Pandemic-related ability and willingness in home healthcare workers

Abstract

Objective: To assess pandemic-related attitudes and behavioral intentions of home healthcare workers (HHCWs).Design: Cross-sectional survey.Setting: New York City.Participants: A convenience sample of 384 HHCWs.Main Outcome Variables: Ability and willingness to report to work during a pandemic influenza outbreak.Results: A large proportion of HHCWs reported that they would be either unable or unwilling (or both) to provide care to their current (83 percent) or new (91 percent) patients during a pandemic. Ability was significantly associated with not having children living at home, having alternatives to mass transportation, not having a spouse/partner employed as a first responder or healthcare worker, and having longer tenure (ie, six or more years) in homecare. During an outbreak, 43 percent of HHCWs said they would be willing to take care of current patients and only 27 percent were willing to take care of new patients.Willingness to care for both current and new patients was inversely associated with fear for personal safety (p 0.01). Provision of key elements of a respiratory protection program was associated with decreased fear (p 0.05). Most participants (86 percent) had not received any work-based, pandemic- related training, and only 5 percent reported that their employer had an influenza pandemic plan.Conclusions: Given that a large majority of the participating HHCWs would either be unable or unwilling to report to duty during a pandemic, potential shortfalls in this workforce may occur. To counter this, organizations should focus on strategies targeting intervenable barriers to ability and to willingness (ie, the provision of a vaccine and respiratory protection programs).