Homecare Worker Health and Safety

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

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

3. NIOSH Homecare Worker Study: 2001 - 2004 Workers’ Safety and Health Consumer’s Safety and Health Safe Home Safe Workplace Homecare Worker and Consumer Safety and Health

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

5. 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

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

7. 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

8. 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

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

10. 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)

11. Challenges of Developing Effective Interventions • Homecare workers don’t always identify as workers with the right to a safe workplace • Consumers don’t 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

12. 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

13. Intervention Materials: The Homecare Workers’ Handbook

14. Safety Tip Example

15. Taking Action

16. 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

17. Where Does it Hurt?

18. Identifying Hazards Hazard Stickers:

19. Taking Action

20. 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

24. 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

25. 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

26. 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

27. Other Resources on Homecare Health and Safety • www.uic.edu/sph/homecarehealthandsafety/index

28. 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?

29. Thank You Laura Stock, MPH lstock@berkeley.edu 510-642-5056 www.lohp.org