Evaluation of a training intervention for personal care assistants and the effect of age and extrinsic job satisfaction: Changes in career commitment and job satisfaction

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EVALUATION OF A TRAINING INTERVENTION FOR PERSONAL CARE ASSISTANTS AND THE EFFECT OF AGE AND EXTRINSIC JOB SATISFACTION: CHANGES IN CAREER COMMITMENT AND JOB SATISFACTION Jason Allan Rachel A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Health Related Sciences at Virginia Commonwealth University. Virginia Commonwealth University, 2011 Dissertation Directors: Iris A. Parham, Ph.D. & Constance L. Coogle, Ph.D. Home care is a vital component of the United States healthcare delivery system. The demand for home care has steadily increased over the past decade and it is projected that this increase will continue over the next several decades. Moreover, the utilization of Medicaid waiver home and community-based care services has expanded to provide an alternative to the more costly institutional placement. In order to meet this growing demand while maintaining the cost-savings, the system relies primarily on the minimally trained, healthcare paraprofessionals known as Personal Care Assistants (PCAs). The present study examined the career commitment and job satisfaction of PCAs who provide Medicaid waiver home and community-based care services and participated in a 40-hour training intervention. Specifically, the study evaluated differences in preand post-training levels of career commitment as measured by the Career Commitment Measure (CCM), in terms of overall career commitment and the three subscales: career identity, career planning, and career resilience; and job satisfaction as measured by the Minnesota Satisfaction Questionnaire (MSQ), in terms of overall job satisfaction and the two subscales: extrinsic job satisfaction and intrinsic job satisfaction, between age groups and groups based on extrinsic job satisfaction. Additionally, the study examined the interaction of age and extrinsic job satisfaction as a moderator on the influence of the training intervention to produce a change in career commitment and the three subscales of career commitment, career identity, career planning, and career resilience job satisfaction. The results of analyses were varied across groups and measures. Specifically, there were no statistically significant differences across age group in terms of changes in career commitment or job satisfaction as a consequence of the training; however, posthoc examinations revealed statistically significant within group changes. A decrease in the overall, intrinsic, and extrinsic job satisfaction score from preto post-training for the 40-49 age group was found. Likewise, the 50-59 age group showed a statistically significant decrease in the extrinsic job satisfaction scores from preto post-training. The PCA’s level of extrinsic job satisfaction did have a statistically significant differential effect on changes in overall career commitment and career planning scores as a consequence of the training. The exploration of the interaction of age and extrinsic job satisfaction to influence changes in career commitment as a consequence of the training found statistically significant main effects with respect to levels of extrinsic job satisfaction for overall career commitment, career identity, career planning, and career resilience. However, no main effects for age and no interaction effects were obtained. These study findings have important implications for future research, and the development of training curricula and evaluation. Results provide critical information about this largely overlooked group of healthcare paraprofessionals, which have practical application in more effectively improving job satisfaction through training initiatives, thereby increasing the recruitment and retention of the paraprofessional healthcare workforce.