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Burns PA, Klukas E, Sims-Gomillia C, Omondi A, Bender M, Poteat T. As Much As I Can - Utilizing Immersive Theatre to Reduce HIV-Related Stigma and Discrimination Toward Black Sexual Minority Men. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2024; 44:151-163. [PMID: 36189845 DOI: 10.1177/0272684x221115920] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Despite advances in biomedical HIV prevention modalities such as pre-exposure prophylaxis to prevent the transmission of HIV, racial/ethnic and sexual/gender minority populations are disproportionately impacted by HIV epidemic. Alarming rates of HIV have persisted among Black gay and bisexual men, particularly in Southern states. METHODS Utilizing data from the ViiV ACCELERATE! initiative, we explored the impact of As Much As I Can, an immersive theatre production, on HIV-related stigma behaviors. A self-administered post-performance survey was conducted with a cohort (n = 322) of randomly selected audience members. RESULTS Overall, the results showed participants had a highly favorable experience, rating the performance with a mean score of 9.77/10. Respondents indicated they intended to change behaviors to promote HIV prevention education and to reduce stigma and discrimination including: (1) Say something if I hear stigmatizing language against people living with HIV (75.4%), (2) Say something if I hear anti-gay language (69.7%) and (3) Tell others about HIV prevention options (e.g., PrEP, PEP, condoms (64.1%). The findings show there is an association between HIV-related behavior intention and linkage to HIV care. Respondents who reported they were more likely to say something about HIV stigma were almost three times (O.R. 2.77; 95% C.I. 0.98-7.8) more likely to indicate they would follow up with a healthcare professional. CONCLUSIONS This study suggests that immersive theatre is an effective method for communicating HIV prevention education and reducing HIV-related structural stigma and discrimination that increases HIV vulnerability for Black sexual minority men.
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Affiliation(s)
- Paul A Burns
- John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA
| | | | - Courtney Sims-Gomillia
- John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA
| | - Angela Omondi
- John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA
| | - Melverta Bender
- Mississippi State Department of Health/Office of STD/HIV, Jackson, MS, USA
| | - Tonia Poteat
- School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
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Bouaddi O, Zbiri S, Belrhiti Z. Interventions to improve migrants' access to sexual and reproductive health services: a scoping review. BMJ Glob Health 2023; 8:e011981. [PMID: 37311580 DOI: 10.1136/bmjgh-2023-011981] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/24/2023] [Indexed: 06/15/2023] Open
Abstract
INTRODUCTION Migrants' access to sexual and reproductive health (SRH) services is constrained by several individual, organisational and structural barriers. To address these barriers, many interventions have been developed and implemented worldwide to facilitate the access and utilisation of SRH services for migrant populations. The aim of this scoping review was to identify the characteristics and scope of interventions, their underlying theory of change, reported outcomes and key enablers and challenges to improve access to SRH services for migrants. METHODS A scoping review was conducted according to the Arksey and O'Malley (2005) guidelines. We searched three electronic databases (MEDLINE, Scopus and Google Scholar) and carried out additional searches using manual searching and citations tracking of empirical studies addressing interventions aimed at improving access and utilisation of SRH services for migrant populations published in Arabic, French or English between 4 September 1997 and 31 December 2022. RESULTS We screened a total of 4267 papers, and 47 papers met our inclusion criteria. We identified different forms of interventions: comprehensive (multiple individual, organisational and structural components) and focused interventions addressing specific individual attributes (knowledge, attitude, perceptions and behaviours). Comprehensive interventions also address structural and organisational barriers (ie, the ability to pay). The results suggest that coconstruction of interventions enables the building of contextual sensitive educational contents and improved communication and self-empowerment as well as self-efficacy of migrant populations, and thus improved access to SRH. CONCLUSION More attention needs to be placed on participative approaches in developing interventions for migrants to improve access to SRH services.
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Affiliation(s)
- Oumnia Bouaddi
- International School of Public Health, Mohammed VI University of Health and Sciences (UM6SS), Casablanca, Morocco
- Knowledge for Health Policies Center, University Mohammed VI of Health and Sciences, (UM6SS), Casablanca, Morocco
- Mohammed VI Center for Research and Innovation, (CM6), Rabat, Morocco
| | - Saad Zbiri
- International School of Public Health, Mohammed VI University of Health and Sciences (UM6SS), Casablanca, Morocco
- Knowledge for Health Policies Center, University Mohammed VI of Health and Sciences, (UM6SS), Casablanca, Morocco
- Mohammed VI Center for Research and Innovation, (CM6), Rabat, Morocco
| | - Zakaria Belrhiti
- International School of Public Health, Mohammed VI University of Health and Sciences (UM6SS), Casablanca, Morocco
- Knowledge for Health Policies Center, University Mohammed VI of Health and Sciences, (UM6SS), Casablanca, Morocco
- Mohammed VI Center for Research and Innovation, (CM6), Rabat, Morocco
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Evagora-Campbell M, Zahidie A, Buse K, Rabbani F, Hawkes S. Promoting labour migrant health equity through action on the structural determinants: a systematic review. J Migr Health 2022; 5:100082. [PMID: 35199076 PMCID: PMC8851278 DOI: 10.1016/j.jmh.2022.100082] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 01/25/2022] [Accepted: 01/26/2022] [Indexed: 11/06/2022] Open
Abstract
Background Labour migrants, who represent over sixty per cent of international migrants globally, frequently have poorer health status than the population of host countries. These health inequities are determined in a large part by structural drivers including political, commercial, economic, normative and social factors, including living and working conditions. Achieving health equity for migrant workers requires structural-level interventions to address these determinants. Methods We undertook a systematic review of peer-reviewed literature designed to answer the question “what is the evidence for the effectiveness of interventions to address the structural determinants of health for labour migrants?” using the Ovid Medline electronic database. Findings We found only two papers that evaluated structural interventions to improve the health of labour migrants. Both papers evaluated the impact of insurance – health or social. In contrast, we found 19 evaluations of more proximal, small-scale interventions focused on changing the knowledge, attitudes and behaviours of labour migrants. Interpretation Despite the rise in international migration, including for work, and evidence that labour migrants have some higher health risks, there is a paucity of research addressing the structural determinants of health inequities in labour migrants. The research community (including funders and academic institutions) needs to pay greater attention to the structural determinants of health – which generally requires working across disciplines and sectors and thinking more politically about health and health inequities. Funding Wellcome Trust (208712/Z/17/Z).
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Vahabi M, Pui-Hing Wong J, Moosapoor M, Akbarian A, Fung K. Effects of Acceptance and Commitment Therapy (ACT) on Mental Health and Resiliency of Migrant Live-in Caregivers in Canada: Pilot Randomized Wait List Controlled Trial. JMIR Form Res 2022; 6:e32136. [PMID: 35084337 PMCID: PMC9090443 DOI: 10.2196/32136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/24/2021] [Accepted: 09/25/2021] [Indexed: 11/13/2022] Open
Abstract
Background
Temporary migrant live-in caregivers constitute a vulnerable stream of temporary foreign workers in Canada. This is because the majority are racialized women from the Global South, the gendered nature of caregiving work has historically been undervalued, and their working and living spheres are intertwined which makes application of labor laws and surveillance almost impossible. Their invisible position in the fabric of Canadian society along with their precarious employment and immigration status place their mental health at jeopardy. There is a paucity of research about psychological support for this population.
Objective
Our pilot study Women Empowerment—Caregiver Acceptance and Resilience E-Learning (WE2CARE) aimed to assess the efficacy of a 6-week online delivery of a psychological intervention based on acceptance and commitment therapy (ACT) in reducing psychological distress and promoting resiliency among live-in care givers in the Greater Toronto Area.
Methods
A pilot randomized wait list controlled design was used. Participants were recruited by two community peer champions working with community health organizations serving migrant live-in caregivers. A total of 36 participants were recruited and randomly assigned to the intervention and wait list control groups; 7 dropped out of the study due to competing life priorities. Standardized self-reported surveys were administered online pre-, post-, and 6-week postintervention to assess mental distress (DASS-21), psychological flexibility (AAQ-2), mindfulness (CAMS-R), and Multi-System Model of Resilience (MSMR-I). Independent and dependent t tests were used to compare study outcomes at pre, post, and 6-week follow-up across and within both arms of the study. Linear mixed effects models were created for each outcome of interest from baseline to postintervention among intervention and control participants. Self-reported impact of the WE2CARE intervention was examined using independent t tests across the study arms.
Results
Average age of participants was 38 years. Many were born in the Philippines (23/29, 79%). The data on the impact of the psychological intervention showed a lower level of depression, anxiety, and stress among the intervention group compared with the control. However, the differences were not significant due to small sample size and COVID-19 crisis (6.94 vs 9.50, P=.54; 6.94 vs 10.83, P=.20; 7.76 vs 10.33, P=.44, respectively). There was a significant improvement in mindful qualities and external resilience, particularly in life satisfaction and accessible support among the intervention group (37.18 vs 32.92, t22=2.35, P=.03; 20.29 vs 16.5, t21=2.98, P=.007; 8.47 vs 6.75, t14=2.41, P=.03; 7.59 vs 5.33, t16=.008, respectively).
Conclusions
WE2CARE is among the first studies exploring the efficacy of online delivery of ACT in addressing mental health challenges among live-in caregivers. While there are increased web-based ACT interventions, few use group videoconferencing to promote peer connection and mutual support. WE2CARE showed promising results in reducing psychological distress and promoting mindfulness and resiliency. The intervention highly motivated participants to engage collectively in building social support networks.
International Registered Report Identifier (IRRID)
RR2-10.2196/preprints.31211
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Affiliation(s)
- Mandana Vahabi
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada
| | | | - Masoomeh Moosapoor
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada
| | - Abdolreza Akbarian
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, Canada
| | - Kenneth Fung
- Toronto Western Hospital, University Health Network, Toronto, ON, Canada
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Menger LM, Rosecrance J, Stallones L, Roman-Muniz IN. A Guide to the Design of Occupational Safety and Health Training for Immigrant, Latino/a Dairy Workers. Front Public Health 2016; 4:282. [PMID: 28066760 PMCID: PMC5179979 DOI: 10.3389/fpubh.2016.00282] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 12/08/2016] [Indexed: 11/13/2022] Open
Abstract
Industrialized dairy production in the U.S. relies on an immigrant, primarily Latino/a, workforce to meet greater production demands. Given the high rates of injuries and illnesses on U.S. dairies, there is pressing need to develop culturally appropriate training to promote safe practices among immigrant, Latino/a dairy workers. To date, there have been few published research articles or guidelines specific to developing effective occupational safety and health (OSH) training for immigrant, Latino/a workers in the dairy industry. Literature relevant to safety training for immigrant workers in agriculture and other high-risk industries (e.g., construction) was examined to identify promising approaches. The aim of this paper is to provide a practical guide for researchers and practitioners involved in the design and implementation of effective OSH training programs for immigrant, Latino/a workers in the dairy industry. The search was restricted to peer-reviewed academic journals and guidelines published between 1980 and 2015 by universities or extension programs, written in English, and related to health and safety training among immigrant, Latino/a workers within agriculture and other high-risk industries. Relevant recommendations regarding effective training transfer were also included from literature in the field of industrial-organizational psychology. A total of 97 articles were identified, of which 65 met the inclusion criteria and made a unique and significant contribution. The review revealed a number of promising strategies for how to effectively tailor health and safety training for immigrant, Latino/a workers in the dairy industry grouped under five main themes: (1) understanding and involving workers; (2) training content and materials; (3) training methods; (4) maximizing worker engagement; and (5) program evaluation. The identification of best practices in the design and implementation of training programs for immigrant, Latino/a workers within agriculture and other high-risk industries can inform the development of more effective and sustainable health and safety training for immigrant, Latino/a dairy workers in the U.S. and other countries.
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Affiliation(s)
- Lauren M. Menger
- Department of Psychology, College of Natural Sciences, Colorado State University, Fort Collins, CO, USA
| | - John Rosecrance
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Lorann Stallones
- Department of Psychology, College of Natural Sciences, Colorado State University, Fort Collins, CO, USA
| | - Ivette Noami Roman-Muniz
- Department of Animal Sciences, College of Agricultural Sciences, Colorado State University, Fort Collins, CO, USA
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Taboada A, Taggart T, Holloway I, Houpt A, Gordon R, Gere D, Milburn N, Lightfoot AF. A Critical Review of the Characteristics of Theater-Based HIV Prevention Interventions for Adolescents in School Settings. Health Promot Pract 2016; 17:537-47. [PMID: 27095037 DOI: 10.1177/1524839916632567] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Theater-based interventions are a viable prevention strategy for changing sexual health knowledge, attitudes, and behaviors related to HIV prevention. However, few studies have explored interventions in English-speaking, high-income countries such as the United States, Canada, or the United Kingdom. This article critically reviews the literature to identify key characteristics of theater-based HIV prevention strategies used for adolescents in school-settings in the United States, Canada, and the United Kingdom. Specifically, we identify the theatrical approach used in HIV prevention interventions, the behavioral theories that inform such interventions, and the study design and results of existing evaluation studies conducted in school settings. In the 10 articles reviewed, we found limited grounding in theory and the use of nonrigorous study design. To strengthen the evidence and practical application of theater-based HIV prevention interventions, we highlight three specific recommendations for practitioners and researchers: (1) define and operationalize the theater approach and techniques used, (2) ensure theater-based interventions are grounded in theory, and (3) conduct rigorous evaluation of theater-based interventions. These recommendations are key to strengthening future research on and implementation of theater-based interventions for HIV prevention.
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Affiliation(s)
| | - Tamara Taggart
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | | | | | - David Gere
- University of California, Los Angeles, CA, USA
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Martinez-Donate AP, Rangel MG, Zhang X, Simon NJ, Rhoads N, Gonzalez-Fagoaga JE, Gonzalez AA. HIV Prevention Among Mexican Migrants at Different Migration Phases: Exposure to Prevention Messages and Association With Testing Behaviors. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2015; 27:547-65. [PMID: 26595267 PMCID: PMC4751078 DOI: 10.1521/aeap.2015.27.6.547] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Mobile populations are at increased risk for HIV infection. Exposure to HIV prevention messages at all phases of the migration process may help decrease im/migrants' HIV risk. We investigated levels of exposure to HIV prevention messages, factors associated with message exposure, and the association between exposure to prevention messages and HIV testing behavior among Mexican im/migrants at different phases of the migration process. We conducted a cross-sectional, probability survey of Mexican im/migrants (N = 3,149) traveling through the border city of Tijuana, Mexico. The results indicate limited exposure to prevention messages (57-75%) and suboptimal last 12-month HIV testing rates (14-25%) across five migration phases. Compared to pre-departure levels (75%), exposure to messages decreases at all post-departure migration phases (57-63%, p < .001). In general, exposure to prevention messages is positively associated with greater odds of HIV testing at the pre-departure, destination, and interception phases. Binational efforts need to be intensified to reach and deliver HIV prevention to Mexican im/migrants across the migration continuum.
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Affiliation(s)
- Ana P. Martinez-Donate
- Department of Community Health & Prevention, School of Public Health, Drexel University, Philadelphia, PA, USA
| | - M. Gudelia Rangel
- U.S.-Mexico Border Health Commission, Mexico Section, Tijuana, Baja California, Mexico
| | - Xiao Zhang
- Department of Community Health & Prevention, School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Norma-Jean Simon
- Department of Community Health & Prevention, School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Natalie Rhoads
- Department of Community Health & Prevention, School of Public Health, Drexel University, Philadelphia, PA, USA
| | | | - Ahmed Asadi Gonzalez
- School of Medicine and Psychology, Autonomous University of Baja California (Universidad Autonoma de Baja California), Tijuana, Baja California, Mexico
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McMahon T, Ward PR. HIV among immigrants living in high-income countries: a realist review of evidence to guide targeted approaches to behavioural HIV prevention. Syst Rev 2012; 1:56. [PMID: 23168134 PMCID: PMC3534573 DOI: 10.1186/2046-4053-1-56] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Accepted: 10/29/2012] [Indexed: 11/10/2022] Open
Abstract
UNLABELLED BACKGROUND Immigrants from developing and middle-income countries are an emerging priority in HIV prevention in high-income countries. This may be explained in part by accelerating international migration and population mobility. However, it may also be due to the vulnerabilities of immigrants including social exclusion along with socioeconomic, cultural and language barriers to HIV prevention. Contemporary thinking on effective HIV prevention stresses the need for targeted approaches that adapt HIV prevention interventions according to the cultural context and population being addressed. This review of evidence sought to generate insights into targeted approaches in this emerging area of HIV prevention. METHODS We undertook a realist review to answer the research question: 'How are HIV prevention interventions in high-income countries adapted to suit immigrants' needs?' A key goal was to uncover underlying theories or mechanisms operating in behavioural HIV prevention interventions with immigrants, to uncover explanations as how and why they work (or not) for particular groups in particular contexts, and thus to refine the underlying theories. The realist review mapped seven initial mechanisms underlying culturally appropriate HIV prevention with immigrants. Evidence from intervention studies and qualitative studies found in systematic searches was then used to test and refine these seven mechanisms. RESULTS Thirty-four intervention studies and 40 qualitative studies contributed to the analysis and synthesis of evidence. The strongest evidence supported the role of 'consonance' mechanisms, indicating the pivotal need to incorporate cultural values into the intervention content. Moderate evidence was found to support the role of three other mechanisms - 'understanding', 'specificity' and 'embeddedness' - which indicated that using the language of immigrants, usually the 'mother tongue', targeting (in terms of ethnicity) and the use of settings were also critical elements in culturally appropriate HIV prevention. There was mixed evidence for the roles of 'authenticity' and 'framing' mechanisms and only partial evidence to support role of 'endorsement' mechanisms. CONCLUSIONS This realist review contributes to the explanatory framework of behavioural HIV prevention among immigrants living in high-income countries and, in particular, builds a greater understanding of the suite of mechanisms that underpin adaptations of interventions by the cultural context and population being targeted.
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Affiliation(s)
- Tadgh McMahon
- Multicultural HIV and Hepatitis Service, PO Box M139, MISSENDEN ROAD, Camperdown, NSW, 2050, Australia
- Discipline of Public Health, School of Medicine, Flinders University, GPO Box 2100, Flinders, SA, 5001, Australia
| | - Paul R Ward
- Discipline of Public Health, School of Medicine, Flinders University, GPO Box 2100, Flinders, SA, 5001, Australia
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Spears CR, Summers PY, Spencer KM, Arcury TA. Informal occupational safety information exchange among Latino migrant and seasonal farmworkers. J Agromedicine 2012; 17:415-20. [PMID: 22994643 DOI: 10.1080/1059924x.2012.713830] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Latino farmworkers in North Carolina are a hard-to-reach population that faces diverse occupational health risks, including pesticide exposure. Health and safety education efforts often employ lay health advisor or promotor(a) de salud models in which farmworker community members are trained to provide health education. As a frequently tight-knit and isolated group, farmworkers may be well suited to serve as resident lay health advisors. This paper presents data collected from a nonrandom sample of Latino farmworkers living in North Carolina regarding the natural level of occupational safety information exchange among Latino farmworkers, specifically pesticide safety information. The data affirm that farmworkers informally exchange occupational safety information with one another, with the level of exchange increasing during the agricultural season. Consequently, if trained, the data suggest that farmworkers might be situated to provide in situ occupational health and safety education to their peers. This remains to be systematically tested and evaluated.
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Affiliation(s)
- Chaya R Spears
- Department of Family and Community Medicine, and the Center for Worker Health, Wake Forest School of Medicine, Winston-Salem, North Carolina 27157, USA
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Preibisch K, Hennebry J. Temporary migration, chronic effects: the health of international migrant workers in Canada. CMAJ 2011; 183:1033-8. [PMID: 21502343 DOI: 10.1503/cmaj.090736] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Kerry Preibisch
- Department of Sociology, University of Guelph, Guelph, Ontario.
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Arcury TA, Estrada JM, Quandt SA. Overcoming language and literacy barriers in safety and health training of agricultural workers. J Agromedicine 2010; 15:236-48. [PMID: 20665309 PMCID: PMC2914347 DOI: 10.1080/1059924x.2010.486958] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The workforce in all areas of United States agriculture and forestry is becoming increasingly diverse in language, culture, and education. Many agricultural workers are immigrants who have limited English language skills and limited educational attainment. Providing safety and health training to this large, diverse, dispersed, and often transient population of workers is challenging. This review, prepared for the 2010 Agricultural Safety and Health Council of America/National Institute for Occupational Safety and Health conference, "Be Safe, Be Profitable: Protecting Workers in Agriculture," is divided into five sections. First, we describe the occupational and demographic characteristics of agricultural workers in the United States to highlight their safety and health training needs. Second, we summarize current research on the social and cultural attributes of agricultural workers and agricultural employers that affect the provision of safety and health training. Worker and employer attributes include language, literacy, financial limitations, work beliefs, and health beliefs. Third, we review current initiatives addressing safety and health training for agricultural workers that consider worker language and literacy. These initiatives are limited to a few specific topics (e.g., pesticides, heat stress); they do not provide general programs of safety training that would help establish a culture of workplace safety. However, several innovative approaches to health and safety training are being implemented, including the use of community-based participatory approaches and lay health promoter programs. Fourth, the limited industry response for safety training with this linguistically diverse and educationally limited workforce is summarized. Finally, gaps in knowledge and practice are summarized and recommendations to develop educationally, culturally, and linguistically appropriate safety and health training are presented.
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Affiliation(s)
- Thomas A Arcury
- Department of Family and Community Medicine, Wake Forest University School of Medicine, Center for Worker Health, Winston-Salem, North Carolina 27157, USA.
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