title: Psychosocial work characteristics of personal care and service occupations: a process for developing meaningful measures for a multiethnic workforce.
abstract: OBJECTIVE
  Despite their rapid increase in number, workers in personal care and service occupations are underrepresented in research on psychosocial work characteristics and occupational health. Some of the research challenges stem from the high proportion of immigrants in these occupations. Language barriers, low literacy, and cultural differences as well as their nontraditional work setting (i.e., providing service for one person in his/her home) make generic questionnaire measures inadequate for capturing salient aspects of personal care and service work. This study presents strategies for (1) identifying psychosocial work characteristics of home care workers that may affect their occupational safety and health and (2) creating survey measures that overcome barriers posed by language, low literacy, and cultural differences.
  
  
  RESULTS
  We pursued these aims in four phases: (Phase 1) Six focus groups to identify the psychosocial work characteristics affecting the home care workers' occupational safety and health; (Phase 2) Selection of questionnaire items (i.e., questions or statements to assess the target construct) and first round of cognitive interviews (n = 30) to refine the items in an iterative process; (Phase 3) Item revision and second round of cognitive interviews (n = 11); (Phase 4) Quantitative pilot test to ensure the scales' reliability and validity across three language groups (English, Spanish, and Chinese; total n = 404). Analysis of the data from each phase informed the nature of subsequent phases. This iterative process ensured that survey measures not only met the reliability and validity criteria across groups, but were also meaningful to home care workers.
  
  
  CONCLUSIONS
  This complex process is necessary when conducting research with nontraditional and multilingual worker populations.
authors.affiliation: a Stanford Prevention Research Center , Stanford University , Stanford , CA , USA.
authors.forename: Annekatrin
authors.initials: A
authors.lastname: Hoppe
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Heaney
authors.forename: Kaori
authors.initials: K
authors.lastname: Fujishiro
authors.forename: Fang
authors.initials: F
authors.lastname: Gong
authors.forename: Sherry
authors.initials: S
authors.lastname: Baron
mesh_terms: D000328:Adult; D002140:California; D003144:Communication Barriers; D003466:Cultural Characteristics; D054242:Emigrants and Immigrants; D005260:Female; D017144:Focus Groups; D006306:Health Surveys; D006699:Home Care Services; D018576:Home Health Aides / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D016272:Occupational Health; D017009:Professional Autonomy; D036301:Qualitative Research; D015203:Reproducibility of Results; D012944:Social Support; D011795:Surveys and Questionnaires; D016526:Workload
keywords: caregivers; home care workers; measurement development; multiethnic workers; psychosocial work characteristics; qualitative analysis