Home health aides are an important group of frontline health workers and one of the fastest-growing sectors of the U.S. workforce. Largely employed by public agencies (Medicare and Medicaid), home health aides currently care for 48 million Americans. However, these workers face numerous challenges as they provide in-home care for people with serious illnesses such as heart failure, diabetes, dementia, and others. Despite spending more time with patients than any other care provider, home health aides, who are mostly women and minorities, are overworked, poorly compensated, and experience high levels of stress and burnout. Their existing tools and technology ecosystems are outdated, hard to use, and largely revolve around monitoring home health aides' labor rather than supporting their work. home health aides find changes in patients' health conditions frightening and struggle to reach supervising clinicians by phone when they need clinical help. Finally, home health aides largely operate day-to-day in isolation, without the ability to be mentored by peers and supervisors, or to grow their skills and advance.

This project addresses some of the challenges home health aides face via five complementary research activities that aim to improve the work satisfaction of home health aides, the care received by patients, and the integration of the care team. The first two activities provide new mechanisms for home health aides to obtain care-related information and support by assisting with routine care tasks via multi-modal conversational agents that provide voice-, video-, and text-based guides for completing tasks safely, and providing decision support for clinical questions via a conversational agent that delivers medically-verified information. In parallel, there is a critical need for new mechanisms that enable reliable and timely communication and coordination between home health aides and the rest of the care team. The next two activities engage with this challenge by developing an asynchronous communication tool that connects home health aides directly with clinical staff; and enables data-driven cooperative work and care coordination via new multi-stakeholder and multiple timescale data collection and reporting mechanisms. Taken together, these innovations provide rich opportunities for home health aides to learn and practice new skills, demonstrate their expertise, receive recognition, and meaningfully shape patient care. The final activity creates opportunities for learning and career advancement via new training programs that sustain a sense of progress and advancement while improving patient outcomes. This project, taken as a whole, will improve the skills, well being, and careers of home health aides of the future.

This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.

National Science Foundation (NSF)
Division of Social and Economic Sciences (SES)
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Sara Kiesler
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Cornell University
United States
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