Capacity Building and Service Enhancement in Integrated Home Care Services

Capacity Building and Service Enhancement of Integrated Home Care Services During COVID-19

As people live longer lives, the ageing population causes an unprecedented rise in healthcare and social services demand. Limited studies were to evaluate the effectiveness of risk management measures of home care service and the needs of service workers, which raised concerns about the needs of staff working in home care settings and how service organizations continuously dealt with those challenges in this ongoing pandemic.

This study includes two parts: Part 1, Needs assessment, a survey to collect feedback from staff and understand their needs.; Part 2, Train-the-trainer workshops for staff and volunteers as lay health promoters to build workforce capacity and enhance trainees' competence and performance in delivering brief health-related information to their service users during COVID-19. It includes quantitative questionnaire assessment and qualitative focus group interview.

Study Overview

• Status: Recruiting
• Conditions: Knowledge, Attitudes, Practice
• Intervention / Treatment: Behavioral: Train-the-trainer workshop

Detailed Description

With modern medicine and technological advancements, the global life expectancy has increased over the last century. As people live longer lives, the ageing population causes an unprecedented rise in demand for healthcare and social services. Integrated Home Care Services (IHCS) provides care and community support services to elderly persons and people with disabilities according to their individual and social needs, to enable them to continue living in the community. This approach helps maintain a sense of attachment and feelings of security and familiarity in relation to both homes and communities and reduces the overload of nursing homes.

The Aberdeen Kai-fong Welfare Association Social Service (AKA) is one of the 61 non-government organisations (NGO) under the IHCS. AKA provides a wide range of services which include home care, nursing and rehabilitation services for elders, people with disabilities and families in need (service users) in the Southern District of Hong Kong.

The pandemic of COVID-19 has brought significant challenges globally and locally. With the safety and distancing measures from the government, the scope of Integrated Home Care Services was restricted to essential services during the early stage of the pandemic. Apart from the suspension of services, other major challenges of home care service providers faced were an insufficient supply of personal protective equipment, an insufficient workforce, inadequate training. These problems have all led to infection control concerns for home care institutions and their staff. To combat the spread of the virus and maintain the continuity of services, IHCS providers applied a series of risk management measures throughout the pandemic.

The train-the-trainer (TTT) model is gaining increasing attention as an effective strategy to build a community workforce for health promotion and disease prevention. Training for participants from the same community they serve as lay health promoters (volunteers), can help build knowledge at the local level. Lay health promoters with training and supervision were shown to have significant impacts on community-based interventions. The training of lay health promoters and reliance on community resources simultaneously reduce the demand on time, resources and manpower from financially strapped and understaffed professional social health services in the community.

Limited studies were to evaluate the effectiveness of risk management measures of home care service and the needs of service workers, which raised concerns about the needs of staff working in home care settings and how service organizations continuously dealt with those challenges in this ongoing pandemic. Besides, the lack of training programs was systematically evaluated.

This proposed study includes two parts: Part 1, Need assessment, a survey to collect feedback from staff and understand their needs.; Part 2, Train-the-trainer workshops for staff and volunteers as lay health promoters to build workforce capacity and enhance trainees' competence and performance in delivering brief health-related information to their service users during COVID-19. Questionnaire assessments will be conducted at baseline, immediately after each session, one- and three-month follow up. Focus-group interviews will be conducted at the end of the study (completion of all train-the-trainer workshops and assessments).

• Study Type: Observational
• Enrollment (Anticipated): 170

Contacts and Locations

• Study Contact: Name: Agnes YK Lai, PhD; Phone Number: 852-3917-6328; Email: agneslai@hku.hk
• Study Contact Backup: Name: Caroline Yang, Master; Phone Number: 852-3917-9810; Email: cwlyang@hku.hk

Study Locations

• Hong Kong
  • Hong Kong, Hong Kong, 852
    • Recruiting
    • Abedreen Kai-fong Association
    • Contact: Mabel Kwok, BSW; Phone Number: 35505566; Email: mablekwok.cw@aka.org.hk
    • Contact: Alice Wan, MBA; Phone Number: 35505566; Email: director@akak.org.hk

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Staff of AKA under the division of IHCS or lay volunteers of Aberdeen Kai-fong Welfare Association volunteer group

Description

Part 1: Needs assessment

Inclusion criteria

• Staff of Aberdeen Kai-fong Welfare Association under the division of Integrated Home Care Services

Exclusion criteria

• Subjects refuse to answer this questionnaire
• Subjects who are unable to read and understand Chinese

Part 2: Train-the-trainer workshops

Inclusion criteria

• Staff of AKA under the division of IHCS or lay volunteers of Aberdeen Kai-fong Welfare Association volunteer group

Exclusion criteria

• Subjects refuse to answer this questionnaire
• Subjects who are unable to read and understand Chinese

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Intervention group; It includes two 1-hour health-related information sessions.	Behavioral: Train-the-trainer workshop; To deliver health-related information to trainees, which facilitate improving their knowledge, confidence, and ability to share and discuss health-related information with others, including service users, families and friends.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Perceived usefulness on institutional risk management	Measured by 15 outcome-based questions. Score of each question ranges from 1 to 6. The highest scores the better the outcomes.	Baseline
Change from baseline competence in delivering health-related information and service to service users	Measured by 4 outcome-based questions. Score of each question ranges from 0 to 10. The highest scores the better the outcomes.	Baseline, immediate after workshop

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in baseline competence in delivering health-related information at month1	Measured by 4 outcome-based questions. Score of each question ranges from 0 to 10.	Baseline, month 1
Change in baseline competence in delivering health-related information at month 3	Measured by 4 outcome-based questions. Score of each question ranges from 0 to 10.	Baseline, month 3
Change in baseline practice in delivering health-related information at month1	Measured by a outcome-based question. Score of each question ranges from 0 to 10.	Baseline, month 1
Change in baseline practice in delivering health-related information at month 3	Measured by a outcome-based question. Score of each question ranges from 0 to 10.	Baseline, month 3

Collaborators and Investigators

• Sponsor: The University of Hong Kong
• Collaborators: Aberdeen Kai-fong Welfare Association Social Service

Publications and helpful links

General Publications

• Pearce J, Mann MK, Jones C, van Buschbach S, Olff M, Bisson JI. The most effective way of delivering a train-the-trainers program: a systematic review. J Contin Educ Health Prof. 2012 Summer;32(3):215-226. doi: 10.1002/chp.21148.
• Rowe TA, Patel M, O'Conor R, McMackin S, Hoak V, Lindquist LA. COVID-19 exposures and infection control among home care agencies. Arch Gerontol Geriatr. 2020 Jul 30;91:104214. doi: 10.1016/j.archger.2020.104214. Online ahead of print.
• Quandt SA, Grzywacz JG, Talton JW, Trejo G, Tapia J, D'Agostino RB Jr, Mirabelli MC, Arcury TA. Evaluating the effectiveness of a lay health promoter-led, community-based participatory pesticide safety intervention with farmworker families. Health Promot Pract. 2013 May;14(3):425-32. doi: 10.1177/1524839912459652. Epub 2012 Oct 17.
• Ayala GX, Vaz L, Earp JA, Elder JP, Cherrington A. Outcome effectiveness of the lay health advisor model among Latinos in the United States: an examination by role. Health Educ Res. 2010 Oct;25(5):815-40. doi: 10.1093/her/cyq035. Epub 2010 Jul 5.
• Shiber S, D'Lugoff M. A win-win model for an academic nursing center: community partnership faculty practice. Public Health Nurs. 2002 Mar-Apr;19(2):81-5. doi: 10.1046/j.1525-1446.2002.19202.x.
• Josiah Willock R, Mayberry RM, Yan F, Daniels P. Peer training of community health workers to improve heart health among African American women. Health Promot Pract. 2015 Jan;16(1):63-71. doi: 10.1177/1524839914535775. Epub 2014 Jun 2.
• Tobias CR, Downes A, Eddens S, Ruiz J. Building blocks for peer success: lessons learned from a train-the-trainer program. AIDS Patient Care STDS. 2012 Jan;26(1):53-9. doi: 10.1089/apc.2011.0224. Epub 2011 Nov 21.
• Layne JE, Sampson SE, Mallio CJ, Hibberd PL, Griffith JL, Das SK, Flanagan WJ, Castaneda-Sceppa C. Successful dissemination of a community-based strength training program for older adults by peer and professional leaders: the people exercising program. J Am Geriatr Soc. 2008 Dec;56(12):2323-9. doi: 10.1111/j.1532-5415.2008.02010.x.
• Milburn K. A critical review of peer education with young people with special reference to sexual health. Health Educ Res. 1995 Dec;10(4):407-20. doi: 10.1093/her/10.4.407.

Helpful Links

• Life expectancy at birth, total (years)- Hong Kong SAR, China
• Elderly Services of Hong Kong
• Integrated Home Care Services.
• Hospital discharges to home health rebounding

Study record dates

Study Major Dates

• Study Start (Actual): December 1, 2021
• Primary Completion (Anticipated): December 31, 2022
• Study Completion (Anticipated): March 31, 2023

Study Registration Dates

• First Submitted: December 29, 2021
• First Submitted That Met QC Criteria: January 13, 2022
• First Posted (Actual): January 14, 2022

Study Record Updates

• Last Update Posted (Actual): April 12, 2022
• Last Update Submitted That Met QC Criteria: April 11, 2022
• Last Verified: April 1, 2022

More Information

Terms related to this study

• Keywords: COVID-19, risk management, service enhancement, capability building
• Other Study ID Numbers: UW21-781

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Need to obtain consent from participants before agreeing to share individual participants data.
• IPD Sharing Time Frame: When study finished
• IPD Sharing Access Criteria: The minimal anonymized dataset will be available upon request to interested researchers. For interested researchers, please contact Dr Agnes Lai (Email: agneslai@hku.hk, School of Nursing, the University of Hong Kong), for further information.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No