Safety and health support for home care workers: The COMPASS randomized controlled trial

Objectives. To determine the effectiveness of the Community of Practice And Safety Support (COMPASS) Total Worker Health intervention for home care workers. Methods. We randomized 16 clusters of workers (n = 149) to intervention or usual practice control conditions. The 12-month intervention was scripted and peer-led, and involved education on safety, health, and well-being; goal setting and self-monitoring; and structured social support. We collected measures at baseline, 6 months, and 12 months, which included workers' experienced community of practice (i.e., people engaged in a common activity who interact regularly for shared learning and improvement). Implementation occurred during 2013 and 2014 in Oregon. Results. In an intent-to-treat analysis, relative to control, the intervention produced significant and sustained improvements in workers' experienced community of practice. Additional significant improvements included the use of ergonomic tools or techniques for physical work, safety communication with consumer-employers, hazard correction in homes, fruit and vegetable consumption, lost work days because of injury, high-density lipoprotein cholesterol, and grip strength. Consumer-employers' reports of caregiver safety behaviors also significantly improved. Conclusions. COMPASS was effective for improving home care workers' social resources and simultaneously impacted both safety and health factors.