title: A mixed-method evaluation of a workforce development intervention for nursing assistants in nursing homes: the case of WIN A STEP UP.
abstract: OBJECTIVE
  The purpose of this study was to evaluate WIN A STEP UP, a workforce development program for nursing assistants (NAs) in nursing homes (NHs) involving continuing education by onsite trainers, compensation for education modules, supervisory skills training of frontline supervisors, and short-term retention contracts for bonuses and/or wage increases upon completion.
  
  
  METHODS
  We collected longitudinal semistructured interview and survey data from NAs, supervisors, and managers at 8 program NHs and 10 comparison NHs. To control for selection bias, we matched 77 NA program participants to 81 participating site and 135 comparison site controls using propensity scores in a quasi-experimental design supplemented by qualitative assessments.
  
  
  RESULTS
  Managers at seven of eight participating NHs wanted to repeat the program. At 3 months after baseline, participants differed from controls by having (a) more improved nursing care and supportive leadership scores, (b) greater improvement in team care, and (c) stronger ratings of career and financial rewards. Nurse supervisors participating in supervisory skills training reported positive changes in management practices for themselves and peers. Modest 3-month turnover reductions occurred in six settings where the program was fully implemented without incident.
  
  
  CONCLUSIONS
  Managers', supervisors', and participating NAs' consistent perceptions of improved quality of care and job quality, along with a promise of increased retention, suggest that interventions like WIN A STEP UP are beneficial.
authors.affiliation: University of North Carolina Institute on Aging, Chapel Hill, NC, USA. craft@email.unc.edu
authors.forename: Jennifer Craft
authors.initials: JC
authors.lastname: Morgan
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Konrad
mesh_terms: D007182:Income; D007318:Inservice Training / Q000379:methods; D009728:Nursing Assistants / Q000191:economics / Q000193:education; D009735:Nursing Homes; D009745:Nursing, Supervisory; D010563:Personnel Turnover; D014481:United States; D000078329:Workforce