EMMA
Summary
The project „EMMA“ addresses health promotion and prevention within the setting of home health care. Home health care employees have high psychological, physical and psychosocial demands however, they have been a neglected target group so far. The project is supported by “Verband der Ersatzkasse e.V. (vdek)” (statutory health insurance) and is conducted from June 2020 until fall 2023.
The structure of the project follows the four stages of the Public Health Action Cycle: assessment, development, assurance and evaluation. Collecting the data for the assessment a mixed method design is used identifying burdens and resources within six home health care facilities in Bavaria. Using these results and participatory decision-making processes six topics are discovered for the development of health promotion and prevention. For each topic six up to eight actions are constructed which are developed resting on best-practice standards. Moreover, the specific actions are customized for the specific/ individual needs of the facilities. The first evaluation process is focused on the implementation outcomes. Within the next step, the successful, feasible actions are tested at their effectiveness collecting data in facilities in Berlin and Brandenburg. The aim of this project is to develop actions, which are practicable in everyday working life and are effective to enhance health. In the end, the developed and evaluated actions are provided nationally for each home health care facility in Germany by vdek.
Background
Home health care facilities maintain 24.3% of the care-dependent people (0.83 million) in Germany. Within the period of 2015 to 2018 the amount of care-dependent people increased by 138,000. Besides the increasing amount of care-dependent people, the demand of care personnel raises as well which cannot covered appropriately: Three out of four home health care facilities have job vacancies. (At the moment 390,322 persons work within home health care facilities.) Moreover, 69% of the employees (of home health care facilities) do not want to continue their job until their retirement. The main reason for considering giving up on their job are health issues. Trying to counteract this supply shortfall the “Pflegepersonal-Stärkungsgesetz” (≙ law of strengthening home health care workers) is established. As major parts, health prevention and promotion are included in this law. However, there are no implementation concepts available, adjusting the working conditions and processes of the specific working environment of home health care facilities. Neither well-evaluated nor practical actions of prevention and promotion customized for this specific working environment are accessible. One reason for this is the lack of a valid and comprehensive database about specific working conditions and processes as well as the linked working burdens and resources of the home health care workers. Through the assessment of the project EMMA, the missing database should be generated. Afterwards customized actions of prevention and promotion are developed and evaluated for home health care facilities. Finally, the results and actions are nationally provided for each home health care facility.
Aim of the project
The three primary aims of the project are: (1) examining and reducing occupational psychosocial and physical burdens and demands; (2) examining and strengthening occupational health resources of home health care employees; and (3) positively influencing health-related outcomes (e.g. job satisfaction, work ability).
Implementation
- Evaluating the Assesment:
The assessment including demands, resources and working conditions is collected with a mixed method design consisting of five methods: Questionnaires, Job Shadowing, Audio Diaries, Participatory Workshops, and Expert Interviews.
- Developing Actions:
Using the results of the questionnaire and the participatory workshops six topics are identified: 1. Promotion Collaboration 2. Rethinking Work Structures 3. Living Self-Care 4. Shaping Temporal Balance 5. Strengthening the Body 6. Mastering Challenging Situations/Tasks. For each topic six up to eight actions are developed which are based on national / international Best-Practice projects or well-evaluated operational health management projects with similar occupational characteristics compared to home health care employees. Moreover, new and customized actions are conceived. The elaboration of the individual actions (including aims, content, and methodology) is finalized with Team Gesundheit – the cooperation partner.
- Assuring Actions:
The cooperation partner – Team Gesundheit- elaborates the materials (e.g. podcast) and provides trainers who execute the actions.
- Evaluation:
Implementation: In the pilot phase, the implementation outcomes are evaluated since home health care workers have specific working conditions (e.g. working alone, working mobile). The evaluation is based on the taxonomy of Proctor et al. 2011 with the following aspects: acceptability, appropriateness, feasibility, costs, fidelity, penetration and sustainability. Evaluating the implementation outcomes a mixed method design is used consisting focus group interviews, semi-structured interviews, questionnaires and documentation forms.
Effectiveness: In the Rollout phase, the effectiveness is evaluated. The objectives (1) reducing psychosocial and physical burdens and demands, (2) strengthening occupational health resources and (3) improving health relevant outcomes are tested. Therefore, again, a mixed method design is used.
Time horizon
The project term comprises three years, starting in June 2020 and ending in fall 2023.
Participating facilities (Pilot phase)
Munich (urban facilities)
- Ambulanter Pflegedienst München Mitte (Hiltenspergerstraße 80, 80796 München)
- Sozialstation Berg am Laim (Berg-am-Laim-Str.141, 81673 München)
- Sozialstation Trudering (Truderinger Str. 277, 81825 München)
- Wohnen im Viertel – Obergiesing (Bayrischzeller Straße 10, 81539 München)
Bavaria (rural facilities)
- Pflege daheim Seniorenstift Kaufering (Albert-Schweitzer Straße 8, 86916 Kaufering)
- Ambulante Pflege Cannalonga (Bahnhofstr. 29a, 86938 Schondorf am Ammersee)
- Ambulanter Pflegedienst Berchtesgadener Land (Salzburger Straße 29B, 83435 Bad Reichenhall