Trabajadora De Salud: An in-Home Intervention for the Transition from Hospital to Home for Latinas/Os with Brain Injuries

Background and Purpose: Latinas/os are more likely to experience penetrating brain injuries and are less likely to receive rehabilitation and return to work and more likely to have worse functional abilities, mental health challenges, and caregiver burden than others. This study aimed to assess the effectiveness of an 90-day in-home intervention aimed at assessing the impact of the transition from hospital to home for Latinas/os with brain injuries, Trabajadora de Salud. The intervention included one visit at the hospital prior to discharge and 5-12 in-home visits for the first 90 days after the participant returned home. Trabajadora de Salud included bilingual, bicultural trabajadoras that supported the patient and their primary caregiver on brain injury education, medication management, and connections with rehabilitation and other health resources. Null hypotheses include: 1) Trabajadora de Salud participants do not return to the hospital within 90 days of discharge due to a brain injury, 2) Trabajadora de Salud participants do not improve receipt of rehabilitation, functional abilities, depression, and caregiver burden before and after the intervention.

Methods: Participants were recruited by a local hospital and referred to a local non-profit that provided the intervention. Fifty patients and 50 of their corresponding caregivers received the intervention in 2017-2018 and each were asked to complete an online survey at the start of the intervention, 30 days later, and 90 days later at the completion of the intervention. The survey asked participants about hospitalizations, receipt of rehabilitation, functional abilities, depression, and caregiver burden. Analyses included cross-tabulations and paired samples t-tests.

Results: Statistically significant improvements were found among patients’ hospitalizations and caregivers’ caregiver burden. Twenty patients reduced the times they were admitted to the ER between the pre and post-survey, while none increased the times they went to the ER and twenty three had the same number of ER visits reported in the pre and post-surveys. A signed-ranks test indicated that the ER post-test scores were statistically significantly lower than the pre-test scores (p = .000). Ten caregivers improved their caregiver burden ratings, two got worse, and four remained the same. A signed-ranks test indicated that the post-test caregiver burden scores were statistically significantly lower than the pre-test scores (p = .000).

Conclusions and Implications: Care transitions interventions, such as trabajadora de salud, may be beneficial in addressing health disparities. Future research is needed using experimental methods to eliminate potential confounding variables.