Systematic evaluation of a safety and health training programs targeting low income home care workers within a CBPR project: Challenges and lessons learned

The workforce in the United States is both more diverse and more concentrated in the service sector than ever before. These two trends pose distinct challenges to those interested in developing occupational health and safety education and training programs. To be effective, these programs must appropriately serve workers with a range of literacy and English proficiency levels. Including a systematic evaluation component in new training initiatives will contribute to our understanding of their effectiveness and improve our practice. The more than 1 million workers who provide in-home health and supportive services to the elderly and disabled are an especially challenging multi-ethnic service sector worker population because their work environments and exposures are highly variable and difficult to control. During a five-year community-based participatory intervention project, we developed an education and training program targeting English, Spanish and Chinese homecare workers that included a systematic randomized controlled evaluation component. The evaluation recruited 350 homecare workers and their clients who were randomly placed into either an intervention or a control group and completed two telephone surveys separated by two months. The development of the evaluation plan involved the active participation of the project stakeholders and was based on information collected through qualitative and quantitative methods. The multi-step process included: 1) developing well-defined intervention outcomes; 2) designing survey measures that adequately assess these outcomes across three languages; and 3) developing appropriate outreach and social marketing materials to recruit participants. Each of these steps, as well as preliminary findings and lessons learned, will be presented.