This resubmission of a competitive renewal application for NIOSH PAR-18-812, addresses the NORA sector Healthcare and Social Assistance and NORA cross-sectors: 1) musculoskeletal health, 2) respiratory health, 3) infectious disease prevention, and 4) traumatic injury prevention. The long-term goal of the study is to protect the occupational safety and health (OSH) of home care (HC) aides. Due to the rapidly aging population, HC aide jobs are among the fastest growing occupations. There is increasing evidence that aides experience many serious OSH hazards to which they are particularly vulnerable because they are low-wage workers and yet there are few HC OSH intervention studies. A major challenge for HC OSH is that the employer has limited control over the work environment because it is a home. To address these challenges, the proposed intervention study will engage HC employers and case managers (CMs), clients and their families, in changing the home-work environment to reduce hazards for HC aides. The overall objectives are to evaluate the effectiveness of interventions and the implementation process and to translate findings to reduce OSH hazards, illness, and injuries among HC aides. The study builds on a highly productive, multidisciplinary research team working with an extensive, active industry-labor-public health-elder services partnership network. Central hypotheses are a) HC aide OSH hazards can be reduced by clients and families with assistance and tools from HC employers and CMs introduced during a client?s home assessment; and b) the interventions will lead to fewer OSH hazards to HC aides. Mixed methods with a research-to-practice (r2p) approach will be used to accomplish specific aims to: 1) Develop OSH interventions and an implementation process to reduce OSH hazards to HC aides; 2) Evaluate the extent to which changes in the home environment by HC clients can reduce the OSH hazards of the aides who visit them by: 2a) implementing OSH hazard interventions and 2b) evaluating the interventions? effectiveness; 3) Evaluate the intervention implementation process; and 4) Translate and disseminate findings via the HC partners. The approach is innovative because it aligns aide and HC client safety; targets a new, potentially powerful leverage point for HC OSH interventions; and seeks to expand OSH into the delivery of elder HC services. It is significant because it aims to reduce OSH hazards, injuries and illnesses among HC aides, a large, low-wage workforce. OSH hazards are also increasingly becoming a burden on HC employers. Expected outputs: evidence-based interventions consisting of activities, tools, and training to reduce OSH hazards for HC aides; lessons learned about how to engage HC clients and families in aide OSH. Expected outcomes- immediate: a reduction in HC aide OSH hazards; intermediate: increased awareness of aide OSH preventive measures among HC clients; incorporation of HC aide OSH in elder services and policies; new knowledge in OSH community about effective HC interventions. Long-term: a healthier, more stable HC workforce to care for our aging population.

Public Health Relevance

The proposed intervention research is relevant to public health because it will promote the health of home care (HC) aides, a low-wage, socially diverse population that provides health and social services to elders and people with disabilities. The project is relevant to the mission of the National Institute for Occupational Safety and Health because it will develop methods for preventing exposure to hazardous conditions in the workplace and translate findings into prevention practices and products to reduce work-related illness and injuries.

National Institute of Health (NIH)
National Institute for Occupational Safety and Health (NIOSH)
Research Project (R01)
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Study Section
Safety and Occupational Health Study Section (SOH)
Program Officer
Chiou, Sharon
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University of Massachusetts Lowell
Sch Allied Health Professions
United States
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Sun, Chuan; Buchholz, Bryan; Quinn, Margaret et al. (2018) Ergonomic evaluation of slide boards used by home care aides to assist client transfers. Ergonomics 61:913-922
Goodyear, Nancy; Markkanen, Pia; Beato-Melendez, Christian et al. (2018) Cleaning and disinfection in home care: A comparison of 2 commercial products with potentially different consequences for respiratory health. Am J Infect Control 46:410-416
Brouillette, Natalie M; Quinn, Margaret M; Kriebel, David (2017) Risk of Sharps Injuries to Home Care Nurses and Aides: A Systematic Review and Meta-Analysis. J Occup Environ Med 59:1072-1077
Markkanen, Pia; Galligan, Catherine; Quinn, Margaret (2017) Safety Risks Among Home Infusion Nurses and Other Home Health Care Providers. J Infus Nurs 40:215-223
Brouillette, Natalie M; Quinn, Margaret M; Kriebel, David et al. (2017) Risk of sharps injuries among home care aides: Results of the Safe Home Care survey. Am J Infect Control 45:377-383
Quinn, Margaret M; Markkanen, Pia K; Galligan, Catherine J et al. (2016) Occupational health of home care aides: results of the safe home care survey. Occup Environ Med 73:237-45
Markkanen, Pia; Galligan, Catherine; Laramie, Angela et al. (2015) Understanding sharps injuries in home healthcare: The Safe Home Care qualitative methods study to identify pathways for injury prevention. BMC Public Health 15:359
Tarigan, Lukman H; Cifuentes, Manuel; Quinn, Margaret et al. (2015) Prevention of needle-stick injuries in healthcare facilities: a meta-analysis. Infect Control Hosp Epidemiol 36:823-9
Galligan, Catherine J; Markkanen, Pia K; Fantasia, Linda M et al. (2015) A growing fire hazard concern in communities: home oxygen therapy and continued smoking habits. New Solut 24:535-54
Markkanen, Pia; Quinn, Margaret; Galligan, Catherine et al. (2014) Characterizing the nature of home care work and occupational hazards: a developmental intervention study. Am J Ind Med 57:445-57

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