Care for the Caretakers: Preventing Workplace Harassment in Home Health Care

With the rise of the #MeToo movement, issues of workplace sexual harassment have come to the forefront. While the allegations from women in Hollywood and Washington have received the most public attention, sexual harassment occurs in nearly every industry. In particular, previous research shows that home health workers—89 percent of whom are female—have a high likelihood of experiencing sexual harassment and assault on the job. Understanding that home health care workers must, by nature of their jobs, continue to provide care in the homes of their employers, researchers have sought to address the problem by improving worker education, specifically by providing training on sexual harassment to home health care workers.

Computer-based interventions have been successful in disseminating behavior-change training modules. In a study published in the American Journal of Industrial Medicine, Glass et al. examined the impact of computer-based training (CBT) on self-reported sexual harassment outcomes for home health care workers and found evidence that CBT can increase worker confidence and reduce incidents of harassment. Only female employees were selected into the study, and each was randomly assigned to one of two groups. Both groups received computer-based training, but one group received additional, small-group support from a peer-professional educator. All study participants were tested prior to any training and were tested again at three and six-month follow-ups, both for confidence and incidents of violence and harassment. Investigators used an algorithm to adjust for statistical differences in the population, mostly to account for the geographic distribution of workers, as well as the probability of taking care of a male patient.

Results from the pre-test and the first post-test showed significant improvement in knowledge of workplace violence and harassment, with participants improving from a mean score of about 70 percent to a mean score of over 90 percent. This improvement in knowledge was not conditional on the extra in-person support; it applied to the CBT-only group as well. The researchers also measured confidence in responding to workplace harassment and found that, while both groups showed improvement, the group with additional peer support experienced higher short-term gains in confidence. Furthermore, workers in both treatment groups who spent more time caring for male patients reported higher feelings of self-confidence than workers who spent more time caring for female patients. The researchers theorize that this is because workers caring for men tend to experience harassment more frequently, and, therefore, have more opportunities to practice the skills they learn from CBT.

Ultimately, the primary goal of CBT intervention is to lower the likelihood of harassment and improve the health and safety of female home health workers. This study showed that CBT, both with and without peer facilitation, can improve confidence and decrease reported incidents of harassment. However, the study did not find that the treatment produced significant changes in physical or mental health or burnout.

This work responds to the call to better understand the effectiveness of sexual harassment training for home health workers. By increasing workers’ knowledge of sexual harassment and confidence to respond to inappropriate behavior, these computer-based training modules could be scaled up to reach a growing sector of home health employees. But this is only half of a solution. Investigators of this study explicitly state the need for researchers and home-health care providers to develop consumer-side tools in the fight against sexual assault. It is predicted that in 2019, there will be more Medicare enrollees than children under the age of five. This dramatic shift in American demographics will only increase the demand for home health provision. Policy-makers must respond to the task of caring for these critical caretakers.

Article source:  Glass, Nancy, Ginger C. Hanson, W. Kent Anger, Naima Laharnar, Jacquelyn C. Campbell, Marc Weinstein, and Nancy Perrin. “Computer-based training (CBT) intervention reduces workplace violence and harassment for homecare workers,” American Journal of Industrial Medicine, Vol. 60, Issue 7 (2017): 635–643.

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