Evaluation of Better Jobs Better Care: Direct Care Worker Survey, 2004-2007 [Iowa, North Carolina, Oregon, Pennsylvania, Vermont]

Funded by the Robert Wood Johnson Foundation and The Atlantic Philanthropies, Better Jobs Better Care (BJBC) was a demonstration program that sought to bring about changes in public policy and management practice that would lead to improved recruitment and retention of high-quality paraprofessional direct care workers (DCW) in nursing homes as well as in home- and community-based settings. This was to be accomplished by implementing both policy and management practice goals. Policy goals included developing initiatives related to wages and benefits, incentives for job redesign, curriculum and credentialing, professional associations, and promotion of public awareness and policies. Practice goals involved interventions related to caregiving skill development, peer mentoring, team building, top management training, supervisor training, and provider-specific interventions. The program established demonstration projects in Iowa, North Carolina, Oregon, Pennsylvania, and Vermont which enrolled long-term care establishments across the spectrum of long-term care settings: skilled nursing facilities, assisted living facilities, home care agencies, and adult day service providers.

Conducted as part of the BJBC evaluation, this survey interviewed DCWs at two points during the demonstration. The Time 1 interview was fielded as soon as establishments enrolled in the demonstration and provided a list of their DCWs (July 2004 to December 2006), and the Time 2 interviews were completed 12 to 28 months after the Time 1 interviews (April 2006 to June 2007). Both rounds of the survey used the same self-administered questionnaire which included questions about length of employment, job satisfaction, job rewards and problems, supervision, perceptions of quality of care, job confidence, training, intent to quit, and demographic characteristics. The survey also elicited recommendations for improving DCWs' jobs by asking the open-ended question "What is the single most important thing your employer could do to improve your job as a direct care worker?"

由罗伯特·伍德·约翰逊基金会（Robert Wood Johnson Foundation）与大西洋慈善基金会（The Atlantic Philanthropies）资助的“更好就业 更好照护”（Better Jobs Better Care，简称BJBC）项目是一项示范计划，旨在推动公共政策与管理实践变革，以改善养老院及居家和社区照护场景中高质量准专业直接照护工作者（direct care worker，简称DCW）的招聘与留存状况。该目标将通过落实政策目标与管理实践目标双轨并行实现。政策目标包括制定与薪资福利、岗位重构激励、课程与资质认证、专业协会建设及公众意识与政策推广相关的举措；实践目标则涉及照护技能提升、同伴导师制、团队建设、高层管理培训、主管培训及机构专属干预措施等方面的干预行动。该项目在艾奥瓦州、北卡罗来纳州、俄勒冈州、宾夕法尼亚州及佛蒙特州开展示范项目，纳入了涵盖各类长期照护场景的机构：专业护理机构、辅助生活机构、居家照护机构及成人日间服务机构。

作为BJBC项目评估的一部分，本调查在示范期间分两个时间点访谈了DCW。第一轮访谈（Time 1）于机构加入示范项目并提交其DCW名单后立即开展（2004年7月至2006年12月）；第二轮访谈（Time 2）则在第一轮访谈后12至28个月完成（2006年4月至2007年6月）。两轮调查均采用同一套自填式问卷，内容涵盖就业时长、工作满意度、工作回报与问题、监督管理、照护质量感知、工作信心、培训经历、离职意向及人口统计学特征等方面。此外，调查通过开放式问题“您认为雇主能为改善您作为直接照护工作者的工作所做的最重要的一件事是什么？”收集了针对DCW岗位优化的建议。