Can Work be Organized to Become More Health Promoting for Employees in Home Care Services?

Study Overview
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Brief Summary
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This is a two-group, cluster randomized controlled trial designed to assess a health promoting intervention in the home care sector. The intervention aims to evenly distribute the patients requiring high levels of demanding care across all workers on the units, which may lower the working strain and thus the incidence of musculoskeletal pain. The two groups in the study will be a control group and an intervention group. The intervention will last for approximately 4 months.

Detailed Description
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This is a two-group cluster randomized controlled trial to compare an organizational intervention to control. The home care units will be treated as clusters to avoid contamination within units. Control group: No intervention, their work will continue as usual without any instructions from researchers. Intervention group: The intervention will consist of the operational managers distributing the physically strenuous shifts evenly between the workers in each home care unit. This will be achieved using a tool developed in Microsoft Excel which gives an overview over how much strain we expect each shift to have and gives a score on how well the operational manager distributes the strain between employees. The intervention will last for approximately 4 months, depending on duration of pre and post measurements.

Official Title
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Can Work be Organized to Become More Health Promoting for Employees in Home Care Services?

Conditions
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Occupational Exposure, Musculoskeletal Pain, Work-related Injury, Shoulder Pain, Neck Pain, Low Back Pain

Intervention / Treatment
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* Behavioral: Goldilocks work principle


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Home care worker in one of the included home care units in Trondheim municipality. More than or equal to 50% working position at the home care unit. Exclusion Criteria: Physically incapable of performing day to day tasks. Any illness during the measurement week Pregnancy

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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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Individuals are grouped in clusters, where the clusters are the home care units in Trondheim. Half of the units will be randomized to control, half will be randomized to intervention. All units will be randomized at the same time.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Control<br>This arm will have no intervention or instructions from researchers. Participants in this arm will perform their work planning as normal. | |
| Experimental: Intervention<br>Introduce a deliberate variation between workers in how much they care for physically strenuous users. Some workers may receive more strenuous work compared to before, some less. | Behavioral: Goldilocks work principle<br>* Using the Goldilocks work principle we have tried to find the just right distribution of physical strain in the home care sector. This is an intervention to test if it possible to distribute the physical strain experienced in the home care sector in a way that may be more health promoting for the workers.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Between group changes in musculoskeletal pain in the neck and shoulder from pre to post measurement | The workers will rate their musculoskeletal pain in the neck and shoulder area after each working day for a week. The measurement will be repeated at the end of the intervention to assess any changes in the experience of musculoskeletal pain. The question assessing musculoskeletal pain in shoulder and neck area is phrased as How much pain did you have in your shoulder/neck at the end of this working day? (Translated from Norwegian). | 7 days during baseline measurements, 7 days during post measurements | 
| in musculoskeletal pain in the lower back from pre to post measurement | The workers will rate their musculoskeletal pain in the lower back after each working day for one week. The measurement will be repeated at the end of the intervention to assess any changes in the experience of musculoskeletal pain. The question assessing musculoskeletal pain in the lower back area is phrased as how much pain did you have in your lower back at the end of the working day? (Translated from Norwegian). | 7 days during baseline measurements, 7 days during post measurements | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Between group changes in the composition of time spent standing, arms elevated and trunk inclined | The difference in physical behavior composition from baseline measurements to post measurements between control and intervention group. The specific variables will be time spent standing, arms elevated, and trunk inclined. | 7 days during baseline measurements, 7 days during post measurements | 
| Between group changes in fatigue at end of shift | The difference between intervention and control group from pre- to post-measurements in how fatigued the workers were at the end of the shift. | 7 days during baseline measurements, 7 days during post measurements |