Computer-Mediated Peer Support Needs of Home Care Workers: Emotional Labor & the Politics of Professionalism

Abstract

Home care workers (HCWs) are increasingly central to post-acute and long-term health services in the United States. Despite being a critical component of the day-to-day care of home-dwelling adults, these workers often feel underappreciated and isolated on the job and come from low-income and marginalized backgrounds. Leveraging the support of peers is one potential way to empower HCWs, but peer support encompasses a broad range of activities and aspects. Traditional conceptions of workplace support may not be appropriate to the home care context, as HCWs are a distributed workforce who have few opportunities to interact with each other. In this study, we explore how HCWs value and conceptualize peer support. Our findings demonstrate the importance of peer support in performing the emotional labor of home care work and ongoing attempts to strategically frame the home care profession as essential and medical in nature. Our results ground design implications for technology-enabled peer support based on the power dynamics of our participants' context and allow us to engage with issues where technology design for empowerment intersects with exploitation in distributed or crowd work, emotional labor, and tacit knowledge.

To care for them, we need to take care of ourselves: A qualitative study on the health of home health aides

“…Other, smaller studies include one by Danilovich et al in which a mobile health application was designed to engage HHAs and their patients in physical activity exercises; findings demonstrated that in doing so, HHAs were empowered to expand their training and skills 19 . Additionally, Poon et al found that virtual peer support programs led by trained HHAs offered a safe space for HHAs to build a sense of community, foster empowerment, and mentor one another by collectively sharing their caregiving experiences during the COVID‐19 pandemic 20 . Finally, a qualitative study during COVID‐19 by Tsui et al found that agency‐led phone‐based group support calls with aides improved communication between aides and the agency as well as creating a space in which aides could support each other and feel valued and respected 21 .…”

Development and Piloting of a Community-Partnered Heart Failure Training Course for Home Health Care Workers

“…Similarly, a physical activity-based training for HHWs by Muramatsu et al (2018) was shown to be well-received by aides and improve their patients’ daily function and physical fitness. 47 Like ours, these studies were single-arm pilot studies composed of unionized and agency-employed aides. Future studies should build on these and test the effectiveness of these disease-specific training courses on not only HHWs but on the self-care and health outcomes of their patients.…”

Mental Health and Well-Being Among Home Health Aides

“…New here is that the HHAs offered suggestions of what programs or interventions would work best for them, including support from trained peers. This finding is consistent with a few studies that found peer coach–delivered emotional support programs were feasible and well-received among HHAs before and during COVID-19 . Future studies are underway to formally tailor these programs to the needs of HHAs and evaluate their impact HHAs’ mental health and well-being, delivery of quality care, and patient outcomes.…”

“…Additionally, they were asked about their preferences toward future interventions that could meet their needs (eAppendix in Supplement 1). 5,26,27 In addition to the interviews and focus groups, selfreported demographic characteristics, including age, sex, race (including Asian, Black, White, and other [including Hispanic, Brown, or not specified]) and Hispanic or Latinx ethnicity, educational level, and employment history, were collected. Race and ethnicity are essential to include since HHAs are historically a minoritized population (mostly women and women of races and ethnicities other than White) of frontline health care workers; we wanted to ensure that we had diversity in race and ethnicity and by language spoken.…”