The objective of this research was to determine the feasibility of and receptivity to the first computerized workplace-based direct caregiver intervention and to assess the effects on businesses, working family caregivers, and their elderly relatives. Working family caregivers, with at least one health and/or safety concern related to an elder residing alone at home during the workday, were recruited from five companies (n = 27). Caregivers received free computer access to the Worker Interactive Networking (WIN) Internet online caregiver support group and a remote elder monitoring system at home for 6 months. The remote monitoring system provided Web-based status reports and e-mail/pager alerts when individualized parameters were exceeded. Motion sensor signals were transmitted to a transponder that uploaded via wireless cellular communications to the project server, thereby not interfering with elders' telephone use. Formative qualitative analyses clarified acceptance and implementation issues. Summative quantitative evaluation determined pilot intervention effects and was conducted by external evaluators. Despite interoperability and cellular reception issues, the system was successfully deployed across four states to a variety of businesses and housing types. Positive results occurred on worker morale, productivity, and reduction of caregiver stress. Participants found it easy to learn and use. Elders did not find the technology "intrusive" or "isolating." Contrary to their expectations, managers reported no abuse of Internet access. Workers expressed a willingness to pay for a similar system in the future ranging from $10 to $130, depending on the features. They would pay the most for the option involving a geriatric nurse coach. The WIN system innovatively tailored to users' wants, and provided users customized control and personalized support. Use of the system was associated with positive outcomes. Enrollment response suggests a specific niche market for remote home monitoring, making it a manageable employee benefit.

Older women of color tend to have much lower rates of regular mammography screening for breast cancer than younger Caucasian women; yet, they have higher rates of mortality. This study was designed to increase mammography rates among inner-city women aged 50 years or older. Another goal was to investigate differences in mammography utilization related to race/ethnicity and language after barriers associated with cost and the difficulty of making an appointment are removed. A peer delivered intervention, which consisted of interview, mammography referral, and the scheduling of a next-day appointment, was conducted among a convenience sample of 151 culturally and racially diverse older women through a primary care referral project operating within an urban emergency department (ED). A brief motivational interview and mammography referral at the time of an ED visit, including scheduling of a next-day no cost appointment, was followed by a cross-sectional telephone survey of utilization and motivating and hindering factors. Follow-up was achieved with 96 women (66%). Fifty-eight women (60%) had a post-intervention mammogram; of those, 69% were first time users. More than 90% planned a repeat mammogram the following year. Of the 27 who did not receive a mammogram, 21 (77%) requested a "second try" appointment. These findings demonstrate that an interactive intervention among older women of color has the potential to dramatically increase mammography rates.

Little research has been conducted to evaluate employer-sponsored elder care service programs. This study assesses the perspectives of senior human resource and employee benefit managers at large U.S. corporations about nine types of elder care services. Survey responses were obtained from 115 employer officials. The majority of employers reported that elder care services help decrease Allard E. Dembe, ScD, is Associate Professor and Chair

It is now widely accepted that employee caregivers-in the main, women-need to make adjustments in or take time from their jobs in order to provide or oversee assistance required by elderly relatives. The absenteeism, lowered productivity, and job turnover noted by many employers in business group surveys have motivated a number of firms to seek ways to address the needs of this group of employees. To date, researchers studying work disruption among employee caregivers have given little attention to the ways in which employees in different types of jobs respond to their dual responsibilities toward employers and elders who require their assistance. Those investigating the ways in which caregivers accommodate these competing demands have speculated that blue- or pink-collar workers may differ from their white-collar counterparts in the kinds or intensity of work disruptions they face, but few studies have contained information on workers' jobs that would permit systematic analysis of this question. This article analyzes patterns of work accommodations among caregivers in the Survey of Informal Caregivers of the 1982 National Long Term Care Survey. Caregivers' occupations are classified as: (a) executive, professional, technical jobs (18%); (b) sales (8%) or service (23%) positions; (c) clerical jobs (19%); or (d) production line and other blue-collar positions (32%). The study concludes that because the approaches caregivers take to address the demands of elder care are quite diverse and vary with membership in occupational group, employers who wish to aid these employees will need to design a set of flexible policies and benefit packages.

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