Abstract TH815: Exploring the Role of Home Care Workers in Supporting Type 2 Diabetes Management in Older Asian American Adults: A Mixed-Methods Study

Abstract

Background: Older Asian American adults experience a high burden of type 2 diabetes (T2DM) and face multifaceted challenges, including cultural and linguistic challenges, in T2DM management. Home care workers (HCWs) provide in-home services, helping older adults who might otherwise need nursing home care to remain in their own homes. We examined HCWs’ knowledge, confidence, barriers, and facilitators in supporting older Asian American adults with T2DM management. Methods: Using an explanatory sequential mixed-methods design, we recruit HCWs from community-based organizations that serve Asian Americans in the Chicagoland area. First, HCWs complete an online survey assessing knowledge and confidence. Then, a subset further complete semi-structured interviews to build on quantitative findings and explore additional barriers and facilitators. We analyzed interim findings using descriptive statistics and thematic analyses. Findings: To date, we have recruited 50 HCWs (n=250 planned). In interim quantitative analyses, participants were predominantly Asian (83%), were caring for a client who was a family member (89%) and primarily used their heritage language to communicate (64%). Higher Asian acculturation was correlated with higher confidence in helping clients maintain a healthy weight. HCWs with lower English proficiency had significantly less diabetes knowledge (M=9.91 vs. 14.92). HCWs expressed high interest in resources on nutrition (79%), chronic disease management (68%), physical activity (66%) and stress management (47%). In interim qualitative analyses, HCWs cited shared language and culture and normalized expectations of caregiving for family members as facilitators for T2DM management support. Reported challenges included counseling clients to follow diabetes-friendly diets that conflict with cultural food traditions, balancing heavy workloads, and managing clients’ multiple comorbidities. Supporting quantitative findings, HCWs expressed interest in training on nutrition and physical activity. Discussion: We identified strengths and gaps in HCWs’ ability to support older Asian American adults with T2DM. Cultural alignment and family caregiving build close client relationships, facilitating HCWs’ confidence in providing care. However, less T2DM knowledge in HCWs with lower English proficiency and expressed challenges suggest a need and opportunities for future HCW-centered culturally tailored interventions.