Community of Practice and Safety Support (COMPASS)

Photo of Oregon Home Care Commission  home care workers and one facilitator in a classroom participating in the COMPASS program.

Creating health and safe "Communities of Practice" for home care workers

The Community of Practice And Safety Support (COMPASS) program is a peer-led social support group intervention designed to improve social resources, reduce the risk of injuries and promote health among caregivers.

COMPASS is unique in that it addresses the lack of occupational social support structures for home care workers while also simultaneously targeting illness and injury prevention behaviors. COMPASS integrates several evidence-based intervention tactics, including elements of effective social support groups,1,2 scripted team-based health promotion programs,3,4,5,6 and goal setting with behavioral self-monitoring.7 The long-term goal of the COMPASS research agenda is to create a model structured program for promoting and protecting home care workers.

Home care worker population 

  • Job duties include assisting the elderly and disabled with self-care and mobility in private homes
  • Typically working for low wages
  • Predominantly female and older than 40
  • Have an injury rate that is nearly four times higher than the US average 
  • Are at elevated risk for mental and physical health problems

Intervention goals

  • Increase experienced community of practice
  • Improve physical and psychological well-being
  • Reduce hazards in homes and improve safety and health behavior

The COMPASS toolkit

  • In-person, small group meetings
  • Lessons on safety and health topics relevant to home care
  • Team activities and challenges
  • Group problem solving
  • Individual goal setting

Program impacts

  • COMPASS has been found to improve home care workers' safety and health knowledge as well as their experienced community of practice (i.e., professional social network) 
  • The program also produces simultaneous improvements in both safety and health behaviors, including the use of ergonomic tools.
  • Home care workers are a vulnerable population with a very limited support structure. The COMPASS program is a highly repeatable resource that provides them support and education resources that were previously unavailable to them. The long term desired impact is to improve health and reduce injuries in the US population of home care workers.

Program results

In a randomized controlled trial, COMPASS intervention participants reported several statistically significant improvements:

  • 76% reported improved safety behaviors
    • 58% had more safety conversations with their consumer-employer(s)
    • 50% corrected more slip, trip, fall safety hazards in consumer-employer(s)' homes
  • 63% reported eating more fruits and vegetables 
  • 62% reported having an enhanced professional social support community
  • Compared to the control group, COMPASS intervention participants had fewer lost work days due to injury.

Knowledge Gains from the Pilot Study 

Effects from the Randomized Controlled Trial 

Peer-led program improves home care workers' health, wellbeing and behavior (news coverage)

"I think anybody new coming into this field should have to take the COMPASS class. If you are brand new… you should have to take this class, because it will help exponentially"  

"I think I've made several changes [because of] the COMPASS program. Awareness was definitely one of those. I think of myself personally as a caregiver - I may focus on my consumer employer's needs more than my own needs, and so it really did bring an awareness that if my needs, you know my health…my mental health and everything, if I'm balanced, then I feel that I'm a better caregiver" 

 "I thought it was amazing to be able to learn and share and get information from other people and help them when they need it, and they help me. I just thought it was great."

  1. Olson, R., Thompson, S., Elliot, D.L., Hess, J.A., Luther Rhoten, K., Parker, K.N., Wright, R.R., Wipfli, B., Bettencourt, K.M., Buckmaster, A., & Marino, M. (2016). Safety and health support for home care workers: The COMPASS randomized controlled trial. American Journal of Public Health, 106 (10), 1823-1832.  
  2. Olson, R., Wright, R.R., Elliot, D., Hess, J., Thompson, S. Buckmaster, K, & Wipfli, B. (2015). The COMPASS pilot study: A Total Worker Health intervention for home care workers. Journal of Occupational and Environmental Medicine, 57(4), 406-416. 
  3. Olson, R., Elliot, D., Hess, J., Thompson, S., Luther, K., Wipfli, B., & Buckmaster, A.M. (2014). The COMmunity of Practice And Safety Support (COMPASS) Total Worker Health study among home care workers: Study protocol for a randomized controlled trial. Trials, 15: 411, 1-13.

Service Employees International Union (SEIU) Local 503

Oregon Home Care Commission  

Following success and positive outcomes of the COMPASS randomized controlled trial, the Oregon Home Care Commission voted unanimously to adapt and assess the COMPASS Program for implementation in their established training system. The program was adapted for the Commission's system, piloted with several groups, and was well-received. It is expected that this extended research partnership will ultimately make COMPASS available to 60% of home care workers in the state of Oregon.

Logo for Oregon Home Care Commission. The Oregon Home Care Commission supports homecare workers, personal support workers and consumer/employers by: Defining qualifications of homecare (HCW) and personal support workers (PSW), providing a statewide registry of HCW and PSW, providing training opportunities and serving as the "employer of record" for collective bargaining for homecare and personal support workers who receive service payments that are from public funds.

 Funding for COMPASS was provided by the National Institute for Occupational Safety and Health (NIOSH; grant: U19OH010154). 

Photo of Ryan Olson, PhD - Co-Principal Investigator (OHSU)
Ryan Olson, PhD (PI)
Jennifer Hess COMPASS Program Co Investigator
Jennifer Hess, MPH, DC, PhD (CI)
Miguel Marino, PhD COMPASS CI
Miguel Marino, PhD (CI)
Ryan Olson, PhD lab members
Visit Ryan Olson's lab page

To learn more about the COMPASS toolkit components or if you are interested in implementing the program in your organization, visit our toolkits and tools website, www.YourWorkpath.com  or by emailing  schucker@ohsu.edu.

 Peer-led program improves home care workers' health, wellbeing and behavior, contact our dissemination specialist Helen Schuckers at schucker@ohsu.edu with questions or if you organization is interested in implementing COMPASS

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2. Delbecq J, DeSchryver Mueller C. The ignatian faculty forum: A transformative faculty formation program. Connections. 2012;12(7):5-9.
3. Elliot DL, Goldberg L, Kuehl KS, Moe EL, Breger RKR, Pickering MA. The PHLAME (promoting healthy lifestyles: Alternative models' effects) firefighter study: Outcomes of two models of behavior change. J Occup Environ Med. 2007;49(2):204-213.
4. Goldberg L, Elliot DL, Clarke GN, et al. The adolescents training and learning to avoid steroids (ATLAS) prevention program: Background and results of a model intervention. Arch Pediat Adol Med. 1996;150:713-721. 
5. Elliot DL, Goldberg L, Moe EL, DeFrancesco CL, Durham MB, Hix-Small H. Preventing substance use and disordered eating: Initial outcomes of the ATHENA (athletes targeting healthy exercise & nutrition alternatives) program. Arch Pediatr Adolesc Med. 2004;158:1043-1049.
6. Kuehl KS, Elliot DL, Goldberg L, et al. The safety and health improvement: Enhancing law enforcement departments study: Feasibility and findings. Front Publ Health. 2014;2:38. 
7. Olson R, Winchester J. Behavioral self-monitoring of safety and productivity in the workplace: A methodological primer and quantitative literature review. J Organ Behav Manage. 2008;28:9-75.