Service enhancement of home-based community care service during the COVID-19 pandemic in Hong Kong

Abstract

The pandemic of COVID-19 has presented substantial risks and challenges to vulnerable groups, particularly the elderly. Home-based community care service (HBCCS) has played a pivotal role in addressing their urgent social needs during the pandemic. In response to the high transmission of Omicron and the sudden deterioration of public health, the government has urged the need to strengthen the capacity to address these urgent social needs. Aberdeen Kai-Fong Association (AKA), a non-governmental organization that operates HBCCS, collaborated with the School of Nursing of the University of Hong Kong to conduct three studies. These studies aimed to review the institutional measures and develop interventions to enhance service capacity and improve quality. The first study was a cross-sectional mixed-method evaluation to collect feedback from HBCCS staff. A total of 109 HBCCS staff completed the survey, and out of them, 26 participated in the focus group interviews. These interviews focused on reviewing the institutional measures on resources, training, service continuation and enhancement, as well as communication. The overall findings suggested that AKA provided adequate resources and training, and communication was well-maintained. However, emotional support was insufficient from the organization during the pandemic. Suggestions for enhancing service quality, including providing more updated COVID-19-related knowledge and regular training, were addressed. The second study was a one-group pilot training workshop with an immediate assessment to evaluate the feasibility and acceptability of the workshop for HBCCS staff during the pandemic. Fifty-nine HBCCS staff members attended the workshop and completed the questionnaire at baseline and immediately after the workshop. The workshop focused on role enhancement, responsibility, and self-efficacy in sharing updated COVID-19-related messages to service users. Most trainees expressed satisfaction with the teaching content, resulting in a high response rate. Positive feedback suggested that the pilot study was feasible and acceptable. The third study was a one-group main study with a 6-month follow-up to evaluate a capacity-building workshop for HBCCS staff to deliver reliable, simple, easy-to-understand, and updated COVID-19-related information. The intervention involved a training workshop and a series of post-training support activities, such as tailored teaching materials. The study found that the workshop effectively improved the knowledge, confidence, and self-efficacy of HBCCS staff in delivering COVID-19-related information to service users, and these effects were sustained in a 6-month follow-up. Almost all trainees reported that they could proactively share the training content with service users and implement COVID-19-related activities to promote vaccination. The study also revealed a high willingness among staff to receive regular training to enhance their knowledge and roles as lay health promoters beyond the pandemic. The studies provided a practical demonstration of an institution using a systematic approach to manage challenges from the pandemic. They highlighted the importance of understanding staff needs to design tailored training interventions in response to the urgent needs of society. The studies also demonstrated effective training could enhance the knowledge, attitudes, and commitment of HBCCS staff while empowering their role development and building capacity for enhancing service delivery. Ongoing training and support are crucial for HBCCS staff and further study is recommended.