Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Class |
|---|---|
| Center for Caregiver Advancement | UNKNOWN |
| Massachusetts Institute of Technology | OTHER |
| University of Chicago | OTHER |
Not provided
Not provided
Not provided
Not provided
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.
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| IHSS Basic Training | Experimental | 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. |
|
| Control | No 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. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| IHSS Basic Training | Other | The intervention is the Center for Caregiver Advancements 30-hour IHSS Basic training course. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of emergency department visits (for consumer) | 1 year after training begins |
| Measure | Description | Time Frame |
|---|---|---|
| Any emergency department visits (for consumer) | 1 year after training begins | |
| Estimated annual health care spending (for consumer) | Estimated annual health care spending will be calculated by multiplying the number of inpatient admissions, emergency department visits, outpatient office visits, long term care stays, and prescription drugs by estimated average costs for those services among low income publicly insured adults. |
| Measure | Description | Time Frame |
|---|---|---|
| Any hospital admissions (for consumer) | 1 year after training begins | |
| Number of hospital admissions (for consumer) | 1 year after training begins | |
| Total length of stay in hospital (for consumer) |
Inclusion Criteria:
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jesse Gubb, Research Manager, PhD | Contact | 617-324-6995 | ihss.study@povertyactionlab.org |
| Name | Affiliation | Role |
|---|---|---|
| Matthew Notowidigdo, PhD | University of Chicago | Principal Investigator |
| David Autor, Phd | Massachusetts Institute of Technology | Principal Investigator |
| Amy Finkelstein, PhD |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| San Bernardino County | Recruiting | San Bernardino | California | 92401 | United States |
To the extent allowed by our data use agreements with administrative data providers, we will share de-identified data and analysis code at the conclusion of the project.
Data will become available after publication and will be hosted on a public research data repository such as the Harvard Dataverse (dataverse.org).
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| 1 year after training begins |
| Share of participants with falls resulting in a health care visit (for consumer) | The share of consumers with falls will be measured using diagnosis codes from medical claims | 1 year after training begins |
| Share of participants with urinary tract infections resulting in a health care visit (for consumer) | The share of consumers with urinary tract infections will be measured using diagnosis codes from medical claims | 1 year after training begins |
| Share of participants with pressure ulcers resulting in a health care visit (for consumer) | The share of consumers with pressure ulcers will be measured using diagnosis codes from medical claims | 1 year after training begins |
| Share of participants with nursing facility utilization (for consumer) | The share of consumers who have a stay in a skilled nursing facility, rehab, or long term care facility during the year after training begins. | 1 year after training begins |
| Share of participants still employed in IHSS (for provider) | The share of IHSS provider participants who remain as workers in the IHSS program 1 year after the start of training. | 1 year after training begins |
| Caregiving knowledge (for provider) | Proportion of correct answers out of 18 true false knowledge questions | 0-3 months after completion of training |
| Total length of stay in nursing facilities (for consumer) | The number of days spent per consumer in a skilled nursing facility, rehab, or long term care facility during the year after training begins. | 1 year after training begins |
| IHSS earnings (for provider) | IHSS earnings for providers, measured weekly, quarterly, and annually, drawn from IHSS payroll data | 1 year after training begins |
| IHSS hours worked (for provider) | IHSS hours worked for providers, measured weekly, quarterly, and annually, drawn from IHSS payroll data | 1 year after training begins |
| 1 year after training begins |
| Depression (for provider) | Patient Health Questionnaire-2 (PHQ-2). Scores range from 0 to 6, with higher values indicating worse outcomes. A score of 3 or higher identifies possible cases of major depressive disorder. | 0-3 months after completion of training |
| Anxiety (for provider) | Generalized Anxiety Disorder 2-item (GAD-2). Scores range from 0 to 6, with higher values indicating worse outcomes. A score of 3 or higher identifies possible cases of generalized anxiety disorder. | 0-3 months after completion of training |
| Caregiver wellbeing (for provider) | 18 question caregiver self assessment questionnaire developed by the American Medical Association (https://www.healthinaging.org/tools-and-tips/caregiver-self-assessment-questionnaire). Includes 16 Yes/No questions and 2 scale of 1 to 10 questions, with higher values indicating worse outcomes. 10 or more yes answers, having crying spells, feeling completely overwhelmed, a stress rating of >=6 out of 10, or health rating of >= 6 out of 10 all indicate distress. | 0-3 months after completion of training |
| Caregiver job satisfaction (for provider) | Self-reported answer to "Overall, how satisfied are you with your IHSS job?" on a 5-point Likert scale from very dissatisfied to very satisfied | 0-3 months after completion of training |
| Number of consumers served (for provider) | How many people the provider is paid to care for as part of the IHSS program | 1 year after training begins |
| Massachusetts Institute of Technology |
| Principal Investigator |
| Anna Russo | Massachusetts Institute of Technology | Principal Investigator |