Understanding Challenges of Infection Prevention in Adult Family Homes


AFHs reported concerns such as staff coming to work sick and lack of PPE.

The state of Washington has 3,324 adult family homes (AFHs), a unique long-term care setting that serves between 2 and 6 residents. While AFHs are important, little is known about infection prevention in these settings.

AFHs in Washington experienced 259 COVID-19 outbreaks between March and October of 2020. Investigators from the Washington State Department of Health recently set out to better understand infection prevention in the AFH setting and inform future public health outreach.

The data was presented at the 2021 Association for Professionals in Infection Control and Epidemiology conference virtual sessions.

For the study, the investigators conducted a literature review across 6 academic databases and relevant regulatory chapters. They then developed an online survey and distributed it to AFH providers.

The survey consisted of 17 questions that addressed infection prevention practices and concerns.

In the literature search, no peer-reviewed articles related to infection prevention in AFHs were discovered. The survey received 110 responses, with most of the participants describing themselves as AFH providers or staff.

Findings showed that the most common infections among residents were urinary tract infection (60%), followed by pneumonia of any type (32.7%) and seasonal influenza (28.0%). 

Major concerns reported by the participants were staff coming to work while sick (21.4%) and challenges obtaining personal protective equipment (23.4%).

“This project found that AFH providers are interested in outreach about infection prevention. Survey results indicated a need for additional outreach on specific infection types, especially respiratory pathogens,” the authors wrote. “These results will guide outreach efforts for infection prevention and public health staff, as they work to increase collaboration with this important care setting.”

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