Catherine Kelleher, ScD, MPH, MS, RN¹, Margaret A. Terry, MS, RN², Penny Carlo, MS, RN², Veronica S. Longstreth, MS, RN², Ana Sanchez, MHS¹, Nadine Kidd, MS, RN², Joan S. Obecny, MS, ANP, RN², Shirley Devitt, MS, RN², Frances Wacker, MSW², Lee R. Bone, MPH, RN³, Sheila Curry, MS⁴, Miyong T. Kim, PhD, RN⁵, Shannon Nagy, BS, RN¹, and Katie Huffling, BS, RN¹. (1) Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, 655 West Lombard Street, Room 475C, Baltimore, MD 21201, 410-706-3187, kelleher@son.umaryland.edu, (2) MedStar Health VNA, 4061 Powder Mill Road, Suite 210, Calverton, MD 20705, (3) Department of Health Policy & Management, Johns Hopkins University, Bloomberg School of Public Health, Hampton House 608, Baltimore, MD 21205, (4) Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, 515 West Lombard Street, Baltimore, MD 21201, (5) Johns Hopkins University School of Nursing, 525 North Wolfe Street, Baltimore, MD 21205

The University of Maryland School of Nursing at Baltimore-MedStar Health VNA community-based participatory research (CBPR) partnership, and its first joint project, an ongoing 4-year AHRQ funded study, will be described with special emphasis on how use of principles of CBPR is likely to produce sustainable change in agency practice based on study results. The study will evaluate impact on home health care cost, rehospitalization, ER use and patient and job satisfaction of training home health aides (HHAs) to act as CHF and diabetes disease management coaches (DMCs) in partnership with RNs using an integration of disease management and community health worker techniques. If HHA DMCs can produce better outcomes and at the same time experience greater job satisfaction and reduced job hopping due to their enhanced role and patient impact, the study will produce a new model of home health care delivery that simultaneously improves patient outcomes, makes more efficient and effective use of HHAs and RNs, which are both in short supply, reduces service use and related costs, and suggests new ways to design and reimburse for home health care.

Learning Objectives:

• To describe how use of community based participatory research principles has fostered a research partnership between a nursing school and home health agency that builds for sustainable agency change via research studies.
• To describe the design and ongoing implementation of the first joint project of the partnership, an AHRQ funded grant to test impact of training home health aides to function in expanded roles as congestive heart failure and diabetes disease management coaches.

Keywords: Home Care, Health Workers Training

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.