Homecare Worker Health and Safety Laura Stock, MPH Labor Occupational Health Program UC Berkeley May 2, 2011

Pop Quiz Homecare workers have ___higher injury rate than workers in the general workforce. 20% 30% 50% 70%

NIOSH Homecare Worker Study: Workers Safety and Health Consumers Safety and Health Homecare Worker and Consumer Safety and Health Safe HomeSafe Workplace

Study Methods Interviews (workers, unions, agencies, advocacy groups, consumers) Focus groups (English, Spahish, Cantonese) Data analysis

Study Results: Stressful tasks associated with personal care Unassisted consumer lifting and transferring Bathing Dressing (especially putting on shoes and lifting legs) Pushing/pulling/lifting wheelchair Supporting consumer while walking or catching them while falling Using needles or sharps/wound care

Results: Stressful tasks associated with housekeeping chores Cleaning kitchen/bathroom/floors Carrying groceries Moving boxes and furniture Prolonged standing

Conclusions Most workers have no training but want it Workers unaware of simple assist devices – gait belts, shower chairs, transfer boards Workers have limited health information Workers comp, blood-borne pathogens, job- related stress, etc. Conflicts between consumers and workers may pose health risks to workers Most consumers homes are not well- equipped for the services they need

Challenges in Addressing Health and Safety Workers are employed in many locations Each workplace is unique Population is very diverse (multiple languages) Consumers are often low income with little access to resources

NIOSH Intervention Study Goal: Develop interventions to improve the safety and health of homecare workers Approach: Community-based participatory research methods

Specific Aims Stage 1: Research and develop intervention materials (handbook and training program) Stage 2: Field test using peer mentors Stage 3: Evaluate effectiveness Stage 4: Disseminate materials (social marketing)

Challenges of Developing Effective Interventions Homecare workers dont always identify as workers with the right to a safe workplace Consumers dont always identify as employers and may lack resources/ability to take on that role Workers may not believe they can make changes Health and safety is not seen as important by many workers and consumers

Intervention Challenges cont. Hard to balance need to cover lots of information and the need for simplicity Hard to meet the needs of such a diverse group of workers and consumers Lack of organizational resources (no training, no time to address safety) Lack of easily accessible referral services

Intervention Materials: The Homecare Workers Handbook

Safety Tip Example

Taking Action

Health and Safety Workshop Designed to: Increase understanding/awareness of homecare worker health and safety Prepare workers to use the materials to identify and address hazards Promote effective communication between homecare worker and consumer

Where Does it Hurt?

Identifying Hazards Hazard Stickers:

Taking Action

Social Marketing Campaign Identifying key messages that will resonate and promote worker health and safety Determining effective dissemination strategies Creating posters/giveaways that can promote materials and messages

Lessons Learned Homecare workers want and value opportunities to share experiences with other workers The relationship between workers and consumers must be respected Involving workers and consumers is essential to creating relevant, useful and practical materials

Lessons, cont. There is a need for easily accessed, local resources – people need to know who to call Communication and negotiation skills are critical to addressing hazards – people need help in advocating for their needs

Next Steps Conduct formal evaluation Work with partners and worker/consumer leaders to promote use of materials and the recognition of importance of homecare worker health and safety Work with stakeholders to address institutional barriers Share materials and lessons learned with others across state and nation

Other Resources on Homecare Health and Safety fety/index fety/index

Discussion Questions: How are you planning to address this issue in your curricula? Where can worker health and safety information be most easily inserted? What further resources/assistance do you need regarding homecare worker health and safety issues?

Thank You Laura Stock, MPH