Effectiveness and Implementation of a Multi-domain Workplace Health Promotion Intervention in Home Care: Findings from a Controlled Pre-Post Study

<title>Abstract</title> <p>Background Home care workers are exposed to high psychological, physical, and social job demands. Evidence of tailored and context-specific health promotion interventions for this target group is still scarce. This study aimed to evaluate the effectiveness and implementation of a multi-domain workplace health promotion intervention to promote health and work-related outcomes among home care workers in Germany. Methods Home care agencies were assigned either to an intervention (n = 6) or a control (n = 5) group. The intervention was delivered either as workshops or in a self-guided format. Effectiveness was assessed using standardized questionnaires, including work ability, health status, and intention to leave as primary outcomes, and burnout, psychological well-being, perceived work strain, occupational self-efficacy, participative safety, work-related resilience, and job satisfaction as secondary outcomes. Implementation was evaluated using Proctor’s implementation outcomes framework and the Consolidated Framework for Implementation Research, drawing on quantitative surveys and qualitative data from workshops. Data were collected between March and November 2023. Results A total of 71 home care workers in the intervention group and 31 in the control group completed both the baseline and follow-up surveys. No statistically significant between-group differences were found for changes in work ability, health status, and intention to leave. However, significant between-group effects were observed for occupational self-efficacy (b = 0.20, 95% CI [0.02, 0.37], p = 0.027) and participative safety (b = 5.08, 95% CI [1.66, 8.51], p = 0.004). In addition, descriptive within-group analyses indicated positive trends in the intervention group for work ability, health status, burnout, perceived work strain, psychological well-being, and resilience, although these did not reach statistical significance. Facilitators were predominantly identified in the innovation domain, whereas barriers were identified in the inner setting domain. Conclusions This study contributes to fostering a supportive and empowering work environment in home care, even though effects on broader health and work-related outcomes were not evident. Implementation into daily practice and application of intervention content remained barriers. Future research should focus on strengthening implementation strategies, organizational readiness, and leadership engagement to enhance the effectiveness of workplace health promotion interventions in home care. Trial registration: German Clinical Trial Register (DRKS00031949), 24 May 2023, Retrospectively registered.</p>