Abstract 13094: Eliciting Home Health Aides Perspectives Towards Achieving Cardiovascular Health

Abstract

Introduction: Home Health Aides (HHAs) provide essential care to adults with cardiovascular (CV) disease in the home. Yet, HHAs themselves are a vulnerable workforce with a high burden of cardiovascular (CV) disease risk factors, which poses challenges to their own health, and potentially their patients’. We elicited the perspectives of HHAs towards achieving CV health within the context of their job. Methods: We conducted focus groups and interviews with HHAs from January to May 2023 in partnership with the 1199SEIU Training and Employment Fund, a benefit fund of the 1199SEIU United Healthcare Workers East, the largest US healthcare union. We included English and Spanish speaking HHAs with poor CV health, defined as having: 1) hypertension, 2) obesity, and 3) ≥1 other CV disease risk factor (self-reported hyperlipidemia, diabetes, smoking, and physical inactivity). Interviews were audio-recorded, professionally transcribed, and translated. Data were analyzed thematically using the Social-Ecological Model. Results: Nineteen HHAs from 12 home care agencies participated. They had a mean age of 57 years (SD 9.3), 18 (94.7 %) were female, 9 (47.4 %) were Black, and 7 (36.8 %) were of Hispanic ethnicity. In line with the Social-Ecological Model, 5 themes emerged. At the individual level, despite having several CV disease risk factors, HHAs’ perceptions of their health ranged from poor to excellent. Many were motivated to eat healthier and be more active but faced challenges including insufficient time and their own physical limitations. At the interpersonal level, the HHA-patient relationship influenced both aides’ and patients’ health (e.g., food in patients’ home). At the community level, HHAs wanted to connect with peers to improve their CV health together. At the organizational level, shift work, long commutes, and agency culture influenced their CV health. At the policy level, structural inequities (e.g., access to health insurance, citizenship) were barriers to CV health. Conclusion: HHAs’ ability to achieve CV health was influenced by personal, interpersonal, organizational, and societal-level factors. The findings can inform future, multi-level interventions, aiming to improve the CV health of HHAs and potentially their patients.