Improving the Heart Health of Home Health Aides

Improving the Cardiovascular Health of Home Health Aides

The goal of this early-stage study is to support the heart health of home health aides, a workforce that provides care for adults at home but whose own health has been historically poor. To do this, the study will use Life's Essential 8 (LE8), a program developed by the American Heart Association (AHA) that promotes cardiovascular wellness through education and lifestyle changes. The program has been adapted specifically for home health aides and will be delivered by trained "peer coaches," who are fellow home health aides who will help guide participants through the program.

The main questions the study aims to answer are:

• Will the LE8 intervention, which provides cardiovascular health education and support with positive thinking, be used by home health aides and do they like it?
• Does the LE8 intervention actually improve home health aides' cardiovascular health after the intervention's conclusion compared to baseline?

Participants will be paired with a trained peer coach and take part in the 10-week program over the course of 6 months. The program includes support for healthy behaviors and positive thinking, with the goal of making lasting improvements in cardiovascular health.

The goal of the proposed project is to improve the cardiovascular (CV) health of home health aides and attendants (HHAs), one of the fastest growing sectors of the healthcare industry, comprised predominantly of middle-aged women of color with a high burden of CV disease risk factors, including obesity, hypertension, hyperlipidemia, physical inactivity, and smoking. Improving HHAs' cardiovascular health and well-being is not only critical to their own longevity as a workforce, but it has the potential to improve the health of the patients for whom they care. The overall goal of the study is to test the preliminary effectiveness of the peer-coach (PC) delivered Life's Essential 8 (LE8) intervention program among 40 HHAs with poor CV health, while gathering data on its implementation.

The investigators have 3 main hypotheses. Under Aim 1, the investigators hypothesize that HHAs who receive the intervention will have higher CV health at follow-up compared to baseline. Under Aim 2, the investigators hypothesize that drivers of implementation will include: intervention adaptability, local conditions, work infrastructure, recipient centeredness, and motivation. Also under Aim 2, the investigators hypothesize the intervention will be feasible (>80% HHAs complete the study) and acceptable (>90% HHAs high levels of satisfaction).

All aspects of the study, including the intervention itself, will be conducted using a hybrid (in-person and virtual) model, with some sessions being completed online and others in person.

Inclusion Criteria

Home Health Aide Participants

• Currently working as a home health aide
• Speak English or Spanish
• ≥ 18 years of age
• Have low CV Health as assessed by LE8 components made up by physical health measurements (blood pressure, BMI) and general self-reported health (physical activity, diet, smoking, sleep); calculated to be a score of 0-50 (the total score ranges from 0-100)

Peer Coach Participants

• Previously participated in and completed Peer Coach training as part of the prior LE8 study (WCM IRB #24-11028134), or are members of the Weill Cornell Medicine study team who are trained in delivering the intervention.
• Speak English or Spanish

Exclusion Criteria:

Home Health Aide Participants

• Less than 1 year of job experience as a home health aide
• Does not possess a smartphone
• Gotten dizzy before with a finger stick blood sugar/cholesterol test
• Have a history of syncope with a finger stick blood sugar/cholesterol test

Peer Coach Participants

• Speak a language other than English or Spanish
• Did not complete Peer Coach training as part of the prior LE8 study (WCM IRB #24-11028134), or are not members of the Weill Cornell Medicine study team who are trained in delivering the intervention.