Injury rates, risk awareness and the effectiveness of a training intervention among home care workers

Backgound: Homecare workers (HCWs) are at high risk of work-related injuries. Lack of awareness of risk and lack of access to training and prevention resources designed for low literacy workers contributes to high injury rates. We conducted a participatory intervention project to develop and evaluate training materials in English, Spanish and Chinese. Methods: For the evaluation 317 HCWs, including all three language groups, were randomized into an intervention or control group. Participants completed a baseline and follow-up telephone survey separated by 2 months. The intervention group received training between the two surveys and the control group after the second. Results: The 317 HCWs were predominately female (86%) and low income (64%). 185 workers (60%) had experienced some work-related injury in the last year, yet only five workers had reported their injury. Among the 51 workers using sharps at work, 30% experienced an accidental needlestick injury in the past year. Although injury rates were high, most workers perceived their work as low risk, though workers who had experienced an injury reported a higher perception of risks. Injured workers also reported greater difficulty in finding information on how to control job risks. Between the baseline and follow-up survey, the intervention group reported a significantly greater increase in risk perception and in their ease of finding information to reduce risks compared to the control group. This difference was most pronounced for HCWs who did not speak English. Conclusions: Training materials designed for low literacy HCWs can be effective especially for immigrant workers.