Impact of an Educational Intervention on Job Satisfaction Among Home Health Aides: Findings from a Mixed-Methods Analysis of a Pilot Randomized Controlled Trial

Background: Home health aides (HHAs) provide critical support for patients with chronic conditions, such as heart failure (HF), by assisting with activities of daily living, symptom monitoring, and medication management. Despite their essential role, HHAs are often undervalued and deal with challenging work conditions which contribute to high turnover rates. In contradiction, job satisfaction has consistently been reported as high, suggesting a disconnect that warrants investigation. While prior research identified factors contributing to job satisfaction and retention, few have evaluated interventions and their subsequent effects on employment outcomes. This study assessed the impact of an educational intervention on job satisfaction and turnover intention among HHAs caring for patients with HF. Methods: We conducted a mixed-method analysis of a pilot randomized clinical trial involving 102 HHAs who received virtual HF training. Job satisfaction and turnover intention were measured at baseline and 90-day follow-up using validated scales. Semi-structured interviews were conducted with 66 HHAs. Results: Baseline job satisfaction was high (77%-86%), with modest improvements observed at follow-up. Turnover intention decreased from 21% to 14%. Qualitative findings revealed HHAs valued the training, reported enhanced motivation for learning, increased self-efficacy, and perceived improvements in patient care. Conclusions: Educational interventions addressing intrinsic motivators may increase job satisfaction and reduce turnover intention among HHAs, suggesting that investing in professional development could strengthen workforce retention in homecare.