Studying home health care nurses and aides: Research design and challenges

Pia Markkanen, Stephanie M. Chalupka, Catherine Galligan, Susan R. Sama, Rebecca J. Gore, Hyun Kim, Anila Bello, David Kriebel, Margaret Quinn

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Home health care (HHC) is growing rapidly and yet health and safety conditions of HHC clinicians are poorly understood. Study of this workforce presents unique challenges because it is decentralised, often part-time and mobile. As part of a larger project on sharps injuries and blood exposures in HHC, this paper addresses the challenges of recruiting a large cohort of HHC nurses and aides and describes novel cross-sectional survey methodology. Recruitment was conducted with cooperation from eight HHC agencies and two labour unions. Intensive personal contacts and a financial incentive ($25) were employed. Some groups of HHC clinicians could be contacted only by mail, while others were contacted during a promotional "mini-fair" at their agency. A total of 1772, 18-page health and safety surveys were distributed and 1225 usable surveys were collected. This 69% overall response rate is better than that in many recent health surveys. Survey returns were highest (67-91%) where promotional events were held. The mailing-only strategy generated lower response rates (53-55%), despite the same financial incentive. Despite the challenges of reaching out to the decentralised HHC workforce, adequate response to a detailed health survey is possible, using appropriate techniques and with the close cooperation of employers and labour unions.

Original languageEnglish (US)
Pages (from-to)480-495
Number of pages16
JournalJournal of Research in Nursing
Issue number6
StatePublished - Nov 1 2008


  • Home health care
  • Occupational safety and health
  • Response rates
  • Study participant recruiting
  • Survey research

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