Patterns and correlates of nutrition among migrant farm-worker children

COVID-19 Pandemic among Latinx Farmworker and Nonfarmworker Families in North Carolina: Knowledge, Risk Perceptions, and Preventive Behaviors

(1) Background: The COVID-19 pandemic poses substantial threats to Latinx farmworkers and other immigrants in food production and processing. Classified as essential, such workers cannot shelter at home. Therefore, knowledge and preventive behaviors are important to reduce COVID-19 spread in the community. (2) Methods: Respondents for 67 families with at least one farmworker (FWF) and 38 comparable families with no farmworkers (nonFWF) in North Carolina completed a telephone survey in May 2020. The survey queried knowledge of COVID-19, perceptions of its severity, self-efficacy, and preventive behaviors. Detailed data were collected to document household members’ social interaction and use of face coverings. (3) Results: Knowledge of COVID-19 and prevention methods was high in both groups, as was its perceived severity. NonFWF had higher self-efficacy for preventing infection. Both groups claimed to practice preventive behaviors, though FWF emphasized social avoidance and nonFWF emphasized personal hygiene. Detailed social interactions showed high rates of inter-personal contact at home, at work, and in the community with more mask use in nonFWF than FWF. (4) Conclusions: Despite high levels of knowledge and perceived severity for COVID-19, these immigrant families were engaged in frequent interpersonal contact that could expose community members and themselves to COVID-19.

Food Insecurity and Major Diet-Related Morbidities in Migrating Children: A Systematic Review

Children of migrant families are known to be at a higher risk of diet-related morbidities due to complex variables including food insecurity, cultural and religious beliefs, and sociodemographic factors like ethnicity, socioeconomic status, and education. Several studies have assessed the presence of specific diseases related to dietary issues in migrant children. This systematic review aims to highlight the existing body of work on nutritional deficiencies in the specific vulnerable pediatric population of immigrants. Refugees were intentionally excluded because of fundamental differences between the two groups including the reasons for migration and health status at the time of arrival. A total of 29 papers were included and assessed for quality. Most of them described a strong correlation between obesity and migration. A high prevalence of stunting, early childhood caries, iron and vitamin D deficiency was also reported, but the studies were few and heterogeneous. Food insecurity and acculturation were found important social factors (nevertheless with inconclusive results) influencing dietary habits and contributing to the development of morbidities such as obesity and other metabolic disorders, which can cause progressive unsustainability of health systems. Public health screening for diet-related diseases in migrant children may be implemented. Educational programs to improve children’s diet and promote healthy-living behaviors as a form of socioeconomic investment for the health of the new generations may also be considered.

Diet Quality among Preschool-Age Children of Latino Migrant and Seasonal Farmworkers in the United States

Dietary quality has been linked to obesity in children. Obesity among children of farmworker families exceeds that of other US Hispanic children. Knowledge of their dietary quality is needed to understand the origins and prevention of this obesity. Mothers (n = 237) of 3-year old children in farmworker families completed 3 24-hour recalls with trained interviewers using the Nutrition Data System for Research (NDS-R). Output was used to calculate total and component scores of the Revised Children's Diet Quality Index (RC-DQI). Mean total score was 62 (range 36-86) of an optimal score of 90. Scores for total fat, total grains, excess juice and iron were >80 % of the optimum, but scores for added sugar, whole grains, fruits, and vegetables were considerably lower. Children in farmworker families have low overall dietary quality. Intervention targeted to specific food issues may be an efficient way to addressing the problem.

Prevalence and Determinants of Overweight and Obesity in Children and Adolescents from Migrant and Seasonal Farmworker Families in the United States-A Systematic Review and Qualitative Assessment

Overweight and obesity (OW/OB) is a pressing health concern among migrant and seasonal farmworker (MSFW) families in the US. The limited number of previously reported research on MSFW families suggests that their unique sociodemographic characteristics and lifestyle predispose them to poor health outcomes including OW/OB. We aimed to synthesize and assess available data on the prevalence and modifiable health determinants of OW/OB in MSFW children and adolescents. Literature search, study selection, data extraction and synthesis, and qualitative assessment of selected studies were performed independently by two authors. Ten cross-sectional studies met the inclusion criteria: articles or dissertations investigating prevalence and association between health determinants and OW/OB in MSFW children and adolescents (<20 years) in the US. The prevalence of OW, OB, and OW/OB ranged from 10%–33%, 15%–37%, and 31%–73%, respectively. Children’s education, household food insecurity, parents’ weight status, parents’ distorted perception of their children’s weight status, and parents’ participation in the federal nutrition assistance program were significantly associated with the children’s and adolescents’ risk of OW/OB. Promotion of culturally relevant public health programs and implementation of a systematic health surveillance plan for MSFWs and their children should be emphasized to combat OW/OB among MSFW children and adolescents.

Influences on Healthy-Eating Decision Making in Latino Adolescent Children of Migrant and Seasonal Agricultural Workers

INTRODUCTION

Latino children demonstrate high rates of unhealthy weight, and children of Latino migrant and seasonal agricultural workers are heavier than their Latino peers.

METHOD

This one-group, cross-sectional, mixed-methods pilot study explored healthy-eating decision making with 12- to 14-year-olds recruited from a Midwest summer migrant education program. Demographics, decision-making, self-efficacy, and social support survey instruments were used, along with gender-specific focus groups.

RESULT

In the convenience sample, which included 24 participants, students felt varying degrees of uncertainty when choosing healthy foods in social situations, and 67% made poor-quality decisions. Parents offered greater support for healthy eating compared with friends. Qualitative analyses identified three themes: healthy decision making includes fruits, vegetables, and physical activity; mothers have influence over health and healthy decisions; and friends encourage unhealthy food choices.

DISCUSSION

Influences on healthy-eating decision making in Latino adolescent children of migrant and seasonal agricultural workers, which were previously missing from the literature, were identified. Future research includes development of interventions to assist these adolescents with healthy-eating decision making.

Making a Difference in Migrant Summer School: Testing a Healthy Weight Intervention

OBJECTIVE

Evaluate the effectiveness of a healthy weight intervention designed for children of migrant farmworkers embedded in a 7-week summer Midwest Migrant Education Program (MEP) for changes in: weight; Body Mass Index (BMI); BMI-percentiles (BMI-p); muscle strength and muscle flexibility; nutrition knowledge; attitudes; and behaviors.

DESIGN AND SAMPLE

This is a two-group pre-post quasi-experimental study. Latino children of migrant farmworkers attending summer MEP in grades one through eight were enrolled (n = 171: comparison n = 33, intervention n = 138).

MEASURES

Weight, BMI, BMI-p, muscle strength and flexibility, knowledge, and healthy behaviors.

INTERVENTION

Classroom content included: food variety; increasing fruits and vegetables; healthy breakfasts; more family meals; increasing family time; decreasing TV and electronic game time; increasing physical activity; limiting sugar-sweetened drinks; portion sizes; and food labels.

RESULTS

Statistically significant were increase in comparison group mean weight, decrease in intervention group BMI-p, and improvements in muscle flexibility and healthy behavior attitudes. The intervention students showed trends toward healthy BMI. The number of MEP days attended was significantly correlated in four outcomes.

CONCLUSION

Study findings have the potential to decrease incidence of unhealthy weight in Latino migrant children, reduce rates of premature adult diseases in these children, and a potential to decrease future health care costs.

Migrant and Seasonal Farmworker Food Insecurity: Prevalence, Impact, Risk Factors, and Coping Strategies

In the United States, nearly 15% of the general population is considered food insecure; ethnic minorities, particularly Latinos, experience disproportionately higher rates. Food insecurity is particularly endemic among the migrant and seasonal farmworker population. This article systematically reviews current knowledge related to the prevalence of food insecurity among migrant and seasonal farmworkers. The impact, risk factors, and coping strategies of food insecurity are also presented. The authors argue for targeted social work efforts at mezzo- and macrolevels and make recommendations aimed at the prevention and amelioration of food insecurity.

The Impact of Head Start Enrollment Duration on Migrant Children's Health Outcomes

The purpose of this study is to examine whether family characteristics and the length of children's enrollment in Migrant Head Start affects children's health treatment. Children in the Michigan Migrant Head Start were classified depending on years of enrollments: One year (n = 638), two years (n = 293), and three or more years (n = 426). Logistic regression analyses were conducted to examine whether the probability of children receiving health treatment differed depending on years of enrollment. There is a higher health treatment rate among children who attended Head Start for multiple years than for those who attended for one year. Children's special needs status, of siblings, ethnicity, parental educational level, and marital status were related to preventative dental and physical health treatment outcomes. Although the primary goal of Head Start is school readiness rather than health improvement, migrant and seasonal farmworker children are likely to receive more health treatment if they attend more years of comprehensive intervention, such as Head Start, for positive physical and dental health.

Summer migrant students learn healthy choices through videography

The purpose of this single-group pre- and posttest intervention pilot study was to teach middle school migrant farmworker children the benefits of healthy eating and activity using a multimedia and ethnic-tailored health curriculum, embedded in a 7-week summer Migrant Education Program. Conceptual frameworks were from transcultural nursing, education, and child development. Student-made video productions enhanced classroom learning and content retention. Outcomes were health infomercials, body mass index (BMI), BMI percentile, muscle strength and flexibility, and We Can! and Coordinated Approach To Child Health (CATCH) surveys. Sixty-four students were enrolled (girls n = 31, boys n = 33), 96% Latino, and 65% were overweight or obese. Students had significant improvement in 12 knowledge and attitudes measures with significant gender differences in 11 measures. Although not statistically significant, trends toward healthier weight were seen. Five student infomercials were produced. The school environment effectively delivered health promotion to migrant children and will serve as a prototype for middle school health interventions.

Effects of a healthy eating intervention on Latina migrant farmworker mothers

This is a report of a 2-group pre-/post-quasi-experimental pilot intervention study, Dietary Intake and Nutrition Education-Phase Three. The purpose of the study was to present self-management health education on healthy eating to Latina migrant farmworker mothers. The intervention had three 1-hour classes. Surveys included household food security, general self-efficacy, acculturation, knowledge, and children's food patterns and anthropometric measurements. Positive results were seen in mothers' nutrition knowledge. Intervention children had decreased body mass index percentiles. Children whose mothers had higher acculturation had greater reduction in body mass index percentiles. Mothers living alone had higher probability to attend intervention classes. Lessons learned will guide future health promotion research.

Audio-Enhanced Tablet Computers to Assess Children's Food Frequency From Migrant Farmworker Mothers

This study sought to improve data collection in children's food frequency surveys for non-English speaking immigrant/migrant farmworker mothers using audio-enhanced tablet computers (ATCs). We hypothesized that by using technological adaptations, we would be able to improve data capture and therefore reduce lost surveys. This Food Frequency Questionnaire (FFQ), a paper-based dietary assessment tool, was adapted for ATCs and assessed consumption of 66 food items asking 3 questions for each food item: frequency, quantity of consumption, and serving size. The tablet-based survey was audio enhanced with each question "read" to participants, accompanied by food item images, together with an embedded short instructional video. Results indicated that respondents were able to complete the 198 questions from the 66 food item FFQ on ATCs in approximately 23 minutes. Compared with paper-based FFQs, ATC-based FFQs had less missing data. Despite overall reductions in missing data by use of ATCs, respondents still appeared to have difficulty with question 2 of the FFQ. Ability to score the FFQ was dependent on what sections missing data were located. Unlike the paper-based FFQs, no ATC-based FFQs were unscored due to amount or location of missing data. An ATC-based FFQ was feasible and increased ability to score this survey on children's food patterns from migrant farmworker mothers. This adapted technology may serve as an exemplar for other non-English speaking immigrant populations.

Rasch Analysis of US Household Food Security Survey Module in Latino Migrant Farmworkers

This secondary analysis evaluated the validation of the short version of the US Department of Agriculture's Household Food Security Survey Module (HFSSM) in a Latino migrant population. The Rasch model assessed the HFSSM's structure, item severity levels, and fitness of the sample population. Differential item functioning (DIF) analysis explored the invariance of HFSSM response patterns between less/more acculturated households. Item infit scores were within an adequate range (0.7-1.3). Item severity scores and unidimensionality structure supported the HFSSM's theoretical framework. Analysis showed statistically nonsignificant DIF contrast between acculturation levels. The adapted HFSSM performed in agreement with the theoretical framework of food insecurity as a managed process in this Latino migrant population.

Midwest growers' mail survey of contributors to migrant health and nutrition

The purpose of this study was to solicit information from farm owners (growers), as representatives of their farm businesses, regarding descriptive information on migrant camp housing that may contribute to the health and nutritional status of employed workers and their families. This cross-sectional descriptive mail survey was sent to 802 growers in Indiana, Michigan, Ohio, and Pennsylvania via the US Postal Service. The growers were identified by an Internet search for licensed agricultural work camps in Midwest departments of agriculture. Response rate was 34%. Overall, growers reported a median of one migrant camp with 23 residents, employing workers seasonally for either 10 weeks or 6 months, with seven accompanying children on site. Individual kitchen appliances varied across the states, potentially influencing the preparation of healthy meals. Three themes were identified from the results. First, over one third of owners lacked or had limited knowledge about the health services available to migrant families. Second, migrant workers may have limited access to a variety of fresh produce for household meal preparation. Third, migrant children were unable to easily access public play areas, and families lacked recreational spaces in agricultural work camps. Play areas in migrant camps were mostly identified as open fields with little play equipment on site. Knowledge learned can influence future agricultural camp practices and the design of future research studies, and provide direction for grower education topics presented at agricultural conferences and by extension services.