Anticipatory guidance preferences of Latina migrant farmworker mothers

Community Health Workers' Role in Addressing Farmworker Health Disparities

Community health workers (CHWs) are uniquely positioned to connect migrant and seasonal farmworkers to health promotion and clinical services. However, research on CHWs' experiences, particularly related to their provision of health education to farmworkers, is limited. To explore CHWs' practices and challenges in conducting health education outreach, we conducted three focus group discussions with farmworker health CHWs (N = 28) in North Carolina in the spring of 2020. We analyzed the focus group transcripts, and we compared the code outputs, thematic code summaries, and memos maintained throughout the analytic process to examine the experiences of CHWs in acquiring and disseminating health information and resources, including use of technology. We identified three themes related to CHWs' experiences providing health information to farmworkers. First, CHWs described short-term preparation, immediately before providing health outreach, and long-term activities, devoted to maintaining and improving their capacity to provide relevant health information to farmworkers. Second, they described their use of health education delivery methods, including open-ended questions, participatory and interactive approaches, and non-verbal aids. Third, participants described their current use of technology and related challenges, as well as the technology needed to enhance health outreach, including internet access. Findings reveal opportunities to improve farmworker health education through professional development for CHWs, identification of preferred methods of health education delivery to farmworkers, and provision of technology to farmworker-serving organizations. Establishing rural internet access and equipping outreach organizations with technology would position CHWs to be maximally effective as they strive to reduce farmworkers' health inequities.Abbreviations: CHW: Community health worker; FGD: focus group discussion; NC: North Carolina.

Agricultural Safety Comic Book for Latinx Migrant Families: Development and Evaluation

INTRODUCTION

Comic books and graphic novels have been used in health education. The youth of migrant and seasonal agricultural workers are highly vulnerable to the health hazards associated with agricultural work and the migrant workers' itinerant home environment.

METHOD

The purpose of the study was to create a bilingual, culturally specific educational comic book to inform families of safety issues in youth hand-harvesting agricultural work and provide anticipatory guidance safety tips for agricultural work camp residence. In a mixed-methods design, a multistate and multidisciplinary team used focus groups to obtain the voice of potential users regarding the strengths and weaknesses of the comic book prototype and scales on satisfaction, helpfulness, and usability.

RESULTS

Focus group participants contributed constructive criticism to modify the prototype. Quantitative surveys found the comic book to be satisfactory, helpful, and highly usable.

DISCUSSION

This report describes the steps in the creation of the comic book that can be used for health promotion education.

Educating Latinas about cervical cancer and HPV: a pilot randomized study

INTRODUCTION

The purpose of this study was to assess effects of three different educational intervention arms on knowledge of and intention to receive Pap testing and HPV co-testing.

METHODS

Three active educational intervention arms were developed: a fotonovela, a radionovela, and a digital story. A pilot randomized controlled trial of 160 Latinas was conducted to assess the effectiveness of the intervention arms in increasing knowledge of cervical cancer and HPV and intention to be screened for cervical cancer compared to an attention control group (flu vaccination).

RESULTS

Women in all three treatment arms significantly increased knowledge about cervical cancer compared to control arm (p = 0.02). Knowledge about cervical cancer screening also increased in the active arms compared to control (p = 0.0003). Knowledge of HPV risk also increased relative to the control (p = 0.0001). There were no significant differences between the intervention arms in increased knowledge of cervical cancer or cervical cancer screening (p = 0.57 and 0.16, respectively).

DISCUSSION

This study supported the use of small media interventions in narrative education form as effective in increasing knowledge and intention to be screened for cervical cancer. The three culturally relevant interventions, built on qualitative data, were all successful in increasing knowledge.

Anticipatory Guidance about Child Diet and Physical Activity for Latino Farmworker Mothers

BACKGROUND

This analysis describes farmworker child health care utilization, anticipatory guidance for child weight, and the association of anticipatory guidance with personal characteristics, practice characteristics, and child's health care utilization.

METHODS

Data are from interviews conducted with 221 North Carolina Latino farmworker mothers with a child aged 4-5 years.

RESULTS

Half of the children were healthy weight, 19.0% were overweight, and 28.5% were obese. Most (56.4%) had been with the usual practice for two years or longer; most had well-child visits less frequently than once per year (71.5%). Fewer children with well-child visits than without were obese (14.8% vs. 35.5%; p=.01). More children with obesity than with healthy weight or overweight received guidance messages; more children without a well-child care visit in the past 12 months received guidance messages.

CONCLUSIONS

Health care providers are addressing anticipatory guidance when the opportunity arises. Creative approaches to address disparate primary care for farmworker families are important.

Educational handouts for Latino youth who are obese

Although obesity is a significant problem for many children in the United States, youth who are ethnic minorities, especially Latinos, are at an even great risk than their White counterparts. This ethnic disparity suggests that it is important to target Latino youth with prevention and intervention efforts if there is to be a meaningful decline in pediatric obesity rates. Unfortunately, children, including Latino youth, often do not receive specific recommendations at their primary care visits regarding proper nutrition and exercise. With this in mind, we summarized literature related to pediatric obesity in Latino youth and translated four educational handouts that were previously published in English. The handouts are designed to be used by a variety of different professionals who work in pediatric obesity clinics and are an efficient way to share detailed information with patients.