222 SW Research Drive, Portland, OR, 97239-3098, USA
- Oregon Health & Science University-Portland State University School of Public Health, VPT, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA
- Department of Psychology, Portland State University, P.O. Box 751, Portland, OR, 97207-0751, USA
| | - Jennifer A Hess
- Labor Education & Research Center, University of Oregon, 1675 Agate Street, Eugene, OR, 97403-1289, USA.
| | - Dennis Turk
- Department of Anesthesiology & Pain Medicine, University of Washington, BB 1425 HSC, Box 356540, 1949 NE Pacific Street, Seattle, WA, 98195-6540, USA
| | - Miguel Marino
- Oregon Health & Science University-Portland State University School of Public Health, VPT, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA
- Family Medicine, School of Medicine, Oregon Health & Science University, FM, 3181 SW Sam Jackson Park, Portland, OR, 97239, USA
| | - Leah Greenspan
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, 3222 SW Research Drive, Portland, OR, 97239-3098, USA
| | - Lindsey Alley
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, 3222 SW Research Drive, Portland, OR, 97239-3098, USA
| | - Courtney Donovan
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, 3222 SW Research Drive, Portland, OR, 97239-3098, USA
| | - Sean P M Rice
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, 3222 SW Research Drive, Portland, OR, 97239-3098, USA
- Oregon Health & Science University-Portland State University School of Public Health, VPT, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA
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O'Connor T, Kinsella J, O'Hora D, McNamara J, Meredith D. Safer tomorrow: Irish dairy farmers' self-perception of their farm safety practices. J Safety Res 2022; 82:450-458. [PMID: 36031275 DOI: 10.1016/j.jsr.2022.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 07/14/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Encouraging safe work practices (SWPs) is challenging in agriculture. Group-based social learning has effectively promoted SWPs and health behaviors in other occupations, and could be applied in agriculture (e.g., through farmer discussion groups (DGs)). In Ireland, dairy DG members are more likely to adopt novel technologies and practices, a relationship that might extend to SWPs. The extent of SWP adoption among Irish dairy farmers is unknown. This paper evaluates a 2018 baseline study of SWP implementation, conducted as part of a dairy DG-based intervention study. METHOD A paper-based survey of SWP implementation and safety self-perception was distributed to 1,220 farmers from 84 dairy DGs. For eight SWPs, associated with high-risk farm hazards (livestock, slurry, machinery, or tractors), farmers were asked how frequently they implemented these practices in the previous year, and how frequently they intended to do so next year (0: never, 1: rarely, 2: sometimes, 3: most of the time, 4: all of the time). RESULTS Surveys were completed by 460 farmers. For the previous year, three SWPs, related to slurry, machinery, and tractor hazards, scored a median frequency of four. Four SWPs, related to livestock, slurry, and machinery hazards, scored a median frequency of three. The lowest median score (two) was for tractor exit behavior. Median intention scores matched or exceeded past frequency for all SWPs, while 73% intended to increase implementation of at least one SWP. Most (96%) considered themselves a "safe farmer." CONCLUSIONS Farmers generally perceived themselves to be safe at work, which is reflected in their SWP implementation. Most farmers intended to increase SWP implementation, suggesting awareness of safety shortcomings and a desire to farm more safely. PRACTICAL APPLICATIONS This study can inform farm safety promotion initiatives. The disconnect between farmers' safety self-perception and SWP implementation merits further research.
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Affiliation(s)
- Tracey O'Connor
- School of Agriculture and Food Science, University College Dublin, Dublin, Ireland.
| | - Jim Kinsella
- School of Agriculture and Food Science, University College Dublin, Dublin, Ireland.
| | - Denis O'Hora
- School of Psychology, National University of Ireland Galway, Galway, Ireland.
| | | | - David Meredith
- Rural Economy Development Programme, Teagasc Food Science Research Centre, Dublin 15, Ireland.
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Ibrahim Puri J. Disease-specific nutrition for the elderly and their Caretakers- What was and what could be. J Prev Interv Community 2021; 50:51-71. [PMID: 34569445 DOI: 10.1080/10852352.2021.1915732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Older adults who suffer from chronic illnesses often employ the help of Home Care Aides (HCAs). These HCAs assist their client's nutrition and other activities of daily living. However, many HCAs who care for the elderly are themselves unaware of proper nutrition habits that can improve health outcomes. This project proposal centers on a nutrition-training program that focuses on HCAs and their knowledge of proper nutrition. It will challenge participants to eat better using foods are best suited to the chronic illness that their client suffers from. APPROACH The Nutrition Training Package contains materials that can be used in training sessions conducted over two days. Each day consists of interactive activities, discussions and presentations. These materials were adapted from interventions used by the Healthy Aging Program- an intervention previously hosted by EverThrive IL. OUTCOMES Although pilot testing is yet to be conducted, the training package is complete and ready for implementation. CONCLUSION Based on literature review, the contents of the Nutrition Training Package for Home Care Aides will guide participants through stages of the Model of Change, simultaneously creating the self-efficacy to contribute to elongated, healthier living for the elderly.
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Wipfli B, Wild S, Hanson GC, Shea SA, Winters-Stone K, Thosar SS. The active workplace study: Protocol for a randomized controlled trial with sedentary workers. Contemp Clin Trials 2021; 103:106311. [PMID: 33539991 DOI: 10.1016/j.cct.2021.106311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 01/25/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Sedentary behavior is pervasive in the workplace and is harmful to health. Research on the effectiveness of comprehensive workplace interventions to reduce sedentary behavior and improve worker health and safety is crucial as sedentary jobs become more common. METHODS We developed a Total Worker Health intervention targeting sedentary behavior in call centers, and are evaluating intervention effectiveness in a randomized controlled trial. Four worksites will be randomly assigned to an intervention or control condition. The intervention condition includes the provision of active workstations along with programs and procedures at environmental, organizational, and individual levels. Control worksites will receive active workstations with no additional support, following common organizational practices. RESULTS Outcomes include objectively measured physical activity, biological markers of health, and self-report survey data at baseline, after the 6-month intervention or control period, and at a 12-month follow-up. CONCLUSIONS The aims of the study are to determine whether a Total Worker Health intervention has stronger impacts on workplace sedentary behavior, uninterrupted bouts of sitting, and worker health and safety compared to a usual practice control condition. The study will inform future workplace sedentary behavior intervention and dissemination research, along with organizational best practices for reducing sedentary behavior in the workplace.
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Olson R, Hess JA, Parker KN, Thompson SV, Rameshbabu A, Luther Rhoten K, Marino M. From Research-to-Practice: An Adaptation and Dissemination of the COMPASS Program for Home Care Workers. Int J Environ Res Public Health 2018; 15:E2777. [PMID: 30544530 DOI: 10.3390/ijerph15122777] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 11/22/2018] [Accepted: 11/24/2018] [Indexed: 11/17/2022]
Abstract
The COMmunity of Practice And Safety Support (COMPASS) program was developed to prevent injuries and advance the health and well-being of home care workers. The program integrates elements of peer-led social support groups with scripted team-based programs to help workers learn together, solve problems, set goals, make changes, and enrich their supportive professional network. After a successful pilot study and randomized controlled trial, COMPASS was adapted for the Oregon Home Care Commission’s training system for statewide dissemination. The adapted program included fewer total meetings (7 versus 13), an accelerated meeting schedule (every two weeks versus monthly), and a range of other adjustments. The revised approach was piloted with five groups of workers (total n = 42) and evaluated with pre- and post-program outcome measures. After further adjustments and planning, the statewide rollout is now in progress. In the adaptation pilot several psychosocial, safety, and health outcomes changed by a similar magnitude relative to the prior randomized controlled trial. Preliminary training evaluation data (n = 265) show high mean ratings indicating that workers like the program, find the content useful, and intend to make changes after meetings. Facilitating factors and lessons learned from the project may inform future similar efforts to translate research into practice.
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Wolfenden L, Goldman S, Stacey FG, Grady A, Kingsland M, Williams CM, Wiggers J, Milat A, Rissel C, Bauman A, Farrell MM, Légaré F, Ben Charif A, Zomahoun HTV, Hodder RK, Jones J, Booth D, Parmenter B, Regan T, Yoong SL. Strategies to improve the implementation of workplace-based policies or practices targeting tobacco, alcohol, diet, physical activity and obesity. Cochrane Database Syst Rev 2018; 11:CD012439. [PMID: 30480770 PMCID: PMC6362433 DOI: 10.1002/14651858.cd012439.pub2] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Given the substantial period of time adults spend in their workplaces each day, these provide an opportune setting for interventions addressing modifiable behavioural risk factors for chronic disease. Previous reviews of trials of workplace-based interventions suggest they can be effective in modifying a range of risk factors including diet, physical activity, obesity, risky alcohol use and tobacco use. However, such interventions are often poorly implemented in workplaces, limiting their impact on employee health. Identifying strategies that are effective in improving the implementation of workplace-based interventions has the potential to improve their effects on health outcomes. OBJECTIVES To assess the effects of strategies for improving the implementation of workplace-based policies or practices targeting diet, physical activity, obesity, tobacco use and alcohol use.Secondary objectives were to assess the impact of such strategies on employee health behaviours, including dietary intake, physical activity, weight status, and alcohol and tobacco use; evaluate their cost-effectiveness; and identify any unintended adverse effects of implementation strategies on workplaces or workplace staff. SEARCH METHODS We searched the following electronic databases on 31 August 2017: CENTRAL; MEDLINE; MEDLINE In Process; the Campbell Library; PsycINFO; Education Resource Information Center (ERIC); Cumulative Index to Nursing and Allied Health Literature (CINAHL); and Scopus. We also handsearched all publications between August 2012 and September 2017 in two speciality journals: Implementation Science and Journal of Translational Behavioral Medicine. We conducted searches up to September 2017 in Dissertations and Theses, the WHO International Clinical Trials Registry Platform, and the US National Institutes of Health Registry. We screened the reference lists of included trials and contacted authors to identify other potentially relevant trials. We also consulted experts in the field to identify other relevant research. SELECTION CRITERIA Implementation strategies were defined as strategies specifically employed to improve the implementation of health interventions into routine practice within specific settings. We included any trial with a parallel control group (randomised or non-randomised) and conducted at any scale that compared strategies to support implementation of workplace policies or practices targeting diet, physical activity, obesity, risky alcohol use or tobacco use versus no intervention (i.e. wait-list, usual practice or minimal support control) or another implementation strategy. Implementation strategies could include those identified by the Effective Practice and Organisation of Care (EPOC) taxonomy such as quality improvement initiatives and education and training, as well as other strategies. Implementation interventions could target policies or practices directly instituted in the workplace environment, as well as workplace-instituted efforts encouraging the use of external health promotion services (e.g. gym membership subsidies). DATA COLLECTION AND ANALYSIS Review authors working in pairs independently performed citation screening, data extraction and 'Risk of bias' assessment, resolving disagreements via consensus or a third reviewer. We narratively synthesised findings for all included trials by first describing trial characteristics, participants, interventions and outcomes. We then described the effect size of the outcome measure for policy or practice implementation. We performed meta-analysis of implementation outcomes for trials of comparable design and outcome. MAIN RESULTS We included six trials, four of which took place in the USA. Four trials employed randomised controlled trial (RCT) designs. Trials were conducted in workplaces from the manufacturing, industrial and services-based sectors. The sample sizes of workplaces ranged from 12 to 114. Workplace policies and practices targeted included: healthy catering policies; point-of-purchase nutrition labelling; environmental supports for healthy eating and physical activity; tobacco control policies; weight management programmes; and adherence to guidelines for staff health promotion. All implementation interventions utilised multiple implementation strategies, the most common of which were educational meetings, tailored interventions and local consensus processes. Four trials compared an implementation strategy intervention with a no intervention control, one trial compared different implementation interventions, and one three-arm trial compared two implementation strategies with each other and a control. Four trials reported a single implementation outcome, whilst the other two reported multiple outcomes. Investigators assessed outcomes using surveys, audits and environmental observations. We judged most trials to be at high risk of performance and detection bias and at unclear risk of reporting and attrition bias.Of the five trials comparing implementation strategies with a no intervention control, pooled analysis was possible for three RCTs reporting continuous score-based measures of implementation outcomes. The meta-analysis found no difference in standardised effects (standardised mean difference (SMD) -0.01, 95% CI -0.32 to 0.30; 164 participants; 3 studies; low certainty evidence), suggesting no benefit of implementation support in improving policy or practice implementation, relative to control. Findings for other continuous or dichotomous implementation outcomes reported across these five trials were mixed. For the two non-randomised trials examining comparative effectiveness, both reported improvements in implementation, favouring the more intensive implementation group (very low certainty evidence). Three trials examined the impact of implementation strategies on employee health behaviours, reporting mixed effects for diet and weight status (very low certainty evidence) and no effect for physical activity (very low certainty evidence) or tobacco use (low certainty evidence). One trial reported an increase in absolute workplace costs for health promotion in the implementation group (low certainty evidence). None of the included trials assessed adverse consequences. Limitations of the review included the small number of trials identified and the lack of consistent terminology applied in the implementation science field, which may have resulted in us overlooking potentially relevant trials in the search. AUTHORS' CONCLUSIONS Available evidence regarding the effectiveness of implementation strategies for improving implementation of health-promoting policies and practices in the workplace setting is sparse and inconsistent. Low certainty evidence suggests that such strategies may make little or no difference on measures of implementation fidelity or different employee health behaviour outcomes. It is also unclear if such strategies are cost-effective or have potential unintended adverse consequences. The limited number of trials identified suggests implementation research in the workplace setting is in its infancy, warranting further research to guide evidence translation in this setting.
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Affiliation(s)
- Luke Wolfenden
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Sharni Goldman
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - Fiona G Stacey
- University of Newcastle, Hunter Medical Research Institute, Priority Research Centre in Health Behaviour, and Priority Research Centre in Physical Activity and NutritionSchool of Medicine and Public HealthCallaghanNSWAustralia2287
| | - Alice Grady
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Melanie Kingsland
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - Christopher M Williams
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - John Wiggers
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Andrew Milat
- NSW Ministry of HealthCentre for Epidemiology and EvidenceNorth SydneyNSWAustralia2060
- The University of SydneySchool of Public HealthSydneyAustralia
| | - Chris Rissel
- Sydney South West Local Health DistrictOffice of Preventive HealthLiverpoolNSWAustralia2170
| | - Adrian Bauman
- The University of SydneySchool of Public HealthSydneyAustralia
- Sax InstituteThe Australian Prevention Partnership CentreSydneyAustralia
| | - Margaret M Farrell
- US National Cancer InstituteDivision of Cancer Control and Population Sciences/Implementation Sciences Team9609 Medical Center DriveBethesdaMarylandUSA20892
| | - France Légaré
- Université LavalCentre de recherche sur les soins et les services de première ligne de l'Université Laval (CERSSPL‐UL)2525, Chemin de la CanardièreQuebecQuébecCanadaG1J 0A4
| | - Ali Ben Charif
- Centre de recherche sur les soins et les services de première ligne de l'Université Laval (CERSSPL‐UL)Université Laval2525, Chemin de la CanardièreQuebecQuebecCanadaG1J 0A4
| | - Hervé Tchala Vignon Zomahoun
- Centre de recherche sur les soins et les services de première ligne ‐ Université LavalHealth and Social Services Systems, Knowledge Translation and Implementation Component of the SPOR‐SUPPORT Unit of Québec2525, Chemin de la CanardièreQuebecQCCanadaG1J 0A4
| | - Rebecca K Hodder
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Jannah Jones
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
| | - Debbie Booth
- University of NewcastleAuchmuty LibraryUniversity DriveCallaghanNSWAustralia2308
| | - Benjamin Parmenter
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
| | - Tim Regan
- University of NewcastleThe School of PsychologyCallaghanAustralia
| | - Sze Lin Yoong
- University of NewcastleSchool of Medicine and Public HealthCallaghanNSWAustralia2308
- Hunter Medical Research InstituteNew LambtonAustralia
- Hunter New England Local Health DistrictHunter New England Population HealthWallsendAustralia
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Mabry L, Parker KN, Thompson SV, Bettencourt KM, Haque A, Luther Rhoten K, Wright RR, Hess JA, Olson R. Protecting workers in the home care industry: workers’ experienced job demands, resource gaps, and benefits following a socially supportive intervention. Home Health Care Serv Q 2018; 37:259-276. [DOI: 10.1080/01621424.2018.1470590] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Linda Mabry
- Department of Teaching and Learning, Washington State University Vancouver, Vancouver, WA, USA
| | - Kelsey N. Parker
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA
| | - Sharon V. Thompson
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA
| | - Katrina M. Bettencourt
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA
| | - Afsara Haque
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA
| | - Kristy Luther Rhoten
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA
| | - Rob R. Wright
- Department of Psychology, Brigham Young University-Idaho, Rexburg, ID, USA
| | - Jennifer A. Hess
- Labor and Education Research Center, University of Oregon, Eugene, OR, USA
| | - Ryan Olson
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA
- Oregon Health & Science University and Portland State University School of Public Health, Portland, OR, USA
- Department of Psychology, Portland State University, Portland, OR, USA
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10
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Hittle B, Agbonifo N, Suarez R, Davis KG, Ballard T. Complexity of occupational exposures for home health-care workers: nurses vs. home health aides. J Nurs Manag 2016; 24:1071-1079. [PMID: 27406330 DOI: 10.1111/jonm.12408] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2016] [Indexed: 12/28/2022]
Abstract
AIM To identify occupational exposures for home health-care nurses and aides. BACKGROUND Home health-care workers' occupational injury rates in the USA are higher than the national average, yet research on causative exposures and hazards is limited. METHODS Participants were interviewed about annual frequency of occupational exposures and hazards. Exposure and hazard means were compared between home health-care nurses and aides using a Wilcoxon two-sample test. RESULTS A majority of the sample was over 40 years old and obese, potentially increasing injury risks. Home health-care nurses performed more clinical tasks, increasing exposure to blood-borne pathogens. Home health-care aides performed more physical tasks with risk for occupational musculoskeletal injuries. They also dispensed oral medications and anti-cancer medications, and were exposed to drug residue at a frequency comparable to home health-care nurses. Both groups were exposed to occupational second-hand smoke. CONCLUSIONS Establishing employee safety-related policies, promoting healthy lifestyle among staff, and making engineered tools readily available to staff can assist in decreasing exposures and hazards. IMPLICATIONS FOR NURSING MANAGEMENT Implications for nursing management include implementation of health-promotion programmes, strategies to reduce exposure to second-hand smoke, ensuring access to and education on assistive and safety devices, and education for all staff on protection against drug residue.
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Affiliation(s)
- Beverly Hittle
- College of Nursing, University of Cincinnati, Cincinnati, OH, USA
| | - Noma Agbonifo
- Department of Environmental Health, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Rassull Suarez
- Department of Environmental Health, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Kermit G Davis
- Department of Environmental Health, College of Medicine, University of Cincinnati, Cincinnati, OH, USA.
| | - Tangela Ballard
- College of Nursing, University of Cincinnati, Cincinnati, OH, USA
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Olson R, Thompson SV, Elliot DL, Hess JA, Rhoten KL, Parker KN, Wright RR, Wipfli B, Bettencourt KM, Buckmaster A, Marino M. Safety and Health Support for Home Care Workers: The COMPASS Randomized Controlled Trial. Am J Public Health 2016; 106:1823-32. [PMID: 27552270 DOI: 10.2105/ajph.2016.303327] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To determine the effectiveness of the COMmunity of Practice And Safety Support (COMPASS) Total Worker Health intervention for home care workers. METHODS We randomized 16 clusters of workers (n = 149) to intervention or usual-practice control conditions. The 12-month intervention was scripted and peer-led, and involved education on safety, health, and well-being; goal setting and self-monitoring; and structured social support. We collected measures at baseline, 6 months, and 12 months, which included workers' experienced community of practice (i.e., people engaged in a common activity who interact regularly for shared learning and improvement). Implementation occurred during 2013 and 2014 in Oregon. RESULTS In an intent-to-treat analysis, relative to control, the intervention produced significant and sustained improvements in workers' experienced community of practice. Additional significant improvements included the use of ergonomic tools or techniques for physical work, safety communication with consumer-employers, hazard correction in homes, fruit and vegetable consumption, lost work days because of injury, high-density lipoprotein cholesterol, and grip strength. Consumer-employers' reports of caregiver safety behaviors also significantly improved. CONCLUSIONS COMPASS was effective for improving home care workers' social resources and simultaneously impacted both safety and health factors.
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Affiliation(s)
- Ryan Olson
- At the time of the study, Ryan Olson, Sharon V. Thompson, Kristy Luther Rhoten, Kelsey N. Parker, Brad Wipfli, Katrina M. Bettencourt, Annie Buckmaster, and Robert R. Wright were with the Oregon Institute of Occupational Health Sciences, Oregon Health & Science University (OHSU), Portland. Miguel Marino is with the Department of Family Medicine, OHSU. Diane L. Elliot is with the Division of Health Promotion and Sports Medicine, OHSU. Jennifer A. Hess is with the Labor Education and Research Center, University of Oregon, Eugene
| | - Sharon V Thompson
- At the time of the study, Ryan Olson, Sharon V. Thompson, Kristy Luther Rhoten, Kelsey N. Parker, Brad Wipfli, Katrina M. Bettencourt, Annie Buckmaster, and Robert R. Wright were with the Oregon Institute of Occupational Health Sciences, Oregon Health & Science University (OHSU), Portland. Miguel Marino is with the Department of Family Medicine, OHSU. Diane L. Elliot is with the Division of Health Promotion and Sports Medicine, OHSU. Jennifer A. Hess is with the Labor Education and Research Center, University of Oregon, Eugene
| | - Diane L Elliot
- At the time of the study, Ryan Olson, Sharon V. Thompson, Kristy Luther Rhoten, Kelsey N. Parker, Brad Wipfli, Katrina M. Bettencourt, Annie Buckmaster, and Robert R. Wright were with the Oregon Institute of Occupational Health Sciences, Oregon Health & Science University (OHSU), Portland. Miguel Marino is with the Department of Family Medicine, OHSU. Diane L. Elliot is with the Division of Health Promotion and Sports Medicine, OHSU. Jennifer A. Hess is with the Labor Education and Research Center, University of Oregon, Eugene
| | - Jennifer A Hess
- At the time of the study, Ryan Olson, Sharon V. Thompson, Kristy Luther Rhoten, Kelsey N. Parker, Brad Wipfli, Katrina M. Bettencourt, Annie Buckmaster, and Robert R. Wright were with the Oregon Institute of Occupational Health Sciences, Oregon Health & Science University (OHSU), Portland. Miguel Marino is with the Department of Family Medicine, OHSU. Diane L. Elliot is with the Division of Health Promotion and Sports Medicine, OHSU. Jennifer A. Hess is with the Labor Education and Research Center, University of Oregon, Eugene
| | - Kristy Luther Rhoten
- At the time of the study, Ryan Olson, Sharon V. Thompson, Kristy Luther Rhoten, Kelsey N. Parker, Brad Wipfli, Katrina M. Bettencourt, Annie Buckmaster, and Robert R. Wright were with the Oregon Institute of Occupational Health Sciences, Oregon Health & Science University (OHSU), Portland. Miguel Marino is with the Department of Family Medicine, OHSU. Diane L. Elliot is with the Division of Health Promotion and Sports Medicine, OHSU. Jennifer A. Hess is with the Labor Education and Research Center, University of Oregon, Eugene
| | - Kelsey N Parker
- At the time of the study, Ryan Olson, Sharon V. Thompson, Kristy Luther Rhoten, Kelsey N. Parker, Brad Wipfli, Katrina M. Bettencourt, Annie Buckmaster, and Robert R. Wright were with the Oregon Institute of Occupational Health Sciences, Oregon Health & Science University (OHSU), Portland. Miguel Marino is with the Department of Family Medicine, OHSU. Diane L. Elliot is with the Division of Health Promotion and Sports Medicine, OHSU. Jennifer A. Hess is with the Labor Education and Research Center, University of Oregon, Eugene
| | - Robert R Wright
- At the time of the study, Ryan Olson, Sharon V. Thompson, Kristy Luther Rhoten, Kelsey N. Parker, Brad Wipfli, Katrina M. Bettencourt, Annie Buckmaster, and Robert R. Wright were with the Oregon Institute of Occupational Health Sciences, Oregon Health & Science University (OHSU), Portland. Miguel Marino is with the Department of Family Medicine, OHSU. Diane L. Elliot is with the Division of Health Promotion and Sports Medicine, OHSU. Jennifer A. Hess is with the Labor Education and Research Center, University of Oregon, Eugene
| | - Brad Wipfli
- At the time of the study, Ryan Olson, Sharon V. Thompson, Kristy Luther Rhoten, Kelsey N. Parker, Brad Wipfli, Katrina M. Bettencourt, Annie Buckmaster, and Robert R. Wright were with the Oregon Institute of Occupational Health Sciences, Oregon Health & Science University (OHSU), Portland. Miguel Marino is with the Department of Family Medicine, OHSU. Diane L. Elliot is with the Division of Health Promotion and Sports Medicine, OHSU. Jennifer A. Hess is with the Labor Education and Research Center, University of Oregon, Eugene
| | - Katrina M Bettencourt
- At the time of the study, Ryan Olson, Sharon V. Thompson, Kristy Luther Rhoten, Kelsey N. Parker, Brad Wipfli, Katrina M. Bettencourt, Annie Buckmaster, and Robert R. Wright were with the Oregon Institute of Occupational Health Sciences, Oregon Health & Science University (OHSU), Portland. Miguel Marino is with the Department of Family Medicine, OHSU. Diane L. Elliot is with the Division of Health Promotion and Sports Medicine, OHSU. Jennifer A. Hess is with the Labor Education and Research Center, University of Oregon, Eugene
| | - Annie Buckmaster
- At the time of the study, Ryan Olson, Sharon V. Thompson, Kristy Luther Rhoten, Kelsey N. Parker, Brad Wipfli, Katrina M. Bettencourt, Annie Buckmaster, and Robert R. Wright were with the Oregon Institute of Occupational Health Sciences, Oregon Health & Science University (OHSU), Portland. Miguel Marino is with the Department of Family Medicine, OHSU. Diane L. Elliot is with the Division of Health Promotion and Sports Medicine, OHSU. Jennifer A. Hess is with the Labor Education and Research Center, University of Oregon, Eugene
| | - Miguel Marino
- At the time of the study, Ryan Olson, Sharon V. Thompson, Kristy Luther Rhoten, Kelsey N. Parker, Brad Wipfli, Katrina M. Bettencourt, Annie Buckmaster, and Robert R. Wright were with the Oregon Institute of Occupational Health Sciences, Oregon Health & Science University (OHSU), Portland. Miguel Marino is with the Department of Family Medicine, OHSU. Diane L. Elliot is with the Division of Health Promotion and Sports Medicine, OHSU. Jennifer A. Hess is with the Labor Education and Research Center, University of Oregon, Eugene
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