Development and Piloting of a Community-Partnered Heart Failure Training Course for Home Health Care Workers.

BACKGROUND: Despite their unique contributions to heart failure (HF) care, home healthcare workers (HHWs) have unmet educational needs and many lack HF caregiving self-efficacy. To address this, we used a community-partnered approach to develop and pilot a HF training course for HHWs. METHODS: We partnered with the Training and Employment Fund, a benefit fund of the largest healthcare union in the United States, to develop a 2-hour virtual HF training course that met HHWs' job-specific needs. English and Spanish-speaking HHWs interested in HF training, with access to Zoom, were eligible. We used a mixed methods design with pre/postsurveys and semi-structured interviews to evaluate the course: (a) feasibility, (b) acceptability, and (c) effectiveness (change in knowledge [Dutch Heart Failure Knowledge Scale range 0-15] and caregiving self-efficacy [HF Caregiver Self-efficacy Scale range 0-100]). RESULTS: Of the 210 HHWs approached, 100 were eligible and agreed, and 70 enrolled. Of them, 53 (employed by 15 different home care agencies) participated. Posttraining data showed significant improvements (pretraining mean [SD] versus posttraining mean [SD]; P value) in HF knowledge (11.21 [1.90] versus 12.21 [1.85]; P=0.0000) and HF caregiving self-efficacy (75.21 [16.57] versus 82.29 [16.49]; P=0.0017); the greatest gains occurred among those with the lowest pre-training scores. Participants found the course engaging, technically feasible, and highly relevant to their scope of care. CONCLUSIONS: We developed and piloted the first HF training course for HHWs, which was feasible, acceptable, and improved their HF knowledge and caregiving self-efficacy. Our findings warrant scalability to the workforce at large with a train-the-trainer model.

Forgotten Front Line: Understanding the Needs of Unionized Home Health Aides in Downstate New York During the COVID-19 Pandemic.

During the coronavirus disease 2019 (COVID-19) pandemic, home health aides (HHAs) provided daily medical and personal care to community-dwelling older adults and those with chronic conditions. Prior qualitative studies have found that providing care during COVID-19 left HHAs susceptible to physical, financial, and emotional risks. However, limited quantitative data exist The objective of this study was to assess the impact of COVID-19 on HHAs and to understand the challenges and opportunities for current and future pandemic planning. A cross-sectional survey of 256 HHAs in the downstate New York region was conducted by telephone in English, French Creole, Chine, Spanish, and Russian between August and November 2020. The survey found that HHAs experienced a variety of physical, financial, and emotional challenges during COVID-19. To better support this work force, action by public health officials and policymakers is warranted, particularly with respect to workplace protections and safety, mental health, compensation, and access to basic resources.