Development of a tailored tobacco control training curriculum for home health aides (HHAs) using qualitative research method

Background: An estimated 7 million (5%) US seniors over the age of 65 receive long-term homecare services. Smoking poses a serious fire hazard in homes where seniors may have decreased mobility, utilize supplemental oxygen, and may be hearing/cognitively impaired. Tobacco control services are an unmet need in the homecare system due to inadequate Home Health Aid (HHA) training, competing priorities, and financial and time constraints.

Methods: The project targeted HHAs at Isabella Homecare located in NYC. Data collection process utilized focus groups—smoking and non-smoking HHAs—conducted using a systematic interview protocol and audio-taped. Analysis consisted of content and thematic.

Results: Preliminary focus group data yielded information about HHAs' barriers to cessation, roles and responsibilities, and challenges in tobacco control with clients. Participants were: 8 Hispanics and 3 African Americans; 1 male and 10 female; and majority had a high school education or less. Smoking and non-smoking HHAs identified stress (work and personal), lack of respect, issues with other family members, and low wages as challenges. Both groups would implement the “Ask”, if it was part of the care plan.

Implications: Utilized a systematic approach to develop a tailored tobacco control training curriculum based on HHAs scope of work, which will best fit their practice. This approach will be generally effective in assisting HHAs to “Ask” about their clients' tobacco use as recommended by the US Health & Human Services. HHAs trained in tobacco control may have a role in reducing fire hazards in seniors' homes and increasing quality of life.