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Objective: To understand the perspectives of home health aides (HHAs) toward their own health and health behaviors, and how their job impacts both. Data Sources and Study Setting: Interviews were conducted with 28 HHAs from 16 unique home care agencies from August 2021 to January 2022. The study was conducted in partnership with the 1199SEIU Training and Employment Fund, a labor‐management fund of the largest health care union in the US. Study Design: A qualitative study with English and Spanish‐speaking HHAs. Interviews were conducted using a semi‐structured topic guide, informed by Pender's Health Promotion Model and the National Institute for Occupational Safety and Health's Total Worker Health Model. To be eligible, HHAs had to be currently employed by a home care agency in New York, NY. Data Collection/Extraction Methods: Interviews were recorded, professionally transcribed, and analyzed thematically. Principal Findings: The 28 HHAs had a mean age of 47.6 years (SD 11.1), 39% were non‐Hispanic Black, 43% were Hispanic, and they had a mean of 14.1 years (SD 7.8) of job experience. Five themes emerged; HHAs were: (1) Healthy enough to work, but were managing their own chronic conditions while working; (2) Motivated to be healthy, in part driven by their desire to care for others; (3) Worked closely with sick patients, which influenced their perceptions of health; (4) Experienced occupational and patient‐level barriers to practicing healthy behaviors; (5) Sought support and resources to improve their health and wellbeing. Conclusions: HHAs have numerous health challenges, many of which are influenced by their job. Culturally and occupationally tailored interventions may mitigate the barriers that HHAs experience to achieve optimal health. [ABSTRACT FROM AUTHOR]

Home health aides and home care agencies, who operate in a high work stress environment under normal conditions, were placed under extraordinary demands during the COVID-19 pandemic. In this paper, we examine the unfolding effort at one agency in New York City to offer phone-based support calls to aides. We used a qualitative, single case study design involving semi-structured interviews with call staff and agency leaders (n = 9) and analysis of one year of thematic notes from the calls. We found that the calls resulted in multidirectional communication between agency staff and aides, an increased sense of empathy among staff, and a greater integration of aides into the agency's overall infrastructure. We explore how these calls might contribute to aide retention, worker voice, and mental health. We note the facilitators and barriers to implementing this type of job-based support to help other agencies that may be considering similar models. [ABSTRACT FROM AUTHOR]

Paid caregivers (for example, home health aides and personal care attendants) are formally tasked with helping older adults with functional impairment meet their basic needs at home. This study used thirty semistructured interviews with dyads of patients or their proxies and their paid caregivers in New York City to understand the range of health-related tasks that paid caregivers perform in the home and determine whether these tasks are taught in the New York State Department of Health's curriculum. We found that patients, proxies, and paid caregivers all reported that paid caregivers performed a wide range of health-related tasks that were often not part of their formal training. Creating clear competencies for paid caregivers that reflect the full breadth of health-related tasks they may perform in the home could help maximize the positive impact of the paid caregiver workforce on the lives of patients living at home with functional impairment. [ABSTRACT FROM AUTHOR]

While many types of health care workers experience patient death, home care workers do so under vastly different social and economic circumstances. When a client dies, home care workers often lose both a close relationship and a job. Though research suggests that health care workers' grief may frequently be disenfranchised, there is no in-depth study of the mechanisms that disenfranchise home care workers' grief specifically. To address this gap, our study used focus groups and peer interviews between home care workers in New York City. We describe four interrelated grief strategies they employ to navigate social and employer-based "grieving rules." Our findings suggest that home care workers' grief is disenfranchised via employer and societal underestimations of their relationships with clients and their losses when clients die, particularly job loss. Building on our findings, we suggest alterations to agency practices and home care systems to improve support for workers. [ABSTRACT FROM AUTHOR]

This article describes a novel approach to reciprocal peer interviewing in which participants interview one another sequentially, allowing each the space of a full interview to articulate her experiences and reflections. This structure of data collection offers a new conceptualization of the way that elicitation functions; not just as a process inside of an interview, but one that is also shaped by factors preceding and outside of the individual interview, a process we call "meta-elicitation." We argue that this form of reciprocal peer interviewing offers a view of the emic that is both participant-led and uniquely balanced between collective and individual perspectives. However, we also argue that shared authority and rapport are actively, and not always successfully, negotiated in such interviews. To prepare participants for peer interviewing, we hosted a 1-day workshop involving interview training, planning, and the recording of interviews. To maximize quality of such projects, we recommend that external researchers consider carefully (1) the balance of structure and flexibility in designing the workshop and interviews, (2) thorough preparation of participants, and (3) the role of meta-elicitation dynamics during analysis. [ABSTRACT FROM AUTHOR]

Objective: To examine the perspectives and practices of cooks responsible for carrying out healthy meal programmes in publicly funded foodservice, in order to better understand what they consider to be 'good' food and where nutrition and nutritional standards fit into this conceptualization.Design: A qualitative, exploratory study involving in-depth interviews that were conducted with cooks and their supervisors about their work practices and perspectives on providing healthy food for clients.Setting: Participants were recruited from child-care, after-school, senior-centre and shelter settings that had participated in healthy menu training in New York City, USA.Subjects: Eighteen cooks and nine supervisors working in the aforementioned settings.Results: The views and practices of both cooks and supervisors about what constitutes 'good' food extend beyond a purely nutritional view of goodness to include the importance of addressing hunger and clients' food preferences, among other factors. Cooks address these by interacting with clients and altering recipes and menus in a range of ways to maximize the likelihood of food consumption and enjoyment. These approaches are often, but not always, compatible with setting-specific nutritional guidelines that may be set at the national, state, local or organizational level.Conclusions: Cooks play a key role in translating nutritional guidelines into what is served. In doing so, they engage in skilled labour and forms of care that increase the ability of public-sector foodservice to address food security and other goals, but these aspects of their work are not widely recognized. [ABSTRACT FROM AUTHOR]