Effects of a training program for home health care workers on the provision of preventive activities and on the health-related behavior of their clients: A quasi-experimental study

Abstract

BackgroundBecause home health care workers repeatedly visit the same older adults, they are in an excellent position to improve the health-related behavior of older adults, their clients, by providing preventive activities. ObjectivesThe objective of this study was to determine the short- and medium term effects of an intervention to support workers in providing preventive activities for older adults. To do this, the number of activities undertaken by workers and the health-related behavior of their clients were assessed. DesignA quasi-experimental study was performed with a pre-post design and inclusion of one control group. SettingsThe study took place in a deprived, semi-rural area in The Netherlands (2011–2013). Data in three districts served by one home health care organization were gathered. ParticipantsThe participants were home health care workers (registered nurses and nurse aides) and home health care clients aged 55 and over (community-dwelling, dependent older adults receiving home health care). 205 home health care workers participated in the study, 97 of them in the first effect measurement; and 83 of them in the second effect measurement. A total of 304 home health care clients participated, 214 of them in the first effect measurement; and 186 of them in the second effect measurement. MethodsDifferences in change were determined in health-related behavior between groups of older adults as a result of training home health care workers in preventive activities ResultsIn the control group of home health care professionals a significant increase was found regarding the provision of preventive activities for the domain ‘weight’ (partial eta squared: 0.05 and 0.08 at first and second effect measurements, respectively). We found preventive activities performed by home health care professionals to have no significant effects on older adult-reported health-related behavior, but observed in the intervention group a non-significant trend in improvement of physical activity of, respectively, 85 and 207min for the first and second effect-measurements. ConclusionThis training program had hardly any effect on preventive activities performed by home health care workers and on the health-related behavior of older adults. Offering health promotion via home health care workers may be promising but its delivery should be enhanced.