Gentle Physical Activity Intervention Led by Caregivers in a Medicaid Home Care Program: Do Outcomes Differ Between Family and Nonfamily Caregiving Dyads?

BACKGROUND AND OBJECTIVES: Caregiving dyads are fertile contexts for health promotion such as physical activity. However, previous physical activity interventions in caregiving dyads paid limited attention to care recipients’ outcomes and rarely involved paid caregivers. Home care aides (HCAs) provide nonmedical care for older family members or nonfamily clients in publicly funded home care programs in the United States. This study examined whether family and nonfamily HCA–client dyads differed in the outcomes of a 4-month gentle physical activity pilot program led by HCAs in a Medicaid home care program. DESIGN AND METHODS: A single-group prepost design was used to assess changes in clients’ function (self-reported and performance-based) and process outcomes (exercise-related social support provided by HCAs) in 18 family and 32 nonfamily HCA–client dyads. Repeated measures analysis controlled for clients’ demographic and health characteristics. Clients’ and HCAs’ motivation to continue the program beyond the intervention period was examined using quantitative and qualitative data. RESULTS: Client outcomes and exercise-related social support provided by HCAs improved, especially in nonfamily dyads. Both family and nonfamily dyads had high levels of motivation to continue the program, supporting the program’s sustainability for both clients and HCAs. DISCUSSION AND IMPLICATIONS: Empowering HCAs to engage in health promoting activities with their clients is a promising strategy to improve the lives of caregiving dyads.