Trial Outcomes & Findings for Leveraging Home Health Aides to Improve Outcomes in Heart Failure (NCT NCT04239911)

NCT ID: NCT04239911

Last Updated: 2025-06-06

Results Overview

As measured by the Dutch Heart Failure Knowledge Scale, scores range from 0-15; higher scores indicate greater heart failure knowledge.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

105 participants

Primary outcome timeframe

Baseline (0 days); at follow-up (90 days)

Results posted on

2025-06-06

Participant Flow

Participant milestones

Participant milestones
Measure
Enhanced Usual Care
Home health aides in the enhanced usual care arm will receive a virtual heart failure training course. Virtual training course: Virtual training course on heart failure for home health aides.
Intervention Arm
Home health aides in the intervention arm will receive a virtual heart failure training course and a communication-based messaging app. mHealth app: The mHealth app will provide heart failure-specific education to home health aides and allow them to report clinical observations and ask nurses questions in real-time. Virtual training course: Virtual training course on heart failure for home health aides.
Overall Study
STARTED
52
53
Overall Study
COMPLETED
50
52
Overall Study
NOT COMPLETED
2
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Enhanced Usual Care
Home health aides in the enhanced usual care arm will receive a virtual heart failure training course. Virtual training course: Virtual training course on heart failure for home health aides.
Intervention Arm
Home health aides in the intervention arm will receive a virtual heart failure training course and a communication-based messaging app. mHealth app: The mHealth app will provide heart failure-specific education to home health aides and allow them to report clinical observations and ask nurses questions in real-time. Virtual training course: Virtual training course on heart failure for home health aides.
Overall Study
Lost to Follow-up
2
1

Baseline Characteristics

Leveraging Home Health Aides to Improve Outcomes in Heart Failure

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Enhanced Usual Care
n=50 Participants
Home health aides in the enhanced usual care arm will receive a virtual heart failure training course. Virtual training course: Virtual training course on heart failure for home health aides.
Intervention Arm
n=52 Participants
Home health aides in the intervention arm will receive a virtual heart failure training course and a communication-based messaging app. mHealth app: The mHealth app will provide heart failure-specific education to home health aides and allow them to report clinical observations and ask nurses questions in real-time. Virtual training course: Virtual training course on heart failure for home health aides.
Total
n=102 Participants
Total of all reporting groups
Years worked at their current agency
6-10 years
16 Participants
n=5 Participants
18 Participants
n=7 Participants
34 Participants
n=5 Participants
Years worked at their current agency
11-15 years
10 Participants
n=5 Participants
8 Participants
n=7 Participants
18 Participants
n=5 Participants
Years worked at their current agency
greater than 15 years
8 Participants
n=5 Participants
6 Participants
n=7 Participants
14 Participants
n=5 Participants
Years worked at their current agency
Missing Information
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Number of Heart Failure Patients Cared for
less than or equal to 5 Heart Failure Patients
38 Participants
n=5 Participants
27 Participants
n=7 Participants
65 Participants
n=5 Participants
Race/Ethnicity, Customized
Missing Information on Race
1 Participants
n=5 Participants
1 Participants
n=7 Participants
2 Participants
n=5 Participants
Education
No Degree or Some High School
9 Participants
n=5 Participants
12 Participants
n=7 Participants
21 Participants
n=5 Participants
Education
Completed High School or GED
18 Participants
n=5 Participants
18 Participants
n=7 Participants
36 Participants
n=5 Participants
Education
Some College
12 Participants
n=5 Participants
8 Participants
n=7 Participants
20 Participants
n=5 Participants
Education
College Degree
8 Participants
n=5 Participants
9 Participants
n=7 Participants
17 Participants
n=5 Participants
Education
Graduate Degree
2 Participants
n=5 Participants
5 Participants
n=7 Participants
7 Participants
n=5 Participants
Education
Missing Information on Education
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Foreign-Born
Foreign-Born
45 Participants
n=5 Participants
43 Participants
n=7 Participants
88 Participants
n=5 Participants
Foreign-Born
US-Born
5 Participants
n=5 Participants
9 Participants
n=7 Participants
14 Participants
n=5 Participants
Primary Language
English
33 Participants
n=5 Participants
32 Participants
n=7 Participants
65 Participants
n=5 Participants
Primary Language
Spanish
11 Participants
n=5 Participants
9 Participants
n=7 Participants
20 Participants
n=5 Participants
Primary Language
Other
6 Participants
n=5 Participants
11 Participants
n=7 Participants
17 Participants
n=5 Participants
Years as Home Health Aide
0-5 years
13 Participants
n=5 Participants
15 Participants
n=7 Participants
28 Participants
n=5 Participants
Years as Home Health Aide
6-10 years
14 Participants
n=5 Participants
17 Participants
n=7 Participants
31 Participants
n=5 Participants
Years as Home Health Aide
11-15 years
9 Participants
n=5 Participants
7 Participants
n=7 Participants
16 Participants
n=5 Participants
Years as Home Health Aide
>15 years
14 Participants
n=5 Participants
13 Participants
n=7 Participants
27 Participants
n=5 Participants
Number of Home Care Agencies worked for in the past
0-1 agency
26 Participants
n=5 Participants
27 Participants
n=7 Participants
53 Participants
n=5 Participants
Number of Home Care Agencies worked for in the past
2 agencies
17 Participants
n=5 Participants
16 Participants
n=7 Participants
33 Participants
n=5 Participants
Number of Home Care Agencies worked for in the past
greater than or equal to 3 agencies
7 Participants
n=5 Participants
9 Participants
n=7 Participants
16 Participants
n=5 Participants
Years worked at their current agency
0-5 years
16 Participants
n=5 Participants
19 Participants
n=7 Participants
35 Participants
n=5 Participants
Number of Heart Failure Patients Cared for
greater than 5 Heart Failure Patients
6 Participants
n=5 Participants
12 Participants
n=7 Participants
18 Participants
n=5 Participants
Number of Heart Failure Patients Cared for
not sure
6 Participants
n=5 Participants
13 Participants
n=7 Participants
19 Participants
n=5 Participants
Hours per week spent with Heart Failure client
1-5 hours per week
9 Participants
n=5 Participants
6 Participants
n=7 Participants
15 Participants
n=5 Participants
Hours per week spent with Heart Failure client
6-10 hours per week
14 Participants
n=5 Participants
20 Participants
n=7 Participants
34 Participants
n=5 Participants
Hours per week spent with Heart Failure client
11-20 hours per week
6 Participants
n=5 Participants
6 Participants
n=7 Participants
12 Participants
n=5 Participants
Hours per week spent with Heart Failure client
Greater than 20 hours per week
16 Participants
n=5 Participants
9 Participants
n=7 Participants
25 Participants
n=5 Participants
Hours per week spent with Heart Failure client
Not Sure
4 Participants
n=5 Participants
10 Participants
n=7 Participants
14 Participants
n=5 Participants
Hours per week spent with Heart Failure client
Missing Information
1 Participants
n=5 Participants
1 Participants
n=7 Participants
2 Participants
n=5 Participants
Heart Failure Training
None
24 Participants
n=5 Participants
22 Participants
n=7 Participants
46 Participants
n=5 Participants
Heart Failure Training
A little
13 Participants
n=5 Participants
18 Participants
n=7 Participants
31 Participants
n=5 Participants
Heart Failure Training
Some
13 Participants
n=5 Participants
10 Participants
n=7 Participants
23 Participants
n=5 Participants
Heart Failure Training
A lot
0 Participants
n=5 Participants
2 Participants
n=7 Participants
2 Participants
n=5 Participants
Management (CC SCHFI)
60 units on a scale
n=5 Participants
55 units on a scale
n=7 Participants
60 units on a scale
n=5 Participants
Race/Ethnicity, Customized
Asian
3 Participants
n=5 Participants
4 Participants
n=7 Participants
7 Participants
n=5 Participants
Race/Ethnicity, Customized
White
6 Participants
n=5 Participants
3 Participants
n=7 Participants
9 Participants
n=5 Participants
Race/Ethnicity, Customized
Other
9 Participants
n=5 Participants
12 Participants
n=7 Participants
21 Participants
n=5 Participants
Age, Continuous
53.2 years
STANDARD_DEVIATION 10.9 • n=5 Participants
54.8 years
STANDARD_DEVIATION 10.2 • n=7 Participants
54.0 years
STANDARD_DEVIATION 10.5 • n=5 Participants
Sex: Female, Male
Female
48 Participants
n=5 Participants
50 Participants
n=7 Participants
98 Participants
n=5 Participants
Sex: Female, Male
Male
2 Participants
n=5 Participants
2 Participants
n=7 Participants
4 Participants
n=5 Participants
Race/Ethnicity, Customized
African-American
30 Participants
n=5 Participants
32 Participants
n=7 Participants
62 Participants
n=5 Participants
Race/Ethnicity, Customized
American Indian/Alaskan Native
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Maintenance (CC SCHFI)
86.7 units on a scale
n=5 Participants
86.7 units on a scale
n=7 Participants
86.7 units on a scale
n=5 Participants

PRIMARY outcome

Timeframe: Baseline (0 days); at follow-up (90 days)

Population: Of the 105 participants that consented to be in the study, 3 participants were lost to follow-up between consents and taking the baseline survey.

As measured by the Dutch Heart Failure Knowledge Scale, scores range from 0-15; higher scores indicate greater heart failure knowledge.

Outcome measures

Outcome measures
Measure
Enhanced Usual Care
n=50 Participants
Home health aides in the enhanced usual care arm will receive a virtual heart failure training course. Virtual training course: Virtual training course on heart failure for home health aides.
Intervention Arm
n=52 Participants
Home health aides in the intervention arm will receive a virtual heart failure training course and a communication-based messaging app. mHealth app: The mHealth app will provide heart failure-specific education to home health aides and allow them to report clinical observations and ask nurses questions in real-time. Virtual training course: Virtual training course on heart failure for home health aides.
Change in Heart Failure Knowledge
0.93 units on a scale
Interval 0.05 to 1.81
1.88 units on a scale
Interval 1.05 to 2.71

PRIMARY outcome

Timeframe: Baseline (0 days); at follow-up (90 days)

Population: Of the 105 participants that consented to be in the study, 3 participants were lost to follow-up between consents and taking the baseline survey.

As measured by the Caregiver Contribution to Self-Care in Heart Failure Index, which is a 22-item scale which assesses maintenance, management, and self-efficacy sub-scales separately. Each sub-scale score ranges from 0-100, with greater scores indicating greater contribution to care or self-efficacy.

Outcome measures

Outcome measures
Measure
Enhanced Usual Care
n=50 Participants
Home health aides in the enhanced usual care arm will receive a virtual heart failure training course. Virtual training course: Virtual training course on heart failure for home health aides.
Intervention Arm
n=52 Participants
Home health aides in the intervention arm will receive a virtual heart failure training course and a communication-based messaging app. mHealth app: The mHealth app will provide heart failure-specific education to home health aides and allow them to report clinical observations and ask nurses questions in real-time. Virtual training course: Virtual training course on heart failure for home health aides.
Change in Heart Failure Caregiving Self-efficacy
1.27 units on a scale
Interval -3.71 to 6.24
1.44 units on a scale
Interval -3.49 to 6.36

SECONDARY outcome

Timeframe: Baseline (0 days); at follow-up (90 days)

Population: Of the 105 participants that consented to be in the study, 3 participants were lost to follow-up between consents and taking the baseline survey.

As measured by the Work Domain Satisfaction Scale, which is a 5-item scale that measures: 1) job satisfaction among care workers; and 2) examines the associations with work environment factors, work stressors, and health issues. Scores range from 5-20, with higher scores indicating stronger satisfaction.

Outcome measures

Outcome measures
Measure
Enhanced Usual Care
n=50 Participants
Home health aides in the enhanced usual care arm will receive a virtual heart failure training course. Virtual training course: Virtual training course on heart failure for home health aides.
Intervention Arm
n=52 Participants
Home health aides in the intervention arm will receive a virtual heart failure training course and a communication-based messaging app. mHealth app: The mHealth app will provide heart failure-specific education to home health aides and allow them to report clinical observations and ask nurses questions in real-time. Virtual training course: Virtual training course on heart failure for home health aides.
Change in Job Satisfaction
0.12 units on a scale
Interval -1.56 to 1.79
-0.31 units on a scale
Interval -1.95 to 1.33

SECONDARY outcome

Timeframe: Baseline (0 days); at follow-up (90 days)

Population: Of the 105 participants that consented to be in the study, 3 participants were lost to follow-up between consents and taking the baseline survey. For non-modeled comparison of count of participants who were thinking of leaving job at 90 days, not all participants responded to the question regarding intentions of 1) leaving their current job and 2) searching for a new job in the baseline survey. Additionally, not all of these participants completed these questions for the 90-day follow-up.

As measured by the Turnover Intention Scale, which is a 2-item scale that measures workers' intentions of 1) leaving their current job (at their agency) and 2) searching for a new job (in another field) in the next year. ) Responses for both included a 7-point likert scale of: very strongly disagree, strongly disagree, disagree neutral, agree, strongly agree, very strongly agree. Both questions were dichotomized into "agree", "strongly agree", and "very strongly" vs. all other responses.

Outcome measures

Outcome measures
Measure
Enhanced Usual Care
n=48 Participants
Home health aides in the enhanced usual care arm will receive a virtual heart failure training course. Virtual training course: Virtual training course on heart failure for home health aides.
Intervention Arm
n=50 Participants
Home health aides in the intervention arm will receive a virtual heart failure training course and a communication-based messaging app. mHealth app: The mHealth app will provide heart failure-specific education to home health aides and allow them to report clinical observations and ask nurses questions in real-time. Virtual training course: Virtual training course on heart failure for home health aides.
Change in Intention to Leave
90 days intention to leave job
6 Participants
6 Participants
Change in Intention to Leave
Baseline intention to search for a new job
6 Participants
5 Participants
Change in Intention to Leave
Baseline intention to leave job
10 Participants
9 Participants
Change in Intention to Leave
90 days intention to search for a new job
3 Participants
3 Participants

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline (0 days); at follow-up (90 days)

All-cause emergency department visits to any emergency department

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline (0 days); at follow-up (90 days)

All-cause readmissions to any hospital

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline (0 days); at follow-up (90 days)

Population: Of the 105 participants that consented to be in the study, 3 participants were lost to follow-up between consents and taking the baseline survey. For non-modeled comparison of count of participants who were thinking of leaving job at 90 days, not all participants responded to the questions regarding preventable 911 calls in baseline survey. Additionally, not all participants responded to preventable 911 call questions at 90-day follow-up.

Preventable 911 calls were assessed with 2-close ended questions that we previously used among HHAs: "I have called 911 when that could have been prevented if I had been able to reach my supervisor/the nurse." and "I have called 911 when that could have been prevented if my supervisor and I had been able to reach the client's doctor." Responses for both included a 7-point Likert scale of: very strongly disagree, strongly disagree, disagree neutral, agree, strongly agree, very strongly agree. Both questions dichotomized into "agree", "strongly agree", and "very strongly" vs. all other responses.

Outcome measures

Outcome measures
Measure
Enhanced Usual Care
n=50 Participants
Home health aides in the enhanced usual care arm will receive a virtual heart failure training course. Virtual training course: Virtual training course on heart failure for home health aides.
Intervention Arm
n=52 Participants
Home health aides in the intervention arm will receive a virtual heart failure training course and a communication-based messaging app. mHealth app: The mHealth app will provide heart failure-specific education to home health aides and allow them to report clinical observations and ask nurses questions in real-time. Virtual training course: Virtual training course on heart failure for home health aides.
Change in Preventable 911 Calls
Baseline-preventable 911 call if reached doctor
20 Participants
26 Participants
Change in Preventable 911 Calls
90 days-preventable 911 call if reached doctor
19 Participants
13 Participants
Change in Preventable 911 Calls
Baseline-preventable 911 call if reached nurse/supervisor
30 Participants
28 Participants
Change in Preventable 911 Calls
90 days-preventable 911 call if reached nurse/supervisor
18 Participants
18 Participants

Adverse Events

Enhanced Usual Care

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Intervention Arm

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Madeline Sterling

Weill Cornell Medicine

Phone: 646-962-5029

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place