**5. Conclusions**

HCWs are a priority population for protective interventions that advance their safety, health, and well-being. Rapidly growing in number, HCWs help some of our most vulnerable citizens remain in their homes and enjoy a higher quality of life. In-home care may also create critical cost-savings in the healthcare system by preventing older adults from transitioning prematurely to long-term care facilities. While some interventions have research evidence for their effectiveness, and other valuable tools and resources are available, we could not find a descriptive or empirical paper about a successful research-to-practice intervention dissemination effort with HCWs. In this regard, the current description of the adaptation and dissemination of COMPASS with the OHCC may help guide future similar efforts with other partners or in other states. Consistent with previous findings in the dissemination science literature, the success of the current effort was facilitated by several favorable factors that can be cultivated in future projects by other intervention scientists. These include early engagement and collaboration with industry and labor in the development of interventions, designing for feasibility and repeatability of intervention tactics, and sustained engagement over time to foster strong relationships and top-level leadership commitment over the long term. We also believe flexibility and persistence from all parties was essential for overcoming barriers as they arose. This persistence included a commitment to the effort during times when resources for dissemination efforts were scarce or uncertain. We are optimistic with continued contingency and structural planning that the rollout of COMPASS will be sustained within the OHCC, with the ultimate potential to improve the safety, health, and well-being of approximately 60% of the Oregon home care work force. **Author Contributions:** All authors contributed substantially to the work reported. Conceptualization, R.O., J.A.H., S.V.T., K.L.R., and M.M.; Methodology, R.O., J.A.H., S.V.T., K.L.R, K.N.P., and M.M.; Formal Analysis, K.N.P. and R.O.; Investigation, S.V.T., K.L.R., K.N.P. and R.O.; Data Curation, S.V.T., K.L.R., K.N.P. and R.O.; Writing-Original Draft Preparation, R.O. and A.R.; Writing-Review & Editing, R.O., J.A.H., S.V.T., A.R., K.N.P., and K.L.R.; Visualization, R.O. and A.R.; Supervision, R.O.; Project Administration, S.V.T. and K.N.P.; Funding Acquisition, R.O., J.A.H., S.V.T., K.N.P, and M.M.

**Funding:** This research was funded by the National Institute for Occupational Safety & Health grant number (U19 OH010154), a contract from the Oregon Home Care Commission, and the Oregon Institute of Occupational Health Sciences.

**Acknowledgments:** We thank the leadership and staff at the Oregon Home Care Commission for their long-term collaboration and commitment to the project (Cheryl Miller, Roberta Lilly, Kristen Eisenman, Leslie Houston, Kelly Rosenau, and many others). The Service Employees International Union Local 503 provided critical support during the development and evaluation of COMPASS, including feedback, guidance, and use of meeting spaces for groups. We are grateful for Diane Elliot's collaboration and contributions as a Co-Investigator during the pilot and RCT phases of the project. The "Fruits & Vegetables" and "Jeopardy" activities in the second meeting of COMPASS guidebook one (pre-dissemination editions) were developed by Diane Elliot, MD, FACSM, Kerry Kuehl, MD, DrPH, and Linn Goldberg, MD, FACSM, Division of Health Promotion and Sports Medicine, OHSU. Brad Wipfli and Robert Wright made important contributions to scripted content in Communication for Hazard Correction and Mental Health meetings in COMPASS guidebook one, and we thank Brian Luke Seaward for his permission to adapt a stress coping activity for the disseminated version of the guidebooks. We thank Kristen Eisenman, Paul Weaver, Sydney Running, Vinesa Faaogea, and Lisa Olson for training evaluation data entry and processing. We also thank student interns and volunteers involved with the adaptation and dissemination phases of the project, including Teala Alvord and Claire Boenisch.

**Conflicts of Interest:** The authors declare no conflict of interest. The funders had no role in the design of the study; in the analyses or interpretation of data; in the writing of the manuscript, and in the decision to publish the results. The Oregon Home Care Commission played a collaborative role in planning COMPASS adaptations and dissemination strategies, and also collected and shared training evaluation data for the dissemination phase of the project.
