Intervention to Help Orient Men to Excel (IN-HOME): A culturally appropriate CHW training program to reduce minority caregiver burden

KDH Research & Communication (KDHRC) submits this proposal to expand and fully evaluate the Intervention to Help Orient Men to Excel (IN-HOME). IN-HOME is a culturally competent, online professional development course to prepare community health workers (CHWs) to conduct outreach to reduce informal caregiver burden, with a specific focus on supporting Black and Latino male caregivers of older adults (aged 65+) who are aging in place. The IN-HOME model has two stages. In stage one, the training course increases CHWs’ knowledge, skills, and perceived self-efficacy to conduct outreach to Black and Latino male caregivers. In stage two, IN-HOME-trained CHWs support Black and Latino male caregivers, and through their interactions, build caregivers’ knowledge, positive attitudes, self-efficacy, and intentions around self-care, their health, and caregiving topics. Our Phase I efforts resulted in a dynamic prototype CHW training course that significantly increased CHWs’ abilities to conduct successful outreach. KDHRC enters the Phase II proposal with a solid prototype, strong feasibility results, pending publications, and an outstanding team of collaborators, consultants, contractors, and expert advisors. Phase II IN-HOME CHW training finalizations plans include adding training lessons, developing additional interactive content, and filming video vignettes. A toolbox app will create a technology that facilitates private synchronous and asynchronous communication between the CHW and caregiver, which KDHRC hypothesizes will build trust and overcome hesitancy to ask for support. Once complete, KDHRC will conduct a well-powered and methodologically strong two-arm randomized controlled trial to explore stage 2 of the model – the impact of receiving outreach from IN-HOME trained CHWs on caregiver outcomes. The need for IN-HOME is substantial. As the population of older adults continues to increase, there is a growing need for informal caregiver support for the 90 percent of the older adults who prefer to stay in their own homes instead of receiving institutionalized care. Almost 40 percent of all informal caregivers are male, and minorities are more likely to be long-time caregivers and are at higher risk for caregiver burden, stress, and burnout. But while there are millions of minority male caregivers, current resources, and even the national discourse, have neglected this important segment of the caregiver population. CHWs are in a strategic position to empower male caregivers, and IN-HOME will be a powerful addition to the public health arsenal to address this challenge.