Capacity Building and Service Enhancement in Integrated Home Care Services

Study Overview
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Brief Summary
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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.

Detailed Description
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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).

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

Conditions
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Knowledge, Attitudes, Practice

Intervention / Treatment
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* Behavioral: Train-the-trainer workshop


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Intervention group<br>It includes two 1-hour health-related information sessions. | Behavioral: Train-the-trainer workshop<br>* 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.<br>|

What is the study measuring?
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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 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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COVID-19, risk management, service enhancement, capability building