Psychosocial work characteristics of personal care and service occupations: a process for developing meaningful measures for a multiethnic workforce

Abstract

Background and objectives. Despite their rapid increase in number, workers in personal care and service occupations are underrepresented in research on psychosocial work characteristics and occupational health. Some of the research challenges stem from the high proportion of immigrants in these occupations. Language barriers, low literacy, and cultural differences as well as their nontraditional work setting (i.e., providing service for one person in his/her home) make generic questionnaire measures inadequate for capturing salient aspects of personal care and service work. This study presents strategies for (1) identifying psychosocial work characteristics of home care workers that may affect their occupational safety and health and (2) creating survey measures that overcome barriers posed by language, low literacy, and cultural differences.

Design and results. We pursued these aims in four phases: (Phase 1) Six focus groups to identify the psychosocial work characteristics affecting the home care workers' occupational safety and health; (Phase 2) Selection of questionnaire items (i.e., questions or statements to assess the target construct) and first round of cognitive interviews (n = 30) to refine the items in an iterative process; (Phase 3) Item revision and second round of cognitive interviews (n = 11); (Phase 4) Quantitative pilot test to ensure the scales' reliability and validity across three language groups (English, Spanish, and Chinese; total n = 404). Analysis of the data from each phase informed the nature of subsequent phases. This iterative process ensured that survey measures not only met the reliability and validity criteria across groups, but were also meaningful to home care workers.

Conclusion. This complex process is necessary when conducting research with nontraditional and multilingual worker populations.

Keywords:

• home care workers
• caregivers
• multiethnic workers
• measurement development
• qualitative analysis
• psychosocial work characteristics

Acknowledgements

The authors wish to thank the interviewers Heather Lloyd, Jimmy Zhang Ming, Anna Grummon, Sonia Mendoza, Sharon Yao and Janette Najera. We also thank SEIU Long Term Care Workers Union and Linda Ayala from Public Authority for IHSS in Alameda County for providing access to the respondents. Thanks to Laura Stock, Dinorah and Ken Fong for facilitating the focus groups and Kai Lui for transcription and translation of the Cantonese interviews and focus groups. This study was funded by the National Institute for Occupational Safety and Health [grant number NORA FY05 DSHEFS12.3]. The findings and conclusions in this paper are those of the authors and do not necessarily represent the views of NIOSH.