Training for Elderly and Disabled Care

Overseen By Jesse Gubb, Research Manager, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Abdul Latif Jameel Poverty Action Lab

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: Unknown

2500 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What data supports the effectiveness of the treatment IHSS Basic Training, IHSS Essentials Course, IHSS Basic Training, CCA IHSS Training?

Research shows that training programs for caregivers, like those in the IHSS program, lead to significant improvements in caregivers' knowledge and skills, especially in handling conditions like dementia. This suggests that such training can help caregivers provide better care for elderly and disabled individuals. ^{1 2 3 4 5}

How is the IHSS Basic Training treatment different from other treatments for elderly and disabled care?

The IHSS Basic Training is unique because it focuses on providing caregivers with interactive, community-based training to improve their knowledge and skills in caring for elderly and disabled individuals, allowing them to remain safely in their homes. Unlike other treatments, it includes language-specific and culturally appropriate education, as well as online training for dementia care, which enhances caregivers' self-efficacy and competence. ^{1 2 6 7 8}

What is the purpose of this trial?

This trial investigates whether high-quality training for consumer-directed home health workers impacts health outcomes for care consumers and employment outcomes for care workers. The investigators are conducting this study in the context of the In-Home Supportive Services (IHSS) program, a consumer-directed, Medicaid-funded home care program in California serving elderly and disabled Medicaid recipients. The investigators will partner with the Center for Caregiver Advancement (CCA), a training provider based in California, to conduct a randomized evaluation of the impact of training for IHSS workers on labor and health care outcomes. The evaluation will enroll IHSS workers in San Bernardino County, where CCA will be expanding its program. Participants will be randomized to either a group that receives CCA's training or a control group that does not receive training. Participants randomized to the training group will complete a 30 hour online course that teaches fundamental caregiving skills. Training includes personal care, infection control, nutrition and body mechanics, medication adherence, and home safety. Researchers will compare outcomes between IHSS providers in the two groups and between IHSS consumers who receive care from the IHSS providers in the two groups to see if training impacts health, health care, and labor market outcomes.

Research Team

Matthew Notowidigdo, PhD

Principal Investigator

University of Chicago

David Autor, Phd

Principal Investigator

Massachusetts Institute of Technology

Amy Finkelstein, PhD

Principal Investigator

Massachusetts Institute of Technology

Anna Russo

Principal Investigator

Massachusetts Institute of Technology

Eligibility Criteria

This trial is for current IHSS providers who live in San Bernardino County, California. It's designed to see if training these caregivers can improve health and employment outcomes for themselves and the elderly or disabled individuals they care for.

Inclusion Criteria

You must reside in San Bernardino County.

Currently receiving services from IHSS (In-Home Supportive Services)

The person lives in San Bernardino County.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Training

Participants in the treatment group complete a 30-hour online course teaching fundamental caregiving skills, including personal care, infection control, nutrition and body mechanics, medication adherence, and home safety.

4 weeks

Online course

Follow-up

Participants are monitored for health, healthcare, and labor market outcomes, including employment status, healthcare spending, and caregiving knowledge.

1 year

Treatment Details

Interventions

• IHSS Basic Training

Trial Overview The study tests a 30-hour online course provided by CCA that covers caregiving skills like personal care, infection control, nutrition, medication adherence, and home safety. Participants are randomly placed into two groups: one receives the training while the other does not.

Participant Groups

Group I: IHSS Basic Training Experimental Treatment 1 Intervention

Individuals in the treatment group will be invited to participate in CCA's IHSS Basic training program. The program is a 30 hour online course for IHSS providers, which teaches fundamental caregiving skills. Training includes personal care, infection control, nutrition and body mechanics, medication adherence, and home safety.

Group II: Control Active Control 1 Intervention

No intervention is delivered to the control group. The control group will be unable to access CCA's training programs for two years following random assignment.

Who Is Running the Clinical Trial?

Abdul Latif Jameel Poverty Action Lab

Lead Sponsor

Trials

31

Recruited

273,000+

Massachusetts Institute of Technology

Collaborator

Trials

104

Recruited

12,810,000+

University of Chicago

Collaborator

Trials

1,086

Recruited

844,000+

Center for Caregiver Advancement

Collaborator

Trials

1

Recruited

2,500+

Findings from Research

In California, many in-home caregivers for older adults with Alzheimer's and related dementias lack proper training, which can impact the quality of care provided.

A training program developed for these caregivers showed significant improvements in their knowledge and self-rated skills, indicating that structured training can enhance caregiver competence and potentially improve care for elderly patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Training for In-Home Supportive Services Caregivers in an Underserved Area. Guerrero, LR., Shim, A., Gans, D., et al.[2020]

The IHSS + ADRD Training Project is a 10-week online training program designed to improve dementia care knowledge among IHSS caregivers in Alameda County.

Preliminary results show that caregivers who completed the training experienced significant increases in their knowledge about dementia and their confidence in providing care, highlighting the need for ongoing training initiatives.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Enhancing Dementia Knowledge and Self-Efficacy of In-Home Supportive Services Caregivers Through Online Training. Yeh, J., Pond, B., Beld, M., et al.[2023]

Education and support services for families caring for frail elderly loved ones can significantly improve their coping abilities and reduce caregiver burden, as shown by the Neurological Sciences Center's programs over eight years.

The Education & Family Support Services (E&FSS) at Good Samaritan Hospital offers a variety of programs, including caregiver support groups and legal planning classes, which not only help families but also enhance the hospital's community image and generate revenue.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

They are not alone: lending support to family care givers. Heagerty, B., Dunn, L., Watson, MA.[2004]

Caregiver training for stroke patients significantly reduced health and social care costs by an average of £4043 (approximately $7249) over one year, primarily due to shorter hospital stays.

While caregiver training improved the overall quality of life for caregivers, it did not show measurable changes in quality-adjusted life years as assessed by the EQ-5D scale.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Training care givers of stroke patients: economic evaluation. Patel, A., Knapp, M., Evans, A., et al.[2022]

A three-year interdisciplinary training program was implemented for students in internal medicine, social work, pharmacy, and nursing at a geriatrics clinic, emphasizing the importance of collaborative care in health settings.

The program is supported by evidence and expert recommendations, highlighting the growing recognition of interdisciplinary training as essential for improving health care delivery, especially in ambulatory contexts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Teaching interdisciplinary geriatrics ambulatory care: a case study. Williams, BC., Remington, TL., Foulk, MA., et al.[2006]

A 2-hour educational program tailored for Vietnamese IHSS caregivers significantly improved their confidence and knowledge in personal care skills, as shown by pre- and post-survey results from 55 participants.

The culturally and language-specific approach of the training was effective, highlighting the importance of tailored education in enhancing caregiver skills for low-income older adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Effectiveness of Language-Specific Personal Care Education on Improving the Knowledge and Skills of Vietnamese American In-Home Supportive Service Caregivers. Vu, TH., Ju, E., Rousseau, J., et al.[2023]

The study highlights the unique challenges faced by unskilled in-home workers who care for frail elderly individuals, emphasizing the need for improved interpersonal skills in these roles.

The authors propose a typology of common interpersonal issues encountered by in-home workers and offer recommendations for training and supervision to enhance the effectiveness of care provided to elderly clients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The in-home worker: serving the frail elderly. Berger, RM., Anderson, S.[2019]

Training support workers in residential care to become 'Hearing Champions' is feasible and effective, as evidenced by the increased knowledge, skills, and confidence reported by the 14 participants who then trained 117 colleagues.

Support workers preferred training methods that were portable, adaptable, and interactive, highlighting the importance of engaging training formats in improving practices for assisting individuals with hearing impairments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

"We forget about peoples' hearing loss": identifying key aspects of hearing aid and communication training in residential care homes. McShea, L., Ferguson, M.[2023]

References

1. United States pubmed.ncbi.nlm.nih.gov

Training for In-Home Supportive Services Caregivers in an Underserved Area. [2020]

2. United States pubmed.ncbi.nlm.nih.gov

Enhancing Dementia Knowledge and Self-Efficacy of In-Home Supportive Services Caregivers Through Online Training. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

They are not alone: lending support to family care givers. [2004]

4. England pubmed.ncbi.nlm.nih.gov

Training care givers of stroke patients: economic evaluation. [2022]

5. England pubmed.ncbi.nlm.nih.gov

Teaching interdisciplinary geriatrics ambulatory care: a case study. [2006]

6. United States pubmed.ncbi.nlm.nih.gov

The Effectiveness of Language-Specific Personal Care Education on Improving the Knowledge and Skills of Vietnamese American In-Home Supportive Service Caregivers. [2023]

7. United States pubmed.ncbi.nlm.nih.gov

The in-home worker: serving the frail elderly. [2019]

8. England pubmed.ncbi.nlm.nih.gov

"We forget about peoples' hearing loss": identifying key aspects of hearing aid and communication training in residential care homes. [2023]