Home support workers play an influential role in the lives of frail elderly and may indirectly promote health and well-being among their elderly clients through assistance in meal preparation, shopping for food and encouragement of exercise. The goal of this study was to identify the health knowledge level of home support workers and their perception of health issues significant to older adults in the domains of nutrition, physical activity and falls prevention. The overall level of knowledge was determined to be low. At the same time, despite knowledge gained from training and workshops, various media, including television and newspapers, were reported as the major sources of information for these front line workers. This raises questions about the best methods for continuing education on nutrition, fall prevention and physical activity in order to better equip home support workers with knowledge to enhance their service quality.

Methods: Home support workers (n = 64) were recruited from five home care and continuing care agencies in Nova Scotia, Canada. Information about the respondents' demographic characteristics and work-related characteristics (e.g., caseload per month) were collected. All participants completed a questionnaire about their own health status. In addition, a multiple-choice questionnaire was used to assess the general health knowledge of home support workers and their perception of health issues significant to older adults in the domains of nutrition, physical activity and fall prevention.

Findings: Most of the respondents had a home support worker designation (69%), while 20% had a community care assistant diploma and 7% were licensed practical nurses.. The average length of employment was 5.9 years, with a workload ranging from 15 to 40 hours per week (average of 33 hours). The respondents had an average caseload of 56 older adults per month. During the home visits, all respondents performed activities in relation to personal care, while 78% engaged in meal preparation and 77% provided respite care and/or assisted in housekeeping. Concerning the participant's own health status, 77% of participants reported having good or excellent nutritional status and 50% reported exercising regularly.

In terms of the home support workers' perceptions of significant health issues among older adults, chronic diseases (66%), changes to the bodily systems (67%), the senior's own personal health practice (47%) and health services (14%) were regarded as being most important. Seventy-five percent of home support workers received health information from training and workshops, while 45% received information from various media, including television and newspapers, 28% from their colleagues and 19% from college/university. Workshops on physical activity and nutrition were attended by 69% of participants, while 50% and 44% of participants received health promotion and exercise training, respectively. Overall, the home support workers' knowledge about seniors' health was low. General knowledge of senior's health presented the lowest knowledge score among home support workers, followed by fall prevention, nutrition and physical activity.

Conclusions: Although home support workers are prime candidates for promoting the health of frail elderly during their daily support tasks, this study revealed that they generally had moderately low knowledge about seniors' health. Relatively higher knowledge scores were found in areas where home support workers had received previous training, highlighting the importance of continuing education. Since various media, including television and newspapers, were reported as being a major source of information (compared to university/college), unconventional approaches which model media formats (e.g., sharing personal stories) may be an effective way to educate home support workers with essential knowledge to enhance their service quality.

Reference Johnson, CS, Noel, M. Level of Empowerment and Health Knowledge of Home Support Workers Providing Care for Frail Elderly. Home Health Care Services Quarterly. 2007, 26(3): 61 - 78.

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