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Evaluating the Impact of Resource Navigators to Support LTC and RH Staff During and Beyond COVID-19

Primary Purpose

Wellness, Burnout, Caregiver, Burnout, Professional

Status
Recruiting
Phase
Not Applicable
Locations
Canada
Study Type
Interventional
Intervention
Intervention
Sponsored by
Unity Health Toronto
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Wellness focused on measuring Caregiver, Personal support worker, long term care home, mental health

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria: A fulltime or part-time employee aged 18 years and older identified as a Long-Term Care and Retirement Home staff (PSW's and other support service staff in those in nutrition, housekeeping and laundry) Work in an Ontario Long-term care or retirement home; Comfortable speaking and reading English; and Access to and willingness to use email for study communications Exclusion Criteria: Do not identify as or are not employed as a PSW and other support service staff; Do not work in an Ontario long-term care or retirement home; Uncomfortable speaking or reading English; and Do not have access to or unwillingness to use email for study communications

Sites / Locations

  • St. Michaels Hospital,Recruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

No Intervention

Experimental

Arm Label

Control

Intervention Group

Arm Description

Receiving monthly resources only

Receiving sessions with a resource navigator 2x a month, and monthly resources.

Outcomes

Primary Outcome Measures

Rate of Change in Wellness
Participant wellness will be assessed using the Personal Wellbeing Score. Survey includes 5 questions and will be scored on a scale from 0 to 16, where 16 is the worst outcome, or poorest level of wellness. For ONS4 life satisfaction, worthwhile and happiness scores, responses 9-10 are grouped as Very high, 7-8 as High, 5-6 as Medium and 0-4 as Low. For anxiety scores, responses 6-10 are grouped as High, 4-5 as Medium, 2-3 as Low and 0-1 as Very low.

Secondary Outcome Measures

Rate of Change in Level of Burnout
Burnout will be assessed with the 22-item Maslach Burnout Inventory for Medical Personnel. The questionnaire has three main areas which are to be scored independently: emotional exhaustion, on a scale of 0 to 54, where 54 is the worse outcome (highest level of emotional exhaustion); depersonalization, on a scale of 0 to 30, where 30 is the worst outcome (highest level of depersonalization); and low sense of personal accomplishment, on a scale of 0 to 48, where 0 is the worst outcome (lowest sense of personal accomplishment).
Rate of Changes in knowledge, access to and use of wellness supports,
There are five individual surveys assessing changes to participants' knowledge, access to, and use of wellness supports.
Rate Changes in number of participants with COVID-19 vaccination, number of participants with COVID infection and hospitalization, over time
Via participants' Ontario Health Insurance Plan (OHIP) number, we will link to the ICES provincial administrative database to obtain participants' vaccine status, and rates of SARS-CoV-2 infection, hospitalization and death.

Full Information

First Posted
December 9, 2022
Last Updated
May 8, 2023
Sponsor
Unity Health Toronto
Collaborators
Canadian Institutes of Health Research (CIHR), University of Toronto
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1. Study Identification

Unique Protocol Identification Number
NCT05677997
Brief Title
Evaluating the Impact of Resource Navigators to Support LTC and RH Staff During and Beyond COVID-19
Official Title
Evaluating the Impact of Resource Navigators to Support Long-term Care and Retirement Home Staff During and Beyond COVID-19
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Recruiting
Study Start Date
March 1, 2023 (Actual)
Primary Completion Date
August 2023 (Anticipated)
Study Completion Date
August 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Unity Health Toronto
Collaborators
Canadian Institutes of Health Research (CIHR), University of Toronto

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The goal of this clinical trial is to test how well resource navigators help long-term care and retirement home staff access the various health and wellness resources available to them and the effects that this has on their health and wellness overall. The main questions it aims to answer are: - How does one-on-one support from a resource navigator affect the wellness of long-term care and retirement home staff, including burnout, vaccination status, and COVID-19 infection? Researchers will compare participants in the intervention group (where participants are paired with a resource navigator) and the control group (where participants are not paired with a resource navigator) to see the impact access to a resource navigator has on wellness (primary outcome), burnout, knowledge of, access to and use of wellness resources, knowledge/alignment with provincial public health guidelines related to SARS-CoV-2 vaccine outcomes, SARS-CoV-2 infection, hospitalization, and death (secondary outcomes). Hypothesis: Researchers anticipate that those in the intervention group (have access to a resource navigator) will report a higher positive change in wellness between baseline and 6 months.
Detailed Description
In response to the increased stress and workload of the COVID-19 pandemic response for long term care home (LTCH) and retirement home (RH) staff, the Knowledge Translation Program (KTP) at St. Michaels Hospital launched efforts to support this population. Via in-depth discussions and surveys, >200 personal support workers (PSWs) were canvassed to identify their needs during the pandemic. Four areas of need were identified, which included supports for: Wellness, burnout and mental health Infection Prevention and Control (IPAC) Wraparound resources (e.g., access to food banks, caring for a family member with COVID-19) and Vaccine information Additionally, using the Theoretical Domains Framework, the KTP identified the following barriers that impact PSWs' and/or other long-term care and retirement home staff's ability to navigate the pandemic [1]: lack of knowledge of available resources perceptions of identity within the long-term care home context, resource challenges (e.g., lack of occupational health programs), and * impact of social influences on beliefs (e.g., family and peer perceptions of vaccine efficacy and safety). These barriers were mapped to corresponding implementation strategies via the Behaviour Change Wheel framework to identify education and enablement (e.g., supporting individuals' own self-efficacy) as interventions to mitigate the identified barriers.[1] Utility of these interventions was confirmed by long-term care home staff partners who believed routine check in calls would reduce social isolation and support PSWs and other long-term care staff to find and use available resources to address their needs.[1] Through funding from the COVID-19 Immunity Task Force (CITF), the Ontario Ministry of Labour Training and Skills Development (MOLTSD) and the Canadian Immunization Research Network (CIRN), the KTP developed educational resources compiled in a single online repository for long-term care home staff on optimizing infection prevention and control (IPAC) [2-5] in long-term care home, promoting wellness and preventing burnout [6, 7] providing 'wraparound' [8 ,9] resource supports to individuals (e.g., access to food banks, resources on self-isolation, caring for a family member with COVID-19), and addressing SARS-CoV-2 vaccine [10-12] myths and questions (via infographics and town halls created in partnership with OPSWA).[13, 14] However, currently long-term care and retirement home staff access these resources passively and many do not have the capacity or skills to implement the resources effectively. A navigator is the missing link to putting these resources into practice. Through this clinical trial, the researchers aim to answer the following research question: What is the impact of tailored 1:1 support from a resource navigator and educational resources (intervention arm) compared to educational resources only (control arm) on the wellness of long-term care and retirement home staff (primary outcome), burnout, knowledge of, access to and use of wellness resources, SARS-CoV- 2 vaccination status, self-reported SARS-CoV-2 infection and hospitalization (secondary outcomes). To achieve the study aim, the researchers will: Conduct a trial, which will randomize PSWs and other support service staff to receive 6 months of tailored 1:1 support from a resource navigator and educational resources (intervention arm) versus educational resources only (control arm) to navigate the pandemic. Evaluate the impact of the intervention on PSW's and other support service staff's wellness (primary outcome), burnout, knowledge of, access to and use of wellness resources, alignment of provincial public health guidelines related to SARS-CoV-2 vaccine outcomes, SARS-CoV-2 infection, hospitalization, and death (secondary outcomes). Conduct a process evaluation to assess quality and delivery of the study intervention. This study will take place in Long-Term Care and Retirement Homes in Ontario. Each month, participants in the intervention arm will receive a PDF package by email from a research staff member, which will include wellness, burnout and mental health resources (e.g., how to use the free, self-referral Centre for Addiction and Mental Health service [6]; tips on reducing/preventing burnout [9]), SARS-CoV-2 vaccine infographics [10], a wraparound [8] resource package, and IPAC [5] tips/guidance. Participants that indicated they would like a print copy of the resources in the pre-screening survey will be provided a copy via mail. Participants will also receive two hours (2, 1-hour sessions) of navigation support sessions from the resource navigator (by phone/zoom) per month for six months (Total 12, 1-hour sessions). While the resource navigator will not directly provide counselling or mental health supports, they will serve as a liaison to link the PSWs and other support service staff (where applicable) to these supports. The resource navigators will hold a degree or diploma in social services/work, psychology or a related field and have at least 2 years of experience in these sectors. In the control arm, participants will receive the monthly educational resources only. Both intervention and control arms will complete a baseline survey, exit survey (at 6 months), and interview if selected to participate.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Wellness, Burnout, Caregiver, Burnout, Professional, COVID-19, Vaccine Refusal
Keywords
Caregiver, Personal support worker, long term care home, mental health

7. Study Design

Primary Purpose
Other
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
174 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Control
Arm Type
No Intervention
Arm Description
Receiving monthly resources only
Arm Title
Intervention Group
Arm Type
Experimental
Arm Description
Receiving sessions with a resource navigator 2x a month, and monthly resources.
Intervention Type
Behavioral
Intervention Name(s)
Intervention
Intervention Description
Sessions to go through goals, problem areas, areas they want to improve.
Primary Outcome Measure Information:
Title
Rate of Change in Wellness
Description
Participant wellness will be assessed using the Personal Wellbeing Score. Survey includes 5 questions and will be scored on a scale from 0 to 16, where 16 is the worst outcome, or poorest level of wellness. For ONS4 life satisfaction, worthwhile and happiness scores, responses 9-10 are grouped as Very high, 7-8 as High, 5-6 as Medium and 0-4 as Low. For anxiety scores, responses 6-10 are grouped as High, 4-5 as Medium, 2-3 as Low and 0-1 as Very low.
Time Frame
Baseline, and 6 months.
Secondary Outcome Measure Information:
Title
Rate of Change in Level of Burnout
Description
Burnout will be assessed with the 22-item Maslach Burnout Inventory for Medical Personnel. The questionnaire has three main areas which are to be scored independently: emotional exhaustion, on a scale of 0 to 54, where 54 is the worse outcome (highest level of emotional exhaustion); depersonalization, on a scale of 0 to 30, where 30 is the worst outcome (highest level of depersonalization); and low sense of personal accomplishment, on a scale of 0 to 48, where 0 is the worst outcome (lowest sense of personal accomplishment).
Time Frame
Baseline, and 6 months.
Title
Rate of Changes in knowledge, access to and use of wellness supports,
Description
There are five individual surveys assessing changes to participants' knowledge, access to, and use of wellness supports.
Time Frame
Baseline, and 6 months.
Title
Rate Changes in number of participants with COVID-19 vaccination, number of participants with COVID infection and hospitalization, over time
Description
Via participants' Ontario Health Insurance Plan (OHIP) number, we will link to the ICES provincial administrative database to obtain participants' vaccine status, and rates of SARS-CoV-2 infection, hospitalization and death.
Time Frame
Baseline, and 6 months.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: A fulltime or part-time employee aged 18 years and older identified as a Long-Term Care and Retirement Home staff (PSW's and other support service staff in those in nutrition, housekeeping and laundry) Work in an Ontario Long-term care or retirement home; Comfortable speaking and reading English; and Access to and willingness to use email for study communications Exclusion Criteria: Do not identify as or are not employed as a PSW and other support service staff; Do not work in an Ontario long-term care or retirement home; Uncomfortable speaking or reading English; and Do not have access to or unwillingness to use email for study communications
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Christine Fahim, PhD
Phone
416-360-4000
Ext
77300
Email
christine.fahim@unityhealth.to
First Name & Middle Initial & Last Name or Official Title & Degree
Sharon Sharon Straus, MD
Phone
416-864-3068
Email
sharon.straus@utoronto.ca
Facility Information:
Facility Name
St. Michaels Hospital,
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5B 1W8
Country
Canada
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lames Danok, BSc
Email
lames.danok@unityhealth.to

12. IPD Sharing Statement

Citations:
PubMed Identifier
21513547
Citation
Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci. 2011 Apr 23;6:42. doi: 10.1186/1748-5908-6-42.
Results Reference
background
Citation
Rios P, Radhakrishnan A, Thomas SM, Darvesh N, Straus SE, Tricco AC. Preventing respiratory illness in older adults aged 60 years and above living in long-term care. MedRxiv. 2020; 1-25. https://doi.org/10.1101/2020.03.19.20039081
Results Reference
background
PubMed Identifier
32977848
Citation
Rios P, Radhakrishnan A, Williams C, Ramkissoon N, Pham B, Cormack GV, Grossman MR, Muller MP, Straus SE, Tricco AC. Preventing the transmission of COVID-19 and other coronaviruses in older adults aged 60 years and above living in long-term care: a rapid review. Syst Rev. 2020 Sep 25;9(1):218. doi: 10.1186/s13643-020-01486-4.
Results Reference
background
Citation
IPAC+ Self-Assessment for Long-term Care Facilities (LTCHs) and Retirement Homes (RHs). https://ipac.knowledgetranslation.ca/. Accessed 2021 Feb 18.
Results Reference
background
Citation
IPAC+ Resource Library. Regional Geriatric Program of Toronto. https://www.rgptoronto.ca/resources/ipac+/. Updated 2021.
Results Reference
background
Citation
Mental Health and COVID-19. Centre for Addiction and Mental Health (CAMH). https://www.camh.ca/en/health-info/mental-health-and-covid-19/information-for-professionals. Published 2020.
Results Reference
background
Citation
Mental Health Supports. Wellness HUB Support for Congregate Living Centres. https://wellness-hub.ca/tag/mental-health-supports/. Published 2021.
Results Reference
background
Citation
Wraparound Resources Package. Wellness Hub. https://wellness-hub.ca/res/wraparound-resources-package/. Published 2021.
Results Reference
background
Citation
Caregiver Resources. The Ontario Caregiver Organization. https://ontariocaregiver.ca/resources-education/caregiver-resources/#caring-for-yourself. Published 2021.
Results Reference
background
Citation
What you need to know about getting the COVID-19 vaccine. Wellness Hub. https://wellness-hub.ca/res/what-you-need-to-know-about-getting-the-covid-19-vaccine/. Published 2021.
Results Reference
background
Citation
February 2nd, 2021 OPSWA Town Hall #2: COVID vaccine questions answered. Knowledge Translation Program. https://www.youtube.com/watch?v=UCzRgtbHFFQ&t=517s. Published 2021 Mar 31.
Results Reference
background
Citation
March 23rd, 2021 OPSWA Town Hall #3: Get you COVID vaccine questions answered. Knowledge Translation Program. https://www.youtube.com/watch?v=hNrNsTXKGT8&t=3s. Published 2021 Mar 26.
Results Reference
background
Citation
Knowledge Translation Program. COVID-19 Knowledge Translation. https://knowledgetranslation.net/expertise/covid-19/. Updated 2021.
Results Reference
background
Citation
COVID-19 Immunity Task Force. Pan-Canadian studies investigate why COVID-19 has been devastating to long-term care facility residents and staff.
Results Reference
background

Learn more about this trial

Evaluating the Impact of Resource Navigators to Support LTC and RH Staff During and Beyond COVID-19

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