# Using Communities of Practice in the Home and Community-Based Service Workforce

**Authors:** Sandi Lane, Caroline Yoon, Zavera Basrai, Yisel Pomier Maren, Trish Farnham, Kezia Scales, Gwen Tanner, Nathan Boucher

PMC · DOI: 10.1093/geroni/igaf122.2342 · Innovation in Aging · 2025-12-31

## TL;DR

This paper explores how communities of practice can improve job quality and skills for home care workers in North Carolina.

## Contribution

The study introduces a training model combining virtual learning and peer-led communities of practice for direct service workers.

## Key findings

- A pilot training program with 50 workers included virtual modules and peer-led learning groups.
- The model aimed to improve communication and self-management skills through active learning methods.
- Participants engaged in shared learning and problem-based approaches to reinforce workplace skills.

## Abstract

Older adults and people living with disabilities receive home- and community-based services (HCBS) from approximately 115,000 often inadequately supported direct service workers (DSW) in North Carolina (NC). The demand for these workers is increasing rapidly yet fragmented long-term services and support system (LTSS) deter new entrants into these careers. The previous stage of this Centers for Medicare/Medicaid Services (CMS)-funded project identified communication and relationship building as key competencies that DSW need to build career pathways, elevate skills and recognition for their work, and improve job quality and retention. Our project team then conducted a pilot DSW training program: asynchronous virtual training modules, virtual facilitated learning labs, and communities of practice (CoPs) led by direct service workers. The training program was designed to build knowledge and skills to support better communication with family caregivers through active listening, self-awareness, and self-management. A total of 50 DSWs from the categories of Home Health Aides, In-Home Aides providing limited assistance, personal care aides, direct support professionals, and self-directed direct care workers participated. Upon completion of asynchronous training, participants engaged in a two-hour learning lab facilitated by direct service workers followed by a series of DSW-facilitated peer learning groups called CoPs. These combined learning experiences encourage workers with lived experiences to engage in shared learning, peer support, and collective problem-based learning, which is crucial for reinforcing and contextualizing their knowledge leading to sustainable skills application in the workplace. We will discuss learnings from our process and the opportunity to scale the CoPs model for DSWs.

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Source: https://tomesphere.com/paper/PMC12760959