On the move: understanding home care workers' experiences of using various modes of transportation at work in an occupational health perspective.

Background: The demand for home care workers (HCWs) is increasing, but home care services face challenges in recruiting and retaining skilled workers, partly due to hazards in the work environment. Transportation to client visits is an important part of HCWs' working conditions, with various modes (e.g., walking, cycling, driving) being utilized. However, these modes are often implemented without considering HCWs' perceptions of their use. Therefore, our study aimed to understand HCWs' perceptions and experiences of using different transportation modes at work, and how they may influence health.

Methods: Fourteen HCWs from a home care unit in Trondheim (Norway) participated in focus group interviews. The interviews were analyzed using a reflexive thematic analysis approach including reflexive journaling. The analytical process was guided by a biopsychosocial understanding of health.

Results: The analysis showed that when different transportation modes were assigned, predictability of the assignment was important for the HCWs. Both walking and driving were regarded to have both positive and negative health impacts. When walking, informants thought that getting fresh air outdoors and doing physical activity was health-promoting, while bad weather conditions and too much walking could be negative for their health. When driving a car, informants talked about privacy and getting physical rest as positive for their health, while traffic and parking conditions could be stressful. Individual factors such as age, physical health, and strong preferences were highlighted as important to consider when planning HCWs' transportation modes in an occupational health perspective.

Conclusions: Walking now and then between client visits was generally believed by the HCWs to lead to positive health effects compared to only driving a car. Introducing planning of various transportation modes in advance, so that they are predictable, seems important to reduce stress among HCWs. In addition, some individual factors should be considered in the planning, and it should be realized that the planning likely represents a trade-off between promoting the psychosocial work environment when driving a car and potentially enhancing long-term physical health when using active transportation. Thus, biopsychosocial aspects of health should be considered when planning the mode of transport between client visits for HCWs.