Evidence map›Paper›PMID 40193072›Full record

ArticleJAMA network open2025

Perceived Contributors to Job Quality and Retention at Home Care Cooperatives.

Geoffrey M Gusoff, Miguel A Cuevas, Catherine Sarkisian, Madeline R Sterling, Ariel C Avgar, Gery W Ryan

Abstract read
In one paragraph

Article in JAMA network open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Geoffrey M GusoffDepartment of Family Medicine, David Geffen School of Medicine at the University of California, Los Angeles.
Miguel A CuevasDivision of General Internal Medicine and Health Services Research, David Geffen School of Medicine at University of California, Los Angeles.
Catherine SarkisianDivision of General Internal Medicine and Health Services Research, David Geffen School of Medicine at University of California, Los Angeles.
Madeline R SterlingDepartment of Medicine, Weill Cornell Medicine, New York, New York.
Ariel C AvgarSchool of Industrial and Labor Relations, Cornell University, Ithaca, New York.
Gery W RyanDepartment of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California.

Funding

UCLA Clinical Translational Science InstituteUL1TR001881 · NCATS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI ARLEEN F. BROWN, ARASH NAEIM · 2016 to 2026
$118.1M
UCLA CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTEUL1RR033176 · NCRR · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI DUBINETT, STEVEN M. · 2011 to 2011
$15.5M
NRSA Training CoreTL1TR001883 · NCATS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI ALEX BUI, Nina Thawata Harawa · 2016 to 2026
$8.6M
Midcareer Award in Patient-Oriented Community-Academic Partnered Aging ResearchK24AG047899 · NIA · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI SARKISIAN, CATHERINE A · 2014 to 2025
$2.0M
Leveraging Home Health Aides to Improve Outcomes in Heart FailureK23HL150160 · NHLBI · WEILL MEDICAL COLL OF CORNELL UNIV · PI STERLING, MADELINE R · 2020 to 2024
$921k
The Role of Home Care Cooperatives in Home Health Aide Turnover, Job Quality, and Care QualityK01AG088782 · NIA · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Geoffrey M Gusoff · 2024 to 2026
$548k
NCATS NIH HHS TL1 TR001883NCATS NIH HHS UL1 TR001881NCRR NIH HHS UL1 RR033176NHLBI NIH HHS K23 HL150160NIA NIH HHS K01 AG088782NIA NIH HHS K24 AG047899
6 · The paper itself

Abstract

Importance: To safely age at home, millions of older adults rely on the services of home care workers (HCWs), a workforce marked by poor working conditions, high turnover, and critical worker shortages. Home care cooperatives-businesses co-owned and controlled by HCWs-have demonstrated significantly lower turnover and higher job quality than traditional home care businesses, but the factors associated with these outcomes have not been investigated. Objective: To identify potential factors associated with higher job quality and lower turnover at home care cooperatives. Design, Setting, and Participants: In this qualitative study, semistructured interviews were conducted in English from November 2023 to June 2024. To be eligible for the study, participants had to be 18 years old or older, speak English, and currently be employed by a home care cooperative. Interviews were conducted remotely over Zoom with individual HCWs and staff from home care cooperatives from across the US. Data were analyzed from May to July 2024. Exposure: Employment at a home care cooperative. Main Outcomes and Measures: Interviews were audio recorded and transcribed. A thematic analysis approach was used to code interviews and identify major themes and subthemes, informed by a conceptual model of direct care worker job outcomes. Results: A total of 23 HCWs and 9 staff members (14 participants aged 20-39 years [44%]; 8 [25%] African American, 4 [13%] Latinx, and 17 [53%] non-Latinx White) from 5 home care cooperatives participated in the study. Participants identified 4 key aspects of the cooperative work environment they perceived to be contributing to higher job quality and lower turnover compared with traditional agencies: (1) greater workplace control regarding patient care, case assignments, and organizational policies; (2) stronger community support and camaraderie; (3) a deeper culture of respect in which HCWs felt more valued; and (4) higher overall compensation in the form of wages, benefits, or profit sharing. Conclusions and Relevance: In this qualitative study of HCWs and staff at home care cooperatives, participants perceived cooperatives' relatively high levels of HCW control, community, respect, and compensation to be important contributors to HCWs' retention in the field. The participatory structure and practices of home care cooperatives in these areas may represent novel approaches for home care agencies to reduce HCW turnover and improve job quality to address critical workforce shortages.

Indexed as

Home Care ServicesHome Health AidesJob SatisfactionPersonnel TurnoverAdultFemaleHumansMaleMiddle AgedQualitative ResearchUnited States

Identifiers

PMID40193072
PMCPMC11976488

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.