Massachusetts personal and home care aide state training: The affects of multi-lingual training options on trainee performance and outcomes

Funded through the Affordable Care Act (ACA), the Personal and Home Care Aide State Training (PHCAST) program provided three-year, federal grants to six states for development and implementation of a training program for the growing population of direct care workers who assist older adults and persons with disabilities. In Massachusetts, preliminary evaluation findings used descriptive statistics, cross-tabulation, and multiple regression techniques to identify differences between direct care workers with varying levels of self-reported English language proficiency. The results of written knowledge pre-/post-tests, hands-on skills tests, satisfaction surveys, and focus groups across trainees and instructors showed lower performance outcomes and job retention for trainees who said their English language skills limited their employment options. Accordingly, additional trainings were made available in Spanish, Portuguese, and Haitian-Creole, languages found to be spoken by many direct care workers in Massachusetts. The outcomes of these bilingual trainings were compared to prior training results to determine the benefits or drawbacks of multi-lingual training. A series of skills videos were also developed for use in trainings to determine whether more visual depictions of hands-on skills might benefit trainees, particularly those trainees with self-reported limited English proficiency. The final comparison results between the English-only and multi-lingual trainings allowed the Massachusetts evaluation team to draw some conclusions about the positive benefits of the PHCAST training for maintaining the direct care workforce across population demographics. These results are being shared with state lawmakers to sustain this direct care worker training beyond the life of the three-year PHCAST grant.