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Project Details

Homecare Worker Health and Safety: Caring for Yourself While Caring for Others.

Homecare Workshop
Project Summary: 

LOHP’s Homecare Project is a community-based participatory research project conducted in partnership with the National Institute of Occupational Safety and Health, the Alameda County Public Authority for In-home Supportive Services, and the Service Employees United Long Term Care Workers Union. The project goals are to develop and evaluate interventions designed to improve the safety and health of homecare workers in Alameda County.

Home care workers (HCWs) who provide housekeeping and routine personal care services to elderly, disabled, or ill individuals are one of the fastest growing health care occupational groups. It is also one of the groups with the highest occupational injury rate. In 1997, the U.S. Bureau of Labor Statistics issued a special report on work-related injuries to HCWs showing an injury rate which was 50% higher than that of workers employed in the private hospital sector and 70% higher than the overall rate for all private industry workers.* Roughly 85% of the 1.5 million workers providing in-home services in the state are low-skilled or unskilled; many are immigrants or people of color. Lack of awareness of risk and lack of access to training and prevention resources designed for this underserved, at-risk population of workers contribute to their high injury rate.

The LOHP homecare project is designed to give caregivers and their clients the tools they need to identify potential hazards in the home and implement needed solutions.

Project activities have included:

  • Focus groups with workers and recipients of homecare (consumers) to identify common hazards and possible solutions
  • Field testing of our project materials conducted by a team of homecare workers and consumers
  • Development of a handbook: “Caring for Yourself While Caring for Others: Practical Tips for Homecare Workers”, in English, Spanish and Chinese. The handbook places special emphasis on promoting positive communication between caregivers and clients, in identifying solutions, and in connecting caregivers to local resources that can support their efforts to stay safe on the job
  • A social marketing campaign, including posters, cards and other giveaways, developed to spread the word about the importance of promoting safe homecare
  • Training workshop for homecare workers to help them use the handbook to improve their working conditions
  • Formal evaluation to assess impact of project intervention

* (Injuries to Caregivers Working in Patients' Homes. [1977]. In: Issues in Labor Statistics, Summary 97-4, US Dept of Labor, BLS, Washington D.C. 20212.)

Main Findings: 

Evaluation findings:

Methods: For the evaluation we recruited a sample of 317 HCWs, including all 3 language groups, who were randomized into an intervention or control group. Each worker completed two 30- minute telephone surveys separated by 2 months. The intervention group received the training and materials between the two surveys and the control group received them after completing both surveys.

Results: The 317 HCWs were predominately female (86%) and low income (64%). 185 workers (60%) had experienced some work-related injury in the last year, yet only 5 workers had reported their injury. Among the 51 workers who used sharps at work, 30% experienced an accidental needlestick injury in the past year. While the injury rate was high, most workers perceived their work to be relatively low risk, though who had experienced any work-related injury did reported a higher perception of risks. Injured workers did report greater difficulty in finding information about how to control job risks. Between the first and second survey, the intervention group reported a greater increase in risk perception and in their ease of finding information to reduce those risks compared to the control group. This difference was most pronounced for those HCWs who did not speak English.

Conclusions: Training and education materials designed for low literacy HCWs can be effective especially for immigrant workers.

Contact Person: 
Laura Stock
Contact Person's Email Address:
Research Publications and Reports: 

Gong F, Baron S, Stock L, Ayala L. (2009) Formative research in occupational health and safety intervention for diverse, underserved worker populations: a homecare worker intervention project. Public Health Reports, Volume 124, Suppl 1: 84-89.

Gong F, Baron S, Ayala L, Stock L, McDevitt S, Heaney C. (2009, November) The role for community-based participatory research in formulating policy initiatives: promoting safety and health for in-home care workers and their consumers. American Journal of Public Health, 99 Suppl 3:S531-8.

Website for Project or Program: 
Sherry Baron, National Institute of Occupational Safety and Health Linda Ayala, Alameda County Public Authority for In-home Supportive Services Pablo Serrano, SEIU-ULTCW United Long Term Care Workers