In keeping with the goals of the Academic Research Enhancement Award (AREA), this project will serve as a training grant for undergraduate students in health sciences, specifically social work and nursing. Each year of the three-year project, a new cadre of students will be involved in all stages of the research project and will participate in a 4-credit research seminar. The research focus of the proposed project is to address the current crisis in our long-term care system, namely maintaining an adequate number of workers to provide the daily care needed by millions of our nation's elders. With a trend toward community-based care, this worker shortage is particularly severe in home care. One solution to this crisis could be to encourage older workers to enter and/or remain in home care.
Specific aims of this study are to: 1) increase the research experience and skills of undergraduate students in social work and nursing and inspire them to pursue doctoral studies in health sciences; 2) investigate the interrelationships of age, employment factors (i.e., net income, client behaviors, and occupational injuries) and job experience factors (i.e., job satisfaction, burnout, and perceived empowerment) among personal care attendants (PCAs) in home care; 3) examine the effects of age in conjunction with employment factors and job experience factors in predicting length of employment and job termination; and 4) gain understanding of how individual (including age), sociocultural, and environmental factors influence job retention. This project will be an 18-month longitudinal study of PCAs in two home care agencies covering all counties of Maine. A mail survey of PCAs (n=240) will gather data on multiple factors potentially related to job tenure. A shorter survey will be sent to all participants either at the time they leave the agency or, if still employed, at the end of the study period. This will be followed by a telephone interview to collect data on factors leading workers to stay with or leave the agency. Structural equation modeling will be used to examine the direct and indirect effects of age, employment factors, and job experience factors on predicting length of employment. Multilevel modeling will examine if the relationships between covariates and length of employment vary as a function of geographic area. Cox regression will be used to predict the outcome variable of job termination and will provide hazard-function information on the likelihood of termination by month. Repeated-measures MANOVA will be used to examine if change in job experience and employment factors are related to job termination. Grounded theory techniques will be used to analyze the narrative data. The study findings will have practical implications in terms of recruitment and retention of home care workers, particularly older workers. Findings from this investigation will inform the development and testing of an intervention geared to the needs of older home care workers with the goal of extending their job tenure. Next steps will include replicating this investigation in other parts of the country in which the home care workforce is more racially diverse. ? ? Public Health Relevance: In addition to its primary goal of training undergraduate students in health sciences research, this study ultimately aims to contribute to a reduction in the negative effects of direct care worker turnover in long-term care, such as compromised care of elders and increased costs for agencies and government health care programs. It also aims to increase the employment of older workers in the field of home care, thereby promoting these workers' psychological, physical, and emotional well-being. The primary public health impact of this study will be the improvement of care received by community-based frail elders. ? ? ?
| Butler, Sandra S; Brennan-Ing, Mark; Wardamasky, Sara et al. (2014) Determinants of longer job tenure among home care aides: what makes some stay on the job while others leave? J Appl Gerontol 33:164-88 |
| Butler, Sandra S (2013) Older women doing home care: exploitation or ideal job? J Gerontol Soc Work 56:299-317 |
| Butler, Sandra S; Wardamasky, Sara; Brennan-Ing, Mark (2012) Older women caring for older women: the rewards and challenges of the home care aide job. J Women Aging 24:194-215 |
| Ashley, Alison; Butler, Sandra S; Fishwick, Nancy (2010) Home care aides' voices from the field: job experiences of personal support specialists. Home Healthc Nurse 28:399-405 |
