Effects of a training program for home health care workers on the provision of preventive activities and on the health-related behavior of their clients: A quasi-experimental study

Background: Because home health care workers repeatedly visit the same older adults, they are in an excellent position to improve the health-related behavior of older adults, their clients, by providing preventive activities. Objectives: The objective of this study was to determine the short- and medium term effects of an intervention to support workers in providing preventive activities for older adults. To do this, the number of activities undertaken by workers and the health-related behavior of their clients were assessed. Design: A quasi-experimental study was performed with a pre-post design and inclusion of one control group. Settings: The study took place in a deprived, semi-rural area in The Netherlands (2011-2013). Data in three districts served by one home health care organization were gathered. Participants: The participants were home health care workers (registered nurses and nurse aides) and home health care clients aged 55 and over (community-dwelling, dependent older adults receiving home health care). 205 home health care workers participated in the study, 97 of them in the first effect measurement; and 83 of them in the second effect measurement. A total of 304 home health care clients participated, 214 of them in the first effect measurement; and 186 of them in the second effect measurement. Methods: Differences in change were determined in health-related behavior between groups of older adults as a result of training home health care workers in preventive activities Results: In the control group of home health care professionals a significant increase was found regarding the provision of preventive activities for the domain 'weight' (partial eta squared: 0.05 and 0.08 at first and second effect measurements, respectively). We found preventive activities performed by home health care professionals to have no significant effects on older adult-reported health-related behavior, but observed in the intervention group a non-significant trend in improvement of physical activity of, respectively, 85 and 207 min for the first and second effect-measurements. Conclusion: This training program had hardly any effect on preventive activities performed by home health care workers and on the health-related behavior of older adults. Offering health promotion via home health care workers may be promising but its delivery should be enhanced.