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Gray KM, Blanchard MR, LePrevost CE. Educator beliefs and organizational constraints: Factors that influence informal education about fish consumption advisories in a southeastern US state. SUSTAINABLE ENVIRONMENT 2023; 9:2259716. [PMID: 38031579 PMCID: PMC10686613 DOI: 10.1080/27658511.2023.2259716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
All US states, and many countries around the world, have waterways with environmental health advisories intended to protect individuals from harmful chemicals in fish, yet little is known about how informal science educators, even those who engage anglers along waterways, incorporate advisory information into their educational activities. This study, grounded in environmental health literacy, investigated the practices, knowledge, and beliefs of 24 informal educators housed in varied agencies and organizations in a southeastern US state. Participants described a range of educational activities and identified organizational constraints on their education about fish consumption advisories, which varied by organization type. Their knowledge of relevant environmental health concepts was incomplete, and they described health and teaching beliefs consistent with limited focus on advisory education. Local government and nonprofit educators were well positioned to educate anglers about advisories, due to their freedom to design and deliver instruction and their regular contact with anglers. Educators in wildlife agencies had more contact with anglers and were identified as potential conduits given their interactions, but organizational constraints (such as educators' ability to choose content/pedagogy and conflicting missions of agencies) would need to be addressed.
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Affiliation(s)
- Kathleen M. Gray
- Institute for the Environment, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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2
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Rattanawitoon T, Siriwong W, Shendell D, Fiedler N, Robson MG. An Evaluation of a Pesticide Training Program to Reduce Pesticide Exposure and Enhance Safety among Female Farmworkers in Nan, Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6635. [PMID: 37681775 PMCID: PMC10487852 DOI: 10.3390/ijerph20176635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 08/11/2023] [Accepted: 08/19/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Although exposure to chemical pesticides is known to cause negative effects on human health, farmers in Ban Luang, Nan, Thailand, continue to use them regularly to protect crops. This study focused on mothers who were engaged in farm tasks and had children between the ages of 0 to 72 months, with the objective of reducing pesticide exposure. METHODS This study was conducted from May 2020 to October 2020 in the Ban Fa and Ban Phi sub-districts in Ban Luang due to the high use of pesticides in these areas. A systematic random sampling technique was used to recruit 78 mothers exposed to pesticides. Thirty-nine mothers from Ban Fa district were randomly assigned to the intervention group and 39 from Ban Phi to the control group over a 3-month period. This study applied a pesticide behavioral change training program for the intervention group. To assess the effectiveness of the program, the study compared the results of a questionnaire regarding knowledge, attitude, and practice (KAP) and health beliefs related to pesticide exposure as well as the levels of acetylcholinesterase (AChE) and butyryl cholinesterase (BChE) enzymes, biomarkers of exposure to pesticides, before and after the intervention using ANCOVA statistical test. Furthermore, to evaluate the effectiveness of the intervention program, a paired t-test was used to investigate the in-home pesticide safety assessment. RESULTS After the intervention, we observed no significant change in AChE; however, a significant improvement in BChE (p < 0.05), a marker of short-term recovery, was observed. Pesticides can cause a reduction in AChE and BChE, however, after eliminating pesticides, BChE takes a shorter time (about 30-50 days) to recover than AChE (around 90-120 days). Therefore, increases in the measured concentrations of AChE and/or BChE suggest the presence of less chemicals from pesticides in the human body. The study also found a significant improvement in KAP and beliefs about chemical pesticide exposure after the intervention (p < 0.05). Furthermore, using a paired t-test, we found a significant increase in pesticide safety practices (p < 0.05) in the intervention group and a borderline significant increase regarding in-home safety (p = 0.051) in the control group. CONCLUSIONS Based on the results, the constructs of the intervention program were effective and could be applied in other agricultural areas in less developed countries. However, due to time limitations during the COVID-19 pandemic, further studies should be conducted to enable data collection over a longer time, with a larger number of subjects providing the ChE levels for the non-agricultural season.
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Affiliation(s)
- Thanawat Rattanawitoon
- Department of Environmental and Occupational Health and Justice, Rutgers School of Public Health, Piscataway, NJ 08854, USA; (D.S.); (N.F.)
| | - Wattasit Siriwong
- College of Public Health Sciences, Chulalongkorn University, Institute Building 3 (10th–11th Floor), Chulalongkorn soi 62, Phyathai Rd., Bangkok 10330, Thailand;
| | - Derek Shendell
- Department of Environmental and Occupational Health and Justice, Rutgers School of Public Health, Piscataway, NJ 08854, USA; (D.S.); (N.F.)
- NJ Safe Schools Program, Rutgers School of Public Health, Piscataway, NJ 08854, USA
- Rutgers Environmental and Occupational Health Sciences Institute, Piscataway, NJ 08854, USA;
| | - Nancy Fiedler
- Department of Environmental and Occupational Health and Justice, Rutgers School of Public Health, Piscataway, NJ 08854, USA; (D.S.); (N.F.)
- Rutgers Environmental and Occupational Health Sciences Institute, Piscataway, NJ 08854, USA;
| | - Mark Gregory Robson
- Rutgers Environmental and Occupational Health Sciences Institute, Piscataway, NJ 08854, USA;
- Department of Plant Biology, Rutgers University, New Brunswick, NJ 08901, USA
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Van Horne YO, Carroll SR, Chief K, Lothrop NZ, Richards JR, Begay MG, Charley PH, Ingram JC, Beamer PI. Using environmental health dialogue in a Diné-centered approach for individualized results reporting in an environmental exposure study following the Gold King Mine Spill. ENVIRONMENTAL RESEARCH 2023; 231:116196. [PMID: 37211184 PMCID: PMC10411314 DOI: 10.1016/j.envres.2023.116196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 05/11/2023] [Accepted: 05/17/2023] [Indexed: 05/23/2023]
Abstract
BACKGROUND On August 5, 2015, the Gold King Mine Spill (GKMS) resulted in 3 million gallons of acid mine drainage spilling into the San Juan River impacting the Diné Bikeyah (traditional homelands of the Navajo people). The Gold King Mine Spill Diné Exposure Project was formed to understand the impacts of the GKMS on the Diné (Navajo). Reporting individualized household results in an exposure study is becoming more common; however, materials are often developed with limited community input with knowledge flowing in one direction - from researcher to participant. In this study we examined the development, dissemination, and evaluation of individualized results materials. METHODS In August 2016, Navajo Nation Community Health Representatives (Navajo CHRs) sampled household water, dust, and soil, and resident blood and urine for lead and arsenic, respectively. From May-July 2017, iterative dialogue with a wide range of community partners and a community focus groups guided the development of a culturally-based dissemination process. In August 2017, Navajo CHRs reported individualized results and they surveyed the participants on the report-back process at that time. RESULTS All of the 63 Diné adults (100%) who participated in the exposure study received their results by a CHR in person and 42 (67%) completed an evaluation. Most of those participants (83%) were satisfied with the result packets. Respondents ranked the individual and overall household results as the most important information they received (69% and 57%, respectively), while information on metals exposures and their health effects were the least helpful. CONCLUSIONS Our project illustrates how a model of environmental health dialogue, defined by iterative, multidirectional communication among Indigenous community members, trusted Indigenous leaders, Indigenous researchers, non-Indigenous researchers, can improve reporting individualized study results. Findings can inform future research to encourage multi-directional environmental health dialogue to craft more culturally responsive and effective dissemination and communication materials.
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Affiliation(s)
- Yoshira Ornelas Van Horne
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
| | - Stephanie Russo Carroll
- Native Nations Institute at the Udall Center for Studies in Public Policy, University of Arizona, Tucson, AZ, 85721, USA; Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA
| | - Karletta Chief
- Department of Environmental Science, University of Arizona, Tucson, AZ 85721, USA; Indigenous Resilience Center, University of Arizona, Tucson, AZ 85721, USA
| | - Nathan Z Lothrop
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA
| | - Jennifer R Richards
- Center for Indigenous Health, Johns Hopkins University, Baltimore, MD 21231, USA
| | | | | | - Jani C Ingram
- Department of Chemistry & Biochemistry, Northern Arizona University, Flagstaff, AZ 86011, USA
| | - Paloma I Beamer
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA
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Muenchamnan N, Naksen W, Ong-Artborirak P. A Two-Pronged Educational Intervention for Caregivers to Prevent Residential Pesticide Exposure Among Thai Young Children Living in Agricultural Area. J Multidiscip Healthc 2023; 16:2339-2350. [PMID: 37601328 PMCID: PMC10439776 DOI: 10.2147/jmdh.s422259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 08/09/2023] [Indexed: 08/22/2023] Open
Abstract
Background Residential pesticide exposure can be harmful to the health of young children, particularly in agricultural areas. It is critical to educate their caregivers on pesticide exposure prevention. The purpose of this study was to determine the effectiveness of a two-pronged education intervention for caregivers in preventing pesticide exposure among Thai young children living in agricultural areas. Methods This was an experimental study with 90 primary caregivers of young children aged 6 months to 5 years. Thirty caregivers each were assigned to one of three groups: booklet plus lecture intervention, only booklet intervention, and control. Caregivers in both interventions received a booklet that educated them on residential pesticide exposure and prevention. The caregivers in the booklet plus lecture group also attended a 2-hour lecture with the same content as the booklet. A questionnaire was developed to assess caregivers' knowledge, attitudes, intention, and behaviors regarding residential pesticide exposure and prevention in children. Face-to-face interviews were conducted at their homes three times: baseline, post-intervention, and follow-up (three weeks after the end of the intervention). Results Linear mixed models showed that, from baseline to post-intervention, the intervention effect on knowledge and attitude in both intervention groups, as well as intention in the booklet plus lecture group, was significant (p<0.05). From baseline to follow-up, the knowledge, attitude, intention, and behavior scores in both intervention groups increased significantly more than the control group (p<0.01). Only the attitude score increased more in the booklet plus lecture group than in the booklet group at post-intervention (p=0.009) and follow-up (p=0.003). Conclusion Both the booklet plus lecture method and the booklet method alone have a positive effect on improving the caregiver's knowledge and behaviors regarding pesticide exposure prevention at home. Thus, providing a booklet to caregivers to reduce children's risk of pesticide exposure is recommended.
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Affiliation(s)
| | - Warangkana Naksen
- Faculty of Public Health, Chiang Mai University, Chiang Mai, Thailand
| | - Parichat Ong-Artborirak
- Faculty of Public Health, Chiang Mai University, Chiang Mai, Thailand
- Department of Research and Medical Innovation, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
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Cultural appropriateness in randomized controlled trials (RCTs) aimed at reducing pesticide exposure among farmers and farmworkers: a systematic review. Int Arch Occup Environ Health 2023; 96:27-44. [PMID: 35838774 DOI: 10.1007/s00420-022-01880-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 05/04/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The widespread use of pesticides poses serious health hazards to farmers and their families. Some evidence shows that culturally sensitive interventions could be associated with improved outcomes; however, little is known about the effectiveness of cultural adaptations in interventions among farmers and farmworkers. Therefore, the purpose of this study was to summarize strategies used in the cultural adaptation interventions addressing the reduction of pesticide exposure in farmers and farmworkers, as well as assessing the effects of these strategies. METHODS A comprehensive systematic literature search was conducted on PubMed, Embase, Clarivate Web of Science, Scopus, NIOSHTIC, Agricola, Agris, as well as reference lists to identify randomized controlled trials (RCTs) published in English from January 2000 until March 2022. Data were extracted to examine the characteristics of interventions in terms of the cultural adaptation strategies and their effectiveness by two independent reviewers. RESULTS Eleven articles from ten trials met the inclusion criteria. The majority of studies were conducted in the USA (n = 7) and were ranked as poor quality (n = 5). Four of the ten studies were rated moderate, and six were rated weak. The socio-cultural and constituent-involving strategies were the most commonly reported across the included studies, followed by linguistic strategy. Six studies (seven articles) were tailored for subgroups or individuals. Overall, 8 of 10 studies reported significant changes in whole and some outcomes in the intervention groups over controls. Seven studies received moderate cultural adaptation scores which may reflect the moderate effectiveness of the interventions. CONCLUSION Our review underscored the paucity and low quality of existing studies investigating the culturally adapted interventions in reducing farmers' and farmworkers' pesticide exposure. Future high-quality culturally sensitive studies could increase our knowledge regarding the culture's role in reducing pesticide exposure in farmers and farmworkers.
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Fernández-Esquer ME, Atkinson JS, Hernandez RA, Aguerre CF, Brown LD, Reininger B, Ojeda MA, Field C, Rhoton JM, Da Silva CE, Diamond PM. Vales+ Tú: a cluster-randomized pilot study to reduce workplace injuries among US Latino day laborers. Health Promot Int 2022; 37:6823578. [DOI: 10.1093/heapro/daac163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Summary
Latino day laborers (LDL) are a vulnerable population of workers facing considerable risk for occupational injury. Under the guidance of our Community Advisory Board, we developed and tested the feasibility, acceptability and preliminary effects of Vales+Tú (You Are Worth More), a workplace injury risk-reduction program implemented by promotores on street-corners where LDL seek employment. The program was informed by theoretical perspectives emphasizing individual and group agency and self-determination. A pilot three-arm cluster-randomized community trial was conducted among 75 LDL. The intervention arms consisted of an individualized Brief Motivational Interview, a Group Problem Solving activity and a standard of care control (OSHA safety cards). We met our study goal of 25 LDL per intervention arm, and contacted 88% of participants post intervention. Participants evaluated the interventions favorably. At post-test, the Brief Motivational Interview group reported significant reductions in exposure to workplace hazards and increases in risk-reduction practices. The Group Problem Solving participants showed significant reductions in exposure to hazards (t-test −4.16, p < 0.001). Both intervention groups increased their reliance on corner peers, a measure of social support. Standard of care participants increased in self-efficacy to work safely. Overall, the only significant different between the three study conditions was in self-efficacy. These findings provide evidence of the feasibility and acceptability of Vales+Tú and show preliminary program efficacy. A large-scale replication trial will permit a more formal modeling of the study findings. Clinical Trial Registration (ClinicalTrials.gov): NCT04378348.
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Affiliation(s)
- Maria Eugenia Fernández-Esquer
- Department for Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth) , Houston, TX , USA
| | - John S Atkinson
- Department for Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth) , Houston, TX , USA
| | - Rodrigo A Hernandez
- Department for Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth) , Houston, TX , USA
| | - Cecilia F Aguerre
- Department for Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth) , Houston, TX , USA
| | - Louis D Brown
- Department for Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth) , El Paso, TX , USA
| | - Belinda Reininger
- Department for Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth) , Brownsville, TX , USA
| | - Martha A Ojeda
- International Center for Labor, Spiritual and Social Activism , Houston, TX , USA
| | - Craig Field
- Department of Psychology, University of Texas at El Paso , El Paso, TX , USA
| | - Jayson M Rhoton
- Department for Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth) , Houston, TX , USA
| | - Cristina Espinosa Da Silva
- Department for Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth) , Houston, TX , USA
| | - Pamela M Diamond
- Department for Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth) , Houston, TX , USA
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Benoit M, Austin E, Simcox N, Rabinowitz P, Yost M. Predictors of Dairy Worker Pre-Test and Post-Test Performance on a Dairy Safety Knowledge Test: Impact of Education Level and Native Language. J Agromedicine 2022; 28:456-469. [PMID: 36300904 DOI: 10.1080/1059924x.2022.2140732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Efficacy-driven assessments of linguistically appropriate occupational health and safety training (OHS) for dairy workers remain uncommon. This study analyzes predictors of performance on a dairy safety knowledge test using pre-and-post knowledge assessments. The safety training course was delivered by iPad™ to Idahoan dairy workers, managers, and owners. OBJECTIVE To determine the predictors of safety knowledge scores among dairy worker course participants. METHODS Predictors of pre-test (baseline) scores and change in test scores of n = 1,336 participants were compared, and multivariate iterative linear regressions were used to predict test performance, adjusting for variables such as occupation, years of formal education, native language, and years in dairy work. RESULTS Test scores for Spanish and English speakers improved between pre-test and post-test. Years of formal education was the most predictive variable of higher baseline scores and change in test scores among dairy safety course participants, regardless of language. CONCLUSION Dairy worker safety training course results showed improvements in safety knowledge and test scores. Years of formal education of participants appears to be a key determinant of increases in safety knowledge, and therefore safety training programs need to address the learning needs of less educated workers.
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Affiliation(s)
- M Benoit
- University of Washington - Environmental & Occupational Health Sciences, Seattle, Washington, United States
| | - E Austin
- University of Washington - Environmental & Occupational Health Sciences, Seattle, Washington, United States
| | - N Simcox
- University of Washington - Environmental & Occupational Health Sciences, Seattle, Washington, United States
| | - P Rabinowitz
- University of Washington - Environmental & Occupational Health Sciences, Seattle, Washington, United States
| | - M Yost
- University of Washington - Environmental & Occupational Health Sciences, Seattle, Washington, United States
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Characterizing the Environmental Health Literacy and Sensemaking of Indoor Air Quality of Research Participants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042227. [PMID: 35206415 PMCID: PMC8871841 DOI: 10.3390/ijerph19042227] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/10/2022] [Accepted: 02/12/2022] [Indexed: 02/04/2023]
Abstract
This study is based on in-depth semi-structured interviews with the participants of an indoor air quality monitoring study. The purpose of the interviews was to capture participants’ perceptions of indoor air quality and engage them in a discussion of those factors that influenced their behavior. Interview study participants (n = 20) noted the importance of family health concerns and their own sensory awareness of possible contaminants. They discussed their level of personal control over their home environment as well as their access to needed resources. This study is based on grounded theory and applies interpretivist epistemological methods. Study findings offer insights into how people perceive their home environment and what influences their decision making and action. Analyses indicate that perceived agency, risk perception, access to resources, and information all influenced participants’ sense of ability to take action as well as their interest in taking action. These insights serve to challenge some of the current work in environmental health literacy which tends to focus on and measure an individual’s knowledge or skills. Our analysis suggests that consideration be given to a number of factors that include perceived agency, access to resources, and the quality of information provided.
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The effectiveness of educational interventions aimed at agricultural workers' knowledge, behaviour, and risk perception for reducing the risk of pesticide exposure: a systematic review and meta-analysis. Int Arch Occup Environ Health 2022; 95:1167-1178. [PMID: 35103845 DOI: 10.1007/s00420-022-01838-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 01/12/2022] [Indexed: 11/05/2022]
Abstract
AIM The aim of this study was to determine the effectiveness of educational interventions aimed at agricultural workers' knowledge, behaviour, and risk perception for reducing the risk of pesticide exposure. METHOD All studies published in the English language between the years 2000 and 2020 were screened on relevant databases. The study protocol was registered on PROSPERO. Randomised controlled studies (RCTs) and quasi-experimental studies meeting the inclusion and exclusion criteria according to the PICOS criteria were included. In line with the PRISMA flow diagram, 38 studies were included in the systematic review and meta-analysis. Risk of bias was assessed with the Cochrane risk-of-bias assessment tool. A random-effects model was applied and Hedge's g was used to calculate effect size. FINDINGS Five of the included studies are RCTs, two are cluster RCTs, 17 are quasi-experimental studies with experimental and control groups, and 14 have single-group pretest-posttest study designs. Educational interventions had a large effect on knowledge level (Hedge's g = 0.890), a medium effect on behaviour level (Hedge's g = 0.707), and a small effect on risk perception (Hedge's g = 0.377). No publication bias was detected. The largest effect of educational interventions on both knowledge and behaviour levels belonged to studies grounded on a theoretical basis and carried out between the years 2011 and 2020. CONCLUSION It was determined that educational interventions are an appropriate method for reducing the pesticide exposure risks of agricultural workers. To increase the effectiveness of these interventions, it is recommended that consideration is given to a theoretical basis, the use of multiple education components, and evidence-based practices.
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Grzywacz JG, Gonzales-Backen M, Liebman A, Trejo M, Ordaz Gudino C, Trejo M, Economos J, Xiuhtecutli N, Tovar-Aguilar JA. Comparative Effectiveness of Training Alternatives for the EPA's Worker Protection Standard Regulation Among Immigrant Latino Farmworkers. J Occup Environ Med 2022; 64:140-145. [PMID: 34456324 DOI: 10.1097/jom.0000000000002368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To determine the comparative effectiveness of two EPA-approved WPS training strategies. METHODS Farmworkers in GA and FL blinded to content before training (N = 339) were randomly assigned to either a video training (n = 121) or a culturally tailored, facilitator-led training (n = 136), or an attention-placebo training focused on heat-related illness (n = 82). Data were obtained immediately before and after training and 3 months after training. RESULTS Both active interventions increased pesticide knowledge. At the 3-month follow-up, participants in the EPA video lost acquired knowledge. Those in the facilitator-led group retained acquired knowledge and showed greater pesticide safety behavior. CONCLUSIONS Standardized training through video improves short-term knowledge, but it is not retained and unable to support desired behavior to reduce pesticide exposure among farmworkers. A culturally tailored, facilitator-led training is more effective in achieving the spirit of the WPS regulation.
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Affiliation(s)
- Joseph G Grzywacz
- Florida State University, Department of Family & Child Sciences (Dr Grzywacz, Dr Gonzales-Backen, Ms Trejo, Ms Ordaz Gudino, and Ms Trejo); Migrant Clinicians Network, Division of Environmental and Occupational Health (Ms Liebman); Farmworker Association of Florida (Ms Economos, Mr Xiuhtecutli, and Dr Tovar-Aguilar)
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Rustage K, Crawshaw A, Majeed-Hajaj S, Deal A, Nellums L, Ciftci Y, Fuller SS, Goldsmith L, Friedland JS, Hargreaves S. Participatory approaches in the development of health interventions for migrants: a systematic review. BMJ Open 2021; 11:e053678. [PMID: 34697122 PMCID: PMC8548676 DOI: 10.1136/bmjopen-2021-053678] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE Analysis of participatory approaches to developing health interventions for migrants and how approaches embody core participatory principles of inclusivity and democracy. DESIGN A systematic review of original articles. Electronic searches within the databases MEDLINE, Embase, Global Health and PsychINFO (from inception-November 2020). ELIGIBILITY CRITERIA FOR STUDY SELECTION Original peer-reviewed articles reporting research to develop and implement a health intervention for migrants, incorporating participatory approaches. We defined migrants as foreign-born individuals. Only articles reporting the full research cycle (inception, design, implementation, analysis, evaluation, dissemination) were included. DATA EXTRACTION We extracted information related to who was involved in research (migrants or other non-academic stakeholders), the research stage at which they were involved (inception, design, implementation, analysis, evaluation, dissemination), the method of their involvement and how this aligned with the core principles of participatory research-categorising studies as exhibiting active or pseudo (including proxy and indirect) participation. RESULTS 1793 publications were screened, of which 28 were included in our analysis. We found substantial variation in the application of participatory approaches in designing health interventions targeting migrants: across 168 individual research stages analysed across the 28 studies, we recorded 46 instances of active participation of migrants, 30 instances of proxy participation and 24 instances of indirect participation. All studies involved non-academic stakeholders in at least one stage of the research, only two studies exhibited evidence of active participation of migrants across all research stages. Evidence is limited due to the variability of terms and approaches used. CONCLUSIONS Important shortfalls in the meaningful inclusion of migrants in developing health interventions exist, suggesting a more rigorous and standardised approach is warranted to better define and deliver participatory research and improve quality. REGISTRATION This review followed Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines and is registered on the Open Science Framework (osf.io/2bnz5).
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Affiliation(s)
- Kieran Rustage
- Migrant Health Research Group, Institute for Infection and Immunity, St George's University of London, London, UK
| | - Alison Crawshaw
- Migrant Health Research Group, Institute for Infection and Immunity, St George's University of London, London, UK
| | | | - Anna Deal
- Migrant Health Research Group, Institute for Infection and Immunity, St George's University of London, London, UK
- Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Laura Nellums
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | | | - Sebastian S Fuller
- Migrant Health Research Group, Institute for Infection and Immunity, St George's University of London, London, UK
| | - Lucy Goldsmith
- Migrant Health Research Group, Institute for Infection and Immunity, St George's University of London, London, UK
- Population Health Research Institute, St George's University of London, London, UK
| | - Jon S Friedland
- Migrant Health Research Group, Institute for Infection and Immunity, St George's University of London, London, UK
| | - Sally Hargreaves
- Migrant Health Research Group, Institute for Infection and Immunity, St George's University of London, London, UK
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Bloss JE, LePrevost CE, Zahra AG, Firnhaber GC, Cofie LE, Zepeda R, Lee JGL. Advancing the Health of Migrant and Seasonal Farmworkers in the United States: Identifying Gaps in the Existing Literature, 2021. Health Promot Pract 2021; 23:432-444. [PMID: 34549654 PMCID: PMC9096586 DOI: 10.1177/15248399211033308] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
There are profound health inequities for agricultural workers. We sought to assess the literature on migrant and seasonal farmworker health with an eye toward health promotion interventions, special populations, use of community health workers (CHWs), and technology. We conducted a systematic mapping review by searching five databases in March 2021. Using quantitative content analysis after establishing interrater reliability, we coded titles and abstracts to assess 13 topics and six characteristics of the research such as its focus on health promotion, use of technology, and inclusion of CHWs. We identified 1,083 records. Just 8.2% of records described or evaluated a health promotion effort to intervene in farmworker well-being and even fewer (4.2%) examined unique populations of farmworkers such as indigenous farmworkers (n = 11) or sexual minority farmworkers (n = 1). A small body of literature focused on the role of CHWs or promotores most frequently described their role in implementing health interventions. The literature on farmworker health has gaps regarding health promotion interventions, special populations, and integration of CHWs into research projects. We offer suggestions to fill in identified gaps in the literature.
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Affiliation(s)
| | - Catherine E LePrevost
- North Carolina State University, Raleigh, NC, USA.,North Carolina Agromedicine Institute, Greenville, NC, USA
| | | | | | | | - Ramón Zepeda
- Student Action with Farmworkers, Durham, NC, USA
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13
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Garrido MA, Parra M, Díaz J, Medel J, Nowak D, Radon K. Occupational Safety and Health in a Community of Shellfish Divers: A Community-Based Participatory Approach. J Community Health 2021; 45:569-578. [PMID: 31728798 DOI: 10.1007/s10900-019-00777-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
In artisanal fishing communities in Chile, the access to occupational safety and health (OSH) is limited by factors such as the informality of employment. Our objective was to analyze the working and health conditions of workers in a coastal town in Southern Chile, under a community-based participatory approach. We carried out two independent social dialogue workshops within the community. The first one (N of participants = 25) was aimed to identify the strengths, weaknesses and challenges for preventing decompression sickness among divers. The second workshop (N of participants = 10) was set to identify the work processes and to map the occupational risks during seafood harvesting and processing in the community. Community members' training for handling and preventing decompression sickness among divers, and the collaboration between a local health representative, stakeholders and authorities, were identified as contributing factors in reducing fatalities and sequels among divers in the past. Technology and safety on board the vessels, training of healthcare personnel in OSH, and access to health programs, were identified as remaining challenges. Through risk mapping, the participants identified the relationship between working and health conditions in the community, reinforcing the necessity of improving access to health and social security. The community participation in identifying and analyzing working and health conditions could be the first step for a strategy to address OSH through primary health care in rural communities. Community empowerment and involvement in action plans, training on basic OSH for health care workers, and public policies are required.
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Affiliation(s)
- Marie A Garrido
- CIHLMU Center for International Health, Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany. .,Comunidad de Práctica sobre el Enfoque Ecosistémico en Salud Humana, COPEH-LAC, Southern Cone node, Santiago de Chile, Chile.
| | - Manuel Parra
- CIHLMU Center for International Health, Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany.,Comunidad de Práctica sobre el Enfoque Ecosistémico en Salud Humana, COPEH-LAC, Southern Cone node, Santiago de Chile, Chile
| | - Juana Díaz
- Terminal Pesquero de Carelmapu, Maullín, Chile
| | - Julia Medel
- Comunidad de Práctica sobre el Enfoque Ecosistémico en Salud Humana, COPEH-LAC, Southern Cone node, Santiago de Chile, Chile.,Centro de Estudios de la Mujer, Santiago de Chile, Chile
| | - Dennis Nowak
- Institute for Occupational, Social and Environmental Medicine, Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany
| | - Katja Radon
- CIHLMU Center for International Health, Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany.,Occupational and Environmental Epidemiology & NetTeaching Unit, Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany
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Castillo F, Mora AM, Kayser GL, Vanos J, Hyland C, Yang AR, Eskenazi B. Environmental Health Threats to Latino Migrant Farmworkers. Annu Rev Public Health 2021; 42:257-276. [PMID: 33395542 PMCID: PMC8168948 DOI: 10.1146/annurev-publhealth-012420-105014] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Approximately 75% of farmworkers in the United States are Latino migrants, and about 50% of hired farmworkers do not have authorization to work in the United States. Farmworkers face numerous chemical, physical, and biological threats to their health. The adverse effects of these hazards may be amplified among Latino migrant farmworkers, who are concurrently exposed to various psychosocial stressors. Factors such as documentation status, potential lack of authorization to work in the United States, and language and cultural barriers may also prevent Latino migrants from accessing federal aid, legal assistance, and health programs. These environmental, occupational, and social hazards may further exacerbate existing health disparities among US Latinos. This population is also likely to be disproportionately impacted by emerging threats, including climate change and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Latino migrant farmworkers are essential to agriculture in the United States, and actions are needed to protect this vulnerable population.
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Affiliation(s)
- Federico Castillo
- Department of Environmental Science, Policy and Management, University of California, Berkeley, California 94720, USA;
| | - Ana M Mora
- Center for Environmental Research and Children's Health, School of Public Health, University of California, Berkeley, California 94720, USA; , ,
- Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia 86-3000, Costa Rica
| | - Georgia L Kayser
- Health Sciences, University of California, San Diego, California 92093, USA; ,
| | - Jennifer Vanos
- School of Sustainability, Arizona State University, Tempe, Arizona 85287, USA;
| | - Carly Hyland
- Center for Environmental Research and Children's Health, School of Public Health, University of California, Berkeley, California 94720, USA; , ,
| | - Audrey R Yang
- Health Sciences, University of California, San Diego, California 92093, USA; ,
| | - Brenda Eskenazi
- Center for Environmental Research and Children's Health, School of Public Health, University of California, Berkeley, California 94720, USA; , ,
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15
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Afshari M, Karimi-Shahanjarini A, Khoshravesh S, Besharati F. Effectiveness of interventions to promote pesticide safety and reduce pesticide exposure in agricultural health studies: A systematic review. PLoS One 2021; 16:e0245766. [PMID: 33497407 PMCID: PMC7837484 DOI: 10.1371/journal.pone.0245766] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 01/08/2021] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE There is a relationship between pesticide exposure and farmworkers' health. Well-conducted evaluations can provide an insight into how to develop and implement more effective interventions to prevent farmers and farmworkers' exposure to pesticides. This review aimed to summarize the literature on the effectiveness of interventions to promote pesticide safety and reduce pesticide exposure among farmers and farmworkers. METHODS A comprehensive search on PubMed, Embase, ISI Web of Science, Scopus, Science Direct, Agricola, NIOSHTIC, and Agris databases was performed to identify relevant studies published from 2000 to 2019. Randomized controlled trials (RCTs) and quasi-experimental studies assessing the effectiveness of interventions on a variety of outcomes related to pesticide exposure were considered. The searches were restricted to articles written in English. The methodological quality of included reviews was appraised using the Effective Public Health Practice Project quality assessment tool (EPHPP). RESULTS The initial search led to 47912 records, 31 studies of which including nine RCTs and twenty-two quasi-experimental studies met the criteria. The majority of the included studies focused on the educational/ behavioral approach. The studies that applied this approach were effective in improving the participants' knowledge and attitude; however, these interventions were less effective in terms of making changes in participants' behaviors and their risk of exposure to toxic pesticides. Multifaceted interventions were moderately effective in terms of improving farmers' and farmworkers' behaviors and reduction in exposure to toxic pesticides. We did not find any studies that had evaluated the effectiveness of engineering/technological, and legislation/enforcement interventions. CONCLUSIONS Although the majority of studies were based on an educational/behavioral approach and did not assess the effect of interventions on objective measures, the results of this review highlight the significant effectiveness of educational programs and some potential key elements of these interventions. These findings may inform policymakers to develop interventions to reduce pesticide exposure among farmers and farmworkers.
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Affiliation(s)
- Maryam Afshari
- Department of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Akram Karimi-Shahanjarini
- Department of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Sahar Khoshravesh
- Department of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Fereshteh Besharati
- Department of Nursing, Zeynab (P.B.U.H) School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
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16
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Rodriguez NM, Casanova F, Pages G, Claure L, Pedreira M, Touchton M, Knaul F. Community-based participatory design of a community health worker breast cancer training intervention for South Florida Latinx farmworkers. PLoS One 2020; 15:e0240827. [PMID: 33075111 PMCID: PMC7571710 DOI: 10.1371/journal.pone.0240827] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 10/02/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Community health worker (CHW)-led education is an important strategy to increase awareness and access to breast cancer screening in medically-underserved communities. This study aimed to develop a context-specific, culturally-appropriate training intervention for South Florida CHWs to educate Latinx immigrant farmworkers on breast cancer and early detection. METHODS A community-based participatory research (CBPR) study, conducted 2017-2019, informed the design of a training curriculum for CHWs and educational dissemination materials. Twenty-two CHWs were trained and knowledge gains were measuring using a one-group pre-and post-test design. Triangulated evaluation consisted of field observations of CHW-client interactions, CHW self-reports, and rapid assessment surveys of community members. RESULTS A community stakeholder-informed breast cancer training curriculum resulted in significant, sustained breast cancer knowledge gains among CHWs when comparing pre-, post-, and 4-6 month post-training follow-up test scores. Field observations of educational material dissemination, CHW self-reported evaluations, and community rapid assessment surveys at three health fairs demonstrated this was an effective strategy to engage female Latinx farmworkers in breast cancer education. CONCLUSIONS Community and key stakeholder participation in the development of a breast cancer educational intervention allowed for tailored design priorities around knowledge-based content, comprehensiveness, relevance, appropriateness, and ease of dissemination to community members. This model of participatory CHW training intervention design can enable future train-the-trainer approaches to disseminate and scale-up evidence-based health education interventions.
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Affiliation(s)
- Natalia M. Rodriguez
- Department of Public Health, College of Health and Human Sciences, Purdue University, West Lafayette, Indiana, United States of America
| | - Felicia Casanova
- Department of Sociology, College of Arts and Sciences, University of Miami, Miami, Florida, United States of America
- Institute for Advanced Study of the Americas, University of Miami, Miami, Florida, United States of America
| | - Gabriela Pages
- Institute for Advanced Study of the Americas, University of Miami, Miami, Florida, United States of America
| | - Layla Claure
- Institute for Advanced Study of the Americas, University of Miami, Miami, Florida, United States of America
| | - Marian Pedreira
- Institute for Advanced Study of the Americas, University of Miami, Miami, Florida, United States of America
| | - Michael Touchton
- Institute for Advanced Study of the Americas, University of Miami, Miami, Florida, United States of America
| | - Felicia Knaul
- Institute for Advanced Study of the Americas, University of Miami, Miami, Florida, United States of America
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17
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López-Gálvez N, Wagoner R, Canales RA, de Zapien J, Calafat AM, Ospina M, Rosales C, Beamer P. Evaluating imidacloprid exposure among grape field male workers using biological and environmental assessment tools: An exploratory study. Int J Hyg Environ Health 2020; 230:113625. [PMID: 32950770 PMCID: PMC7965794 DOI: 10.1016/j.ijheh.2020.113625] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/03/2020] [Accepted: 09/04/2020] [Indexed: 12/11/2022]
Abstract
Imidacloprid is a neonicotinoid insecticide commonly injected through agricultural drip irrigation systems to reduce the population of vine mealybugs (P. ficus) in grape farms. There is a growing concern of potential human health effects of imidacloprid, however, there is limited information on the exposure to imidacloprid in farm workers. Imidacloprid exposure was evaluated in this exploratory study of 20 male migrant grape workers sampled five days after imidacloprid was injected in the irrigation system during winter and summer seasons. We administered a questionnaire on work activities, exposure characteristics, and socio-demographics and collected personal air, hand wipe, and spot urine samples. Heat exposure was also assessed. Spearman's correlation coefficients and Wilcoxon rank-sum tests were utilized to evaluate associations and differences in imidacloprid exposures with socio-demographic, occupational, and environmental characteristics. All participants had less than a high school education and about half identified an Indigenous language as their primary language. Although not detected in air samples, imidacloprid was detected in 85% of the hand wipes (median: 0.26: 0.41 μg/wipe, range: 0.05-7.10 μg/wipe). The majority of participants (75%) had detectable urinary concentrations of imidacloprid (median: 0.11 μg/g creatinine, range: 0.05-3.90 μg/g of creatinine), and nearly all (95%) had detectable urinary concentrations of 5-hydroxy-Imidacloprid (5-OH-IMI), a metabolite of imidacloprid (median: 1.28 μg/g creatinine, range: 0.20-27.89 μg/g creatinine). There was a significant correlation (p < 0.001) between imidacloprid in hand wipes and urinary imidacloprid and 5-OH-IMI (rs: 0.67 for imidacloprid and 0.80 for 5-OH-IMI). Hand temperature was significantly and positively correlated (p < 0.05) with imidacloprid concentration on hand wipes (rs: 0.70), and urinary biomarkers (rs: 0.68 for imidacloprid, and 0.60 for 5-OH-IMI) suggesting that working in high temperatures may influence the exposure and absorption of imidacloprid. Thus, research on farm workers would benefit in the future by evaluating imidacloprid exposure in relation to heat stress and other occupational factors.
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Affiliation(s)
- Nicolás López-Gálvez
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave. PO 245210, Tucson, AZ, 85724, USA.
| | - Rietta Wagoner
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave. PO 245210, Tucson, AZ, 85724, USA
| | - Robert A Canales
- Interdisciplinary Program in Applied Mathematics, University of Arizona, 617 N. Santa Rita Ave. PO Box 210089, Tucson, AZ, 85721, USA
| | - Jill de Zapien
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave. PO 245210, Tucson, AZ, 85724, USA
| | - Antonia M Calafat
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Laboratory Sciences, 4770 Buford Hwy, Atlanta, GA, 30341, United States
| | - Maria Ospina
- Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Laboratory Sciences, 4770 Buford Hwy, Atlanta, GA, 30341, United States
| | - Cecilia Rosales
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave. PO 245210, Tucson, AZ, 85724, USA
| | - Paloma Beamer
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave. PO 245210, Tucson, AZ, 85724, USA
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18
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Where Is the Break-even Point for Community Health Workers? Using National Data and Local Programmatic Costs to Find the Break-even Point for a Metropolitan Community Health Worker Program. Med Care 2020; 58:314-319. [PMID: 32197027 DOI: 10.1097/mlr.0000000000001273] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Community health worker (CHW) programs take many forms and have been shown to be effective in improving health in several contexts. The extent to which they reduce unnecessary care is not firmly established. OBJECTIVES This study estimates the number of hospitalizations and emergency department (ED) visits that would need to be avoided to recoup program costs for a CHW program that addressed both medical and social needs. RESEARCH DESIGN A programmatic cost analysis is conducted using 6 different categories: personnel, training, transportation, equipment, facilities, and administrative costs. First, baseline costs are established for the current program and then estimate the number of avoided ED visits or hospitalizations needed to recoup program costs using national average health care estimates for different patient populations. MEASURES Data on program costs are taken from administrative program records. Estimates of ED visit and hospitalization costs (or charges in some cases) are taken from the literature. RESULTS To fully offset program costs, each CHW would need to work with their annual caseload of 150 participants to avoid almost 50 ED visits collectively. If CHW participants also avoided 2 hospitalizations, the number of avoided ED visits needed to offset costs reduces to about 34. CONCLUSIONS Estimates of avoided visits needed to reach the break-even point are consistent with the literature. The analysis does not take other outcomes of the program from the clients' or workers' perspectives into account, so it is likely an upper bound on the number of avoided visits needed to be cost-effective.
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19
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Courses on Basic Occupational Safety and Health: A Train-the-Trainer Educational Program for Rural Areas of Latin America. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061842. [PMID: 32178363 PMCID: PMC7143534 DOI: 10.3390/ijerph17061842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 02/29/2020] [Accepted: 03/05/2020] [Indexed: 11/16/2022]
Abstract
Integrating basic occupational health services into primary care is encouraged by the Pan American Health Organization. However, concrete initiatives are still scarce. We aimed to develop a training program focusing on prevention of occupational risks for primary healthcare professionals. This train-the-trainer program was piloted at four universities in Chile and Peru. Occupational health or primary healthcare lecturers formed a team with representative(s) of one rural primary healthcare center connected to their university (Nparticipants = 15). Training started with a workshop on participatory diagnosis of working conditions. Once teams had conducted the participatory diagnosis in the rural communities, they designed in a second course an active teaching intervention. The intervention was targeted at the main occupational health problem of the community. After implementation of the intervention, teams evaluated the program. Evaluation results were very positive with an overall score of 9.7 out of 10. Teams reported that the methodology enabled them to visualize hazardous working conditions. They also stated that the training improved their abilities for problem analysis and preventive actions. Aspects like time constraints and difficult geographical access were mentioned as challenges. In summary, addressing occupational health in primary care through targeted training modules is feasible, but long-term health outcomes need to be evaluated.
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20
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Attending to Pesticide Exposure and Heat Illness Among Farmworkers: Results From an Attention Placebo-Controlled Evaluation Design. J Occup Environ Med 2019; 61:735-742. [PMID: 31205205 DOI: 10.1097/jom.0000000000001650] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to determine the effectiveness of curricula for improving knowledge and attitudes pertaining to pesticide exposure and heat illness among immigrant Latino farmworkers. METHODS A pesticide safety curriculum informed by the revised Worker Protection Standard (WPS) was tested against an attention placebo-controlled curriculum (heat illness) in a sample of Latino farmworkers (N = 127). RESULTS Pesticide safety knowledge increased in the overall sample, but did not differ by curriculum assignment. Pesticide safety behavioral intentions increased among participants in the pesticide safety curriculum but decreased among those in the other curriculum (P < 0.05). Heat illness knowledge and behavioral intentions increased more for farmworkers assigned to the heat illness than the pesticide safety curriculum. CONCLUSION The developed curricula show good promise for meeting the spirit of the revised WPS and for reducing the burden of heat-related fatality and morbidity among Latino farmworkers.
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21
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Premji S. Discourse on culture in research on immigrant and migrant workers' health. Am J Ind Med 2019; 62:460-470. [PMID: 31111524 DOI: 10.1002/ajim.22987] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 04/23/2019] [Accepted: 04/24/2019] [Indexed: 01/26/2023]
Abstract
BACKGROUND Health and safety researchers and practitioners have proposed that cultural differences help explain inequalities between foreign and native-born workers. While cultural explanations for inequalities have long been debated in other fields, there exists little critique of cultural discourses in occupational health. METHODS This article examines and discusses the discourse on culture in 107 articles on immigrant or migrant workers' health published between 2011 and 2015. For each article, passages on culture were identified and analysed for both the context and the manner in which culture was discussed. RESULTS The discourse on culture was found to be generally simplistic, individualistic, and uncritical, intentionally or unintentionally supporting the worldview that workers' "otherness" is both cause of inequalities and target for interventions. CONCLUSION The article argues that empirical, theoretical and interdisciplinary work is needed to document the mechanisms and pathways that underlie health and safety inequalities by foreign-born status.
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Affiliation(s)
- Stephanie Premji
- School of Labour Studies, Department of Health, Aging and SocietyMcMaster UniversityHamilton Ontario Canada
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22
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Griffith WC, Vigoren EM, Smith MN, Workman T, Thompson B, Coronado GD, Faustman EM. Application of improved approach to evaluate a community intervention to reduce exposure of young children living in farmworker households to organophosphate pesticides. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2019; 29:358-365. [PMID: 29662130 PMCID: PMC6192874 DOI: 10.1038/s41370-018-0028-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 08/18/2017] [Accepted: 08/25/2017] [Indexed: 06/01/2023]
Abstract
The take-home pathway is a significant source of organophosphate pesticide exposure for young children (3-5 years old) living with an adult farmworker. This avoidable exposure pathway is an important target for intervention. We selected 24 agricultural communities in the Yakima Valley of Washington State and randomly assigned them to receive an educational intervention (n = 12) to reduce children's pesticide exposure or usual care (n = 12). We assessed exposure to pesticides in nearly 200 adults and children during the pre and post-intervention periods by measuring metabolites in urine. We compared pre- and post-intervention exposures by expressing the child's pesticide metabolite concentration as a fraction of the adult's concentration living in the same household, because the amount of pesticides applied during the collection periods varied. Exposures in our community were consistently higher, sometimes above the 95th percentile of the exposures reported by the National Health and Nutrition Examination Survey (NHANES). While intervention and control communities demonstrated a reduction in the ratio of child to adult exposure, this reduction was more pronounced in intervention communities (2.7-fold, p < 0.001 compared to 1.7-fold, p = 0.052 for intervention and control, respectively). By examining the child/adult biomarker ratio, we demonstrated that our community-based intervention was effective in reducing pesticide exposure to children in agricultural communities.
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Affiliation(s)
- William C. Griffith
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA
- Institute for Risk Analysis & Risk Communication, University of Washington, Seattle, WA
| | - Eric M. Vigoren
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA
- Institute for Risk Analysis & Risk Communication, University of Washington, Seattle, WA
| | - Marissa N. Smith
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA
- Institute for Risk Analysis & Risk Communication, University of Washington, Seattle, WA
| | - Tomomi Workman
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA
- Institute for Risk Analysis & Risk Communication, University of Washington, Seattle, WA
| | - Beti Thompson
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | - Elaine M. Faustman
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA
- Institute for Risk Analysis & Risk Communication, University of Washington, Seattle, WA
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23
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Swanberg JE, Nichols HM, Clouser JM, Check P, Edwards L, Bush AM, Padilla Y, Betz G. A Systematic Review of Community Health Workers' Role in Occupational Safety and Health Research. J Immigr Minor Health 2019; 20:1516-1531. [PMID: 29502238 DOI: 10.1007/s10903-018-0711-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We systematically reviewed the literature to describe how community health workers (CHWs) are involved in occupational health and safety research and to identify areas for future research and research practice strategies. We searched five electronic databases from July 2015 through July 2016. Inclusion criteria were as follows: (1) study took place in the United States, (2) published as a full peer-review manuscript in English, (3) conducted occupational health and safety research, and (4) CHWs were involved in the research. The majority of 17 included studies took place in the agriculture industry (76%). CHWs were often involved in study implementation/design and research participant contact. Rationale for CHW involvement in research was due to local connections/acceptance, existing knowledge/skills, communication ability, and access to participants. Barriers to CHW involvement in research included competing demands on CHWs, recruitment and training difficulties, problems about research rigor and issues with proper data collection. Involving CHWs in occupational health and safety research has potential for improving inclusion of diverse, vulnerable and geographically isolated populations. Further research is needed to assess the challenges and opportunities of involving CHWs in this research and to develop evidence-based training strategies to teach CHWs to be lay-health researchers.
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Affiliation(s)
- Jennifer E Swanberg
- University of Maryland School of Social Work, Baltimore, MD, USA. .,Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA.
| | - Helen M Nichols
- University of Maryland School of Social Work, Baltimore, MD, USA
| | - Jessica M Clouser
- Center for Health Services Research, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Pietra Check
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Lori Edwards
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Ashley M Bush
- Center for Health Services Research, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Yancy Padilla
- University of Maryland School of Social Work, Baltimore, MD, USA
| | - Gail Betz
- Health Sciences and Human Services Library, University of Maryland, Baltimore, Baltimore, MD, USA
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Luque JS, Bossak BH, Davila CB, Tovar-Aguilar JA. "I Think the Temperature was 110 Degrees!": Work Safety Discussions Among Hispanic Farmworkers. J Agromedicine 2018; 24:15-25. [PMID: 30317928 DOI: 10.1080/1059924x.2018.1536572] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Heat-related illness (HRI) among migrant and seasonal farmworkers is an occupational risk addressed through varying mitigation strategies by individual workers and supervisors. The purpose of this pilot study was to describe farmworkers' experience with HRI prevention strategies and assess HRI information seeking preferences, especially the feasibility of using mobile phone apps to access this information. Five focus groups were administered to Hispanic farmworkers in South Carolina. Questions included the following topics: health information seeking preferences; farmworkers' perceptions of occupational risks; coping strategies; past experiences with HRIs; water, rest, and shade practices; access to health care; and any employer-provided training received. There was consensus across the groups that the workers at highest risk for HRIs were either inexperienced or new workers in the fields. Farmworkers ascribed responsibility for one's well-being while working in the heat more as an individual factor than as an employer's responsibility. Farmworkers received training on the OSHA Heat Safety Tool app and provided positive feedback about the educational content and temperature information warnings. These findings suggest the potential for supervisors to take a more active role in heat safety education using mobile technology.
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Affiliation(s)
- John S Luque
- a Institute of Public Health , Florida A&M University , Tallahassee , Florida , USA
| | - Brian H Bossak
- b Department of Health and Human Performance , College of Charleston , Charleston , South Carolina , USA
| | - Caroline B Davila
- c Department of Public Health Sciences , Medical University of South Carolina , Charleston , South Carolina , USA
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25
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Caffaro F, Micheletti Cremasco M, Bagagiolo G, Vigoroso L, Cavallo E. Effectiveness of occupational safety and health training for migrant farmworkers: a scoping review. Public Health 2018; 160:10-17. [PMID: 29702273 DOI: 10.1016/j.puhe.2018.03.018] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 02/26/2018] [Accepted: 03/15/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Migrant farmworkers report higher rates of work-related illnesses, injuries and fatalities compared with local workers. Language and cultural barriers represent a relevant source of risk, which can be reduced by means of targeted training interventions. However, very little evidence is available about the effectiveness of Occupational Safety and Health (OSH) training programmes addressing migrant farmworkers. STUDY DESIGN We carried out a scoping review. METHODS Currently available literature about the effectiveness of OSH training for migrant farmworkers-in terms of improvements in at least one of the following: safety knowledge, behaviours, attitudes and beliefs and health outcomes-was searched from four databases: PubMed, PsycINFO, Scopus and Web of Science. The screening was performed independently by two authors, and any disagreement was resolved through discussion until consensus was achieved. Once the articles eligible for inclusion were selected, the objectives, design, sample and setting, interventions and findings of each study were recorded. No quality assessment tool for publications considered by this study has been used because a scoping review does not aim for critical appraisal. RESULTS Twenty-nine publications met the inclusion criteria. Of these, nine cross-sectional studies discussed the effectiveness of training activities in terms of whether participating in any programme had or did not have a significant effect on the dependent variables, when training was considered along with other sociodemographic factors. In the majority of these studies, training appeared to have low or no effect on the dependent variables considered. Twenty mainly within-subject experimental studies addressed the effectiveness of specific training methods, reporting significant improvements especially for interventions based on a participatory approach. CONCLUSIONS Training could greatly contribute to an effective attainment of OSH information, but the present review shows that more evidence is needed to guide the future development of effective training activities.
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Affiliation(s)
- F Caffaro
- Institute for Agricultural and Earthmoving Machines (IMAMOTER), Italian National Research Council (CNR), Strada delle Cacce, 73, 10135 Torino, Italy.
| | - M Micheletti Cremasco
- Department of Life Sciences and Systems Biology, University of Turin, via Accademia Albertina, 13, 10123, Torino, Italy.
| | - G Bagagiolo
- Institute for Agricultural and Earthmoving Machines (IMAMOTER), Italian National Research Council (CNR), Strada delle Cacce, 73, 10135 Torino, Italy.
| | - L Vigoroso
- Institute for Agricultural and Earthmoving Machines (IMAMOTER), Italian National Research Council (CNR), Strada delle Cacce, 73, 10135 Torino, Italy.
| | - E Cavallo
- Institute for Agricultural and Earthmoving Machines (IMAMOTER), Italian National Research Council (CNR), Strada delle Cacce, 73, 10135 Torino, Italy.
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Gray KM. From Content Knowledge to Community Change: A Review of Representations of Environmental Health Literacy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018. [PMID: 29518955 PMCID: PMC5877011 DOI: 10.3390/ijerph15030466] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Environmental health literacy (EHL) is a relatively new framework for conceptualizing how people understand and use information about potentially harmful environmental exposures and their influence on health. As such, information on the characterization and measurement of EHL is limited. This review provides an overview of EHL as presented in peer-reviewed literature and aggregates studies based on whether they represent individual level EHL or community level EHL or both. A range of assessment tools has been used to measure EHL, with many studies relying on pre-/post-assessment; however, a broader suite of assessment tools may be needed to capture community-wide outcomes. This review also suggests that the definition of EHL should explicitly include community change or collective action as an important longer-term outcome and proposes a refinement of previous representations of EHL as a theoretical framework, to include self-efficacy.
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Affiliation(s)
- Kathleen M Gray
- Institute for the Environment, Center for Environmental Health and Susceptibility, University of North Carolina, Chapel Hill, NC 27599-1105, USA.
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Perceptions and Practices of the Iranian Population regarding Skin Cancers: A Literature Review. J Skin Cancer 2017; 2017:4934108. [PMID: 29348940 PMCID: PMC5733983 DOI: 10.1155/2017/4934108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 10/15/2017] [Indexed: 11/17/2022] Open
Abstract
Despite being preventable, more than 15% of all cancer cases in Iran occur in the skin, making them the most commonly diagnosed malignancy in the country. The purpose of this study is to gain an insight into the current skin cancer related knowledge, attitudes, beliefs, and practices among the Iranian population. A systematic computer based literature search was conducted using databases for articles published through April 2017. Research studies included those that measured skin cancer or sun protection related knowledge, attitudes, beliefs, and behaviors in different Iranian population groups. Exclusion criteria for the articles included (1) irrelevant topics to the review article's aim, (2) articles that focused on the treatment of skin cancers instead of prevention practices, and (3) similar studies conducted on populations not indigenous to Iran. A total of 25 articles that met the eligibility criteria were included in the review. Predominant data were collected via questionnaires. Skin cancer related knowledge varied from low to high across the studies. Moreover, there was a pattern of low perceived skin cancer susceptibility and severity. Overall, there was low usage of sun protection methods among the Iranian population. The findings of this study show that efforts to prevent skin cancer are needed. Education concerning the dangers of sun exposure as well as strategies used to prevent or lower the risk of developing skin cancer should be stressed.
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Arcury TA, Wiggins MF, Brooke C, Jensen A, Summers P, Mora DC, Quandt SA. Using "Policy Briefs" to Present Scientific Results of CBPR: Farmworkers in North Carolina. Prog Community Health Partnersh 2017; 11:137-147. [PMID: 28736406 DOI: 10.1353/cpr.2017.0018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Using scientific results to inform policy that improves health and well-being of vulnerable community members is essential to community-based participatory research (CBPR). OBJECTIVES We describe "policy briefs," a mechanism developed to apply the results of CBPR projects with migrant and seasonal farmworkers to policy changes. LESSONS LEARNED Policy briefs are two-page summaries of published research that address a single policy issue using language and graphics to make the science accessible to diverse audiences. Policy brief topics are selected by community advocates, based on collaborative research, and address a specific policy or regulation. Development is an iterative process of discussion with community representatives. Briefs have been used to provide information to advocates, state and national policymakers, and the public. CONCLUSIONS Disseminating CBPR results to address policy is needed. Collaborating with community partners to produce policy briefs ensures that information about concerns and struggles reflects their priorities.
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Arcury TA, Jensen A, Mann M, Sandberg JC, Wiggins MF, Talton JW, Hall MA, Quandt SA. Providing Health Information to Latino Farmworkers: The Case of the Affordable Care Act. J Agromedicine 2017; 22:275-281. [PMID: 28409702 DOI: 10.1080/1059924x.2017.1319314] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Providing health program information to vulnerable communities, such as Latino farmworkers, is difficult. This analysis describes the manner in which farmworkers receive information about the Affordable Care Act, comparing farmworkers with other Latinos. METHODS Interviews were conducted with 100 Latino farmworkers and 100 urban Latino North Carolina residents in 2015. RESULTS Most farmworkers had received health information from a community organization. Trusted sources for health information were health care providers and community organizations. Sources that would influence decisions to enroll were Latino nurses and doctors, religious leaders, and family members. Traditional media, including oral presentation and printed material at the doctor's office, were preferred by the majority of farmworkers and non-farmworkers. Farmworkers used traditional electronic media: radio, television, and telephone. More non-farmworkers used current electronic media: e-mail and Internet. CONCLUSIONS Latino farmworkers and non-farmworkers prefer traditional media in the context of a health care setting. They are willing to try contemporary electronic media for this information.
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Affiliation(s)
- Thomas A Arcury
- a Department of Family and Community Medicine , Wake Forest School of Medicine , Winston-Salem , North Carolina , USA.,b Center for Worker Health , Wake Forest School of Medicine , Winston-Salem , North Carolina , USA
| | - Anna Jensen
- c North Carolina Farmworkers' Project , Benson , North Carolina , USA
| | - Mackenzie Mann
- c North Carolina Farmworkers' Project , Benson , North Carolina , USA
| | - Joanne C Sandberg
- a Department of Family and Community Medicine , Wake Forest School of Medicine , Winston-Salem , North Carolina , USA.,b Center for Worker Health , Wake Forest School of Medicine , Winston-Salem , North Carolina , USA
| | | | - Jennifer W Talton
- e Department of Biostatistical Sciences, Division of Public Health Sciences , Wake Forest School of Medicine , Winston-Salem , North Carolina , USA
| | - Mark A Hall
- f Department of Social Science and Health Policy, Division of Public Health Sciences , Wake Forest School of Medicine , Winston-Salem , North Carolina , USA.,g Health Law and Policy Program , School of Law, Wake Forest University , Winston-Salem , North Carolina , USA
| | - Sara A Quandt
- b Center for Worker Health , Wake Forest School of Medicine , Winston-Salem , North Carolina , USA.,h Department of Epidemiology and Prevention, Division of Public Health Sciences , Wake Forest School of Medicine , Winston-Salem , North Carolina , USA
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Development and evaluation of a training workshop for lay health promoters to implement a community-based intervention program in a public low rent housing estate: The Learning Families Project in Hong Kong. PLoS One 2017; 12:e0183636. [PMID: 28841677 PMCID: PMC5571957 DOI: 10.1371/journal.pone.0183636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Accepted: 06/27/2017] [Indexed: 12/03/2022] Open
Abstract
This paper presents the development and evaluation of the train-the-trainer (TTT) workshop for lay resident leaders to be lay health promoters. The TTT workshop aimed to prepare the trainees to implement and/or assist in conducting a series of community-based family well-being activities for the residents in a public low rent housing estate, entitled “Learning Families Project”, under the FAMILY project. The four-hour TTT workshop was conducted for 32 trainees (72% women, 43% aged ≥ 60, 41% ≤ elementary school education). The workshop aimed to promote trainees’ knowledge, self-efficacy, attitude and practice of incorporating the positive psychology themes into their community activities and engaging the residents to join these activities and learn with their family members. Post-training support was provided. The effectiveness of the TTT was examined by self-administered questionnaires about trainees’ reactions to training content, changes in learning and practice at three time points (baseline, and immediately and one year after training), and the difference in residents’ survey results before and after participating in the community activities delivered by the trainees. The trainees’ learning about the general concepts of family well-being, learning family, leadership skills and planning skills increased significantly with medium to large effect sizes (Cohen’s d: 0.5–1.4) immediately after the training. The effects of perceived knowledge and attitude towards practice were sustained to one year (Cohen’s d: 0.4–0.6). The application of planning skills to implement community activities was higher at one year (Cohen’s d: 0.4), compared with baseline. At one year, the residents’ survey results showed significant increases in the practice of positive communication behaviours and better neighbour cohesions after joining the family well-being activities of LFP. Qualitative feedback supported the quantitative results. Our TTT workshop could serve as a practical example of development and evaluation of training programs for lay personnel to be lay health promoters. Trial registration: ClinicalTrials.gov NCT02844244
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Abstract
Agriculture remains a dangerous industry, even as agricultural science and technology continue to advance. Research that goes beyond technological changes to address safety culture and policy are needed to improve health and safety in agriculture. In this commentary, I consider the potential for anthropology to contribute to agricultural health and safety research by addressing three aims: (1) I briefly consider what the articles in this issue of the Journal of Agromedicine say about anthropologists in agricultural health and safety; (2) I discuss what anthropologists can add to agricultural health and safety research; and (3) I examine ways in which anthropologists can participate in agricultural health and safety research. In using their traditions of rigorous field research to understand how those working in agriculture perceive and interpret factors affecting occupational health and safety (their "emic" perspective), and translating this perspective to improve the understanding of occupational health professionals and policy makers (an "etic" perspective), anthropologists can expose myths that limit improvements in agricultural health and safety. Addressing significant questions, working with the most vulnerable agricultural communities, and being outside establishment agriculture provide anthropologists with the opportunity to improve health and safety policy and regulation in agriculture.
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Affiliation(s)
- Thomas Arcury
- a Department of Family and Community Medicine , Wake Forest School of Medicine , Winston-Salem , North Carolina , USA
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Bonney T, Forst L, Rivers S, Love M, Pratap P, Bell T, Fulkerson S. Occupational Safety and Health in the Temporary Services Industry: A Model for a Community-University Partnership. New Solut 2017; 27:246-259. [PMID: 28554306 DOI: 10.1177/1048291117712545] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Workers in the temporary staffing industry face hazardous working conditions and have a high risk of occupational injury. This project brought together local workers' centers and university investigators to build a corps of Occupational Health Promoters (OHPs) and to test a survey tool and recruitment methods to identify hazards and raise awareness among workers employed by temporary staffing companies. OHPs interviewed ninety-eight workers employed by thirty-three temporary agencies and forty-nine client companies, working mainly in shipping and packing, manufacturing, and warehousing sectors. Surveys identified workplace hazards. OHPs reported two companies to OSHA, resulting in several citations. Partners reported greater understanding of occupational safety and health challenges for temporary workers and continue to engage in training, peer education, and coalition building.
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Affiliation(s)
- Tessa Bonney
- 1 University of Illinois at Chicago School of Public Health, Chicago, IL, USA
| | - Linda Forst
- 1 University of Illinois at Chicago School of Public Health, Chicago, IL, USA
| | | | - Marsha Love
- 1 University of Illinois at Chicago School of Public Health, Chicago, IL, USA
| | - Preethi Pratap
- 1 University of Illinois at Chicago School of Public Health, Chicago, IL, USA
| | - Tim Bell
- 3 Chicago Workers' Collaborative, Chicago, IL, USA
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Galvin K, Krenz J, Harrington M, Palmández P, Fenske RA. Practical Solutions for Pesticide Safety: A Farm and Research Team Participatory Model. J Agromedicine 2017; 21:113-22. [PMID: 26488540 DOI: 10.1080/1059924x.2015.1107519] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Development of the Practical Solutions for Pesticide Safety guide used participatory research strategies to identify and evaluate solutions that reduce pesticide exposures for workers and their families and to disseminate these solutions. Project principles were (1) workplace chemicals belong in the workplace, and (2) pesticide handlers and farm managers are experts, with direct knowledge of production practices. The project's participatory methods were grounded in self-determination theory. Practical solutions were identified and evaluated based on five criteria: practicality, adaptability, health and safety, novelty, and regulatory compliance. Research activities that had more personal contact provided better outcomes. The Expert Working Group, composed of farm managers and pesticide handlers, was key to the identification of solutions, as were farm site visits. Audience participation, hands-on testing, and orchard field trials were particularly effective in the evaluation of potential solutions. Small work groups in a Regional Advisory Committee provided the best direction and guidance for a "user-friendly" translational document that provided evidence-based practical solutions. The "farmer to farmer" format of the guide was endorsed by both the Expert Working Group and the Regional Advisory Committee. Managers and pesticide handlers wanted to share their solutions in order to "help others stay safe," and they appreciated attribution in the guide. The guide is now being used in educational programs across the region. The fundamental concept that farmers and farmworkers are innovators and experts in agricultural production was affirmed by this study. The success of this process demonstrates the value of participatory industrial hygiene in agriculture.
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Affiliation(s)
- Kit Galvin
- a Pacific Northwest Agricultural Safety and Health Center, Department of Environmental and Occupational Health Sciences, School of Public Health , University of Washington , Seattle , Washington , USA
| | - Jen Krenz
- a Pacific Northwest Agricultural Safety and Health Center, Department of Environmental and Occupational Health Sciences, School of Public Health , University of Washington , Seattle , Washington , USA
| | - Marcy Harrington
- a Pacific Northwest Agricultural Safety and Health Center, Department of Environmental and Occupational Health Sciences, School of Public Health , University of Washington , Seattle , Washington , USA
| | - Pablo Palmández
- a Pacific Northwest Agricultural Safety and Health Center, Department of Environmental and Occupational Health Sciences, School of Public Health , University of Washington , Seattle , Washington , USA
| | - Richard A Fenske
- a Pacific Northwest Agricultural Safety and Health Center, Department of Environmental and Occupational Health Sciences, School of Public Health , University of Washington , Seattle , Washington , USA
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Martin B, Nahar VK, Hutcheson AK, Boyas JF, Sharma M. Increasing sun protection behaviors among Iranian farmworkers: a call for action. Health Promot Perspect 2017; 7:4-6. [PMID: 28058235 PMCID: PMC5209649 DOI: 10.15171/hpp.2017.02] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 11/22/2016] [Indexed: 02/01/2023] Open
Affiliation(s)
- Brian Martin
- Biomedical Professionals, Lincoln Memorial University, Harrogate, TN, USA
| | - Vinayak K Nahar
- Department of Dermatology, School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA; Department of Health, Physical Education, and Exercise Science, School of Allied Health Sciences, Lincoln Memorial University, Harrogate, TN, USA
| | - Amanda K Hutcheson
- Department of Health Science, College of Human Environmental Sciences, The University of Alabama, Tuscaloosa, AL, USA
| | - Javier F Boyas
- Department of Social Work, School of Applied Sciences, University of Mississippi, University, MS, USA
| | - Manoj Sharma
- Behavioral & Environmental Health, School of Public Health, Jackson State University, MS, USA; College of Health Sciences, Walden University, Minneapolis, MN, USA
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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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Shearer JE. A Critical Caring Theory of Protection for Migrants and Seasonal Farmworkers. Public Health Nurs 2016; 34:370-379. [PMID: 27862249 DOI: 10.1111/phn.12304] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Pesticide exposures represent inequities among a vulnerable population of migrant and seasonal farmworkers. A social justice theory synthesized from an environmental health research framework, a middle range theory of critical caring, and literature on pesticide exposure is presented as a situation-specific public health practice theory. Concepts from the physiological, epistemological, vulnerability, and health protection domains are related to concepts of critical caring revealing protective strategies for vulnerable populations exposed to pesticides. The key concepts are risk exposure, community assessment, transpersonal health promotion, community competence, and controllability. Protection from exposure involves raising awareness, critically assessing communities, educating for empowerment, building capacity, and advocating to ensure social justice. Critical caring protection is provided in a mutually respectful relationship that promotes responsibility at the individual and population levels.
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Affiliation(s)
- Jennifer E Shearer
- College of Nursing, Charleston Southern University, Charleston, South Carolina
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Arcury TA, Skelton JA, Ip EH, Suerken CK, Trejo G, Quandt SA. Anticipatory Guidance about Child Diet and Physical Activity for Latino Farmworker Mothers. J Health Care Poor Underserved 2016; 27:1064-79. [PMID: 27524752 DOI: 10.1353/hpu.2016.0136] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
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.
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Abstract
BACKGROUND Work organization is important for the health of vulnerable workers, particularly women. This analysis describes work organization for Latinas in farmworker families and delineates the associations of work organization with health indicators. METHODS Up to 220 Latina women in farmworker families completed interviews from October 2012 to July 2013. Interviews addressed job structure, job demand, job control, and job support. Health measures included stress, depressive symptoms, physical activity, family conflict, and family economic security. RESULTS Three fifths of the women were employed. Several work organization dimensions, including shift, psychological demand, work safety climate, and benefits, were associated with participant health as expected, on the basis of the work organization and job demands-control-support models. CONCLUSIONS Research should address women's health and specific work responsibilities. Occupational safety policy must consider the importance of work organization in the health of vulnerable workers.
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Postma J, Ramon C. Strengthening Community Capacity for Environmental Health Promotion through Photovoice. Public Health Nurs 2015; 33:316-24. [DOI: 10.1111/phn.12243] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Julie Postma
- Washington State University College of Nursing; Washington State University Puyallup Research and Extension Center; Puyallup Washington
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Salvatore AL, Castorina R, Camacho J, Morga N, López J, Nishioka M, Barr DB, Eskenazi B, Bradman A. Home-based community health worker intervention to reduce pesticide exposures to farmworkers' children: A randomized-controlled trial. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2015; 25:608-15. [PMID: 26036987 PMCID: PMC6380488 DOI: 10.1038/jes.2015.39] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 03/16/2015] [Accepted: 03/24/2015] [Indexed: 05/05/2023]
Abstract
We conducted a randomized-controlled trial of a home-based intervention to reduce pesticide exposures to farmworkers' children in Monterey County, California (n=116 families). The intervention consisted of three home-based educational sessions delivered by community health workers in Spanish. Measurements of organophosphate (OP) insecticide metabolites in child urine (n=106) and pesticides in home floor wipes (n=103) were collected before and after the intervention. Median child urinary dialkyl phosphate (DAP) metabolite levels were slightly lower among the intervention group children at follow-up compared with baseline, albeit nonsignificantly. DAP metabolite levels in the control group children were markedly higher at follow-up compared with baseline. In adjusted models, intervention participation was associated with a 51% decrease in total DAP metabolite levels. Carbaryl, chlorpyrifos, cypermethrin, dacthal, diazinon, malathion, and trans-permethrin were commonly detected in the floor wipes. In adjusted models, intervention participation was significantly associated with a 37% decrease in trans-permethrin floor wipe levels in homes, but not OP or other agricultural pesticides. In summary, intervention group children had slightly reduced pesticide exposures, whereas child exposures were higher among the control group. Additional intervention studies evaluating methods to reduce pesticide exposures to farmworker families and children are needed.
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Affiliation(s)
- Alicia L. Salvatore
- University of Oklahoma Health Sciences Center College of Public Health, Oklahoma City, OK, USA
- Center for Environmental Research and Children’s Health (CERCH), School of Public Health, University of California, Berkeley, CA, USA
| | - Rosemary Castorina
- Center for Environmental Research and Children’s Health (CERCH), School of Public Health, University of California, Berkeley, CA, USA
| | - José Camacho
- Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS), Clínica de Salud del Valle de Salinas, Salinas, CA, USA
| | - Norma Morga
- Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS), Clínica de Salud del Valle de Salinas, Salinas, CA, USA
| | - Jesús López
- California Rural Legal Assistance, Salinas, CA, USA
| | | | - Dana Boyd Barr
- Emory University, School of Public Health, Atlanta Georgia, USA
| | - Brenda Eskenazi
- Center for Environmental Research and Children’s Health (CERCH), School of Public Health, University of California, Berkeley, CA, USA
| | - Asa Bradman
- Center for Environmental Research and Children’s Health (CERCH), School of Public Health, University of California, Berkeley, CA, USA
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Arcury TA, Trejo G, Suerken CK, Grzywacz JG, Ip EH, Quandt SA. Housing and Neighborhood Characteristics and Latino Farmworker Family Well-Being. J Immigr Minor Health 2015; 17:1458-67. [PMID: 25367531 PMCID: PMC4418958 DOI: 10.1007/s10903-014-0126-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Housing quality and neighborhood characteristics affect individual health and family well-being. This analysis describes characteristics of farmworker housing and neighborhoods and delineates the associations of housing and local neighborhood with indicators of family well-being. Mothers in North Carolina farmworker families (n = 248) completed interviews in 2011-2012. Family well-being measures included stress, family conflict, and outward orientation. Housing measures included ownership and facilities, and neighborhood measures included heavy traffic and driving time to grocery stores. Families experienced elevated stress and conflict, and limited outward orientation. Few owned their homes, which were generally crowded. Few had enclosed play spaces for their children. For many, traffic made it difficult to walk on the street. Housing and neighborhood characteristics were related to increased stress and limited outward orientation. Housing and neighborhood characteristics are important for research on the health of families in vulnerable populations, such as farmworker families.
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Affiliation(s)
- Thomas A Arcury
- Department of Family and Community Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA,
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Marsh B, Milofsky C, Kissam E, Arcury TA. Understanding the Role of Social Factors in Farmworker Housing and Health. New Solut 2015; 25:313-33. [PMID: 26315036 DOI: 10.1177/1048291115601020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Differences in social advantage significantly influence health conditions and life expectancy within any population. Such factors reproduce historic class, race, and ethnic disparities in community success. Few populations in the United States face more social and economic disadvantage than farmworkers, and farmworker housing has significant potential to ameliorate or amplify the health impact of those disadvantages. Drawing on the limited direct research on farmworkers, and on additional research about poor, isolated, and immigrant societies, we propose four mechanisms through which housing can be expected to affect farmworker health: quality of social capital within farmworker communities, stress effects of poor housing situations, effects of housing on social support for healthy behaviors, and interactions among these factors, especially effects on children that can last for generations. Policy and planning definitions of "adequate" farmworker housing should take a more holistic view of housing needs to support specific social and community benefits in design decisions.
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Affiliation(s)
- Ben Marsh
- Department of Geography and Environmental Studies, Bucknell University, Lewisburg, PA, USA
| | - Carl Milofsky
- Department of Sociology and Anthropology, Bucknell University, Lewisburg, PA, USA
| | | | - Thomas A Arcury
- Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Anderson LM, Adeney KL, Shinn C, Safranek S, Buckner‐Brown J, Krause LK. Community coalition-driven interventions to reduce health disparities among racial and ethnic minority populations. Cochrane Database Syst Rev 2015; 2015:CD009905. [PMID: 26075988 PMCID: PMC10656573 DOI: 10.1002/14651858.cd009905.pub2] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Racial and ethnic disparities in health status are pervasive at all stages of the life cycle. One approach to reducing health disparities involves mobilizing community coalitions that include representatives of target populations to plan and implement interventions for community level change. A systematic examination of coalition-led interventions is needed to inform decision making about the use of community coalition models. OBJECTIVES To assess effects of community coalition-driven interventions in improving health status or reducing health disparities among racial and ethnic minority populations. SEARCH METHODS We searched MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, Social Science Citation Index, Dissertation Abstracts, System for Information on Grey Literature in Europe (SIGLE) (from January 1990 through September 30, 2013), and Global Health Library (from January 1990 through March 31, 2014). SELECTION CRITERIA Cluster-randomized controlled trials, randomized controlled trials, quasi-experimental designs, controlled before-after studies, interrupted time series studies, and prospective controlled cohort studies. Only studies of community coalitions with at least one racial or ethnic minority group representing the target population and at least two community public or private organizations are included. Major outcomes of interest are direct measures of health status, as well as lifestyle factors when evidence indicates that these have an effect on the direct measures performed. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed risk of bias for each study. MAIN RESULTS Fifty-eight community coalition-driven intervention studies were included. No study was considered to be at low risk of bias. Behavioral change outcomes and health status change outcomes were analyzed separately. Outcomes are grouped by intervention type. Pooled effects across intervention types are not presented because the diverse community coalition-led intervention studies did not examine the same constructs or relationships, and they used dissimilar methodological designs. Broad-scale community system level change strategies led to little or no difference in measures of health behavior or health status (very low-certainty evidence). Broad health and social care system level strategies leds to small beneficial changes in measures of health behavior or health status in large samples of community residents (very low-certainty evidence). Lay community health outreach worker interventions led to beneficial changes in health behavior measures of moderate magnitude in large samples of community residents (very low-certainty evidence). Lay community health outreach worker interventions may lead to beneficial changes in health status measures in large samples of community residents; however, results were not consistent across studies (low-certainty evidence). Group-based health education led by professional staff resulted in moderate improvement in measures of health behavior (very low-certainty evidence) or health status (low-certainty evidence). Adverse outcomes of community coalition-led interventions were not reported. AUTHORS' CONCLUSIONS Coalition-led interventions are characterized by connection of multi-sectoral networks of health and human service providers with ethnic and racial minority communities. These interventions benefit a diverse range of individual health outcomes and behaviors, as well as health and social care delivery systems. Evidence in this review shows that interventions led by community coalitions may connect health and human service providers with ethnic and racial minority communities in ways that benefit individual health outcomes and behaviors, as well as care delivery systems. However, because information on characteristics of the coalitions themselves is insufficient, evidence does not provide an explanation for the underlying mechanisms of beneficial effects. Thus, a definitive answer as to whether a coalition-led intervention adds extra value to the types of community engagement intervention strategies described in this review remains unattainable.
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Affiliation(s)
- Laurie M Anderson
- University of WashingtonDepartment of Epidemiology, School of Public HealthP.O. Box 357236SeattleWAUSA98195‐7236
| | - Kathryn L Adeney
- Washington State Institute for Public PolicyEpidemiology and Public Health110 Fifth Avenue SE, Suite 214SeattleWAUSA98504
| | - Carolynne Shinn
- New Hampshire Department of Health and Human ServicesNew Hampshire Division of Public Health ServicesConcordNew HampshireUSA03301‐3852
| | - Sarah Safranek
- University of WashingtonHealth Sciences Library1959 NE Pacific StreetSeattleWAUSA98195‐7155
| | - Joyce Buckner‐Brown
- Centers for Disease Control and PreventionNational Center for Chronic Disease Prevention and Health Promotion, Division of Community Health, Research Surveillance & Evaluation Branch4770 Buford Hwy NE, Mailstop K81AtlantaGeorgiaUSA30341
| | - L Kendall Krause
- Bill & Melinda Gates FoundationEpidemiology and Surveillance DivisionSeattleWAUSA
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Song Y, Anderson RA, Corazzini KN, Wu B. Staff characteristics and care in Chinese nursing homes: A systematic literature review. Int J Nurs Sci 2014. [DOI: 10.1016/j.ijnss.2014.10.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Bush DE, Wilmsen C, Sasaki T, Barton-Antonio D, Steege AL, Chang C. Evaluation of a pilot promotora program for Latino forest workers in southern Oregon. Am J Ind Med 2014; 57:788-99. [PMID: 24890853 DOI: 10.1002/ajim.22347] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Forest work, an occupation with some of the highest injury and illness rates, is conducted primarily by Latino immigrant workers. This study evaluates a pilot program where promotoras (lay community health educators) provided occupational health and safety trainings for Latino forest workers. METHODS Evaluation methods included a focus group, post-tests, and qualitative feedback. RESULTS Community capacity to address working conditions increased through (i) increased leadership and community access to information and resources; and (ii) increased worker awareness of workplace health and safety rights and resources. Fear of retaliation remains a barrier to workers taking action; nevertheless, the promotoras supported several workers in addressing-specific workplace issues. CONCLUSIONS For working conditions to significantly improve, major structural influences need to be addressed. A long-term, organizationally supported promotora program can play a key role in linking and supporting change at the individual, interpersonal and community levels, contributing to and supporting structural change.
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Affiliation(s)
- Diane E. Bush
- Labor Occupational Health Program; University of California Berkeley; Berkeley California
| | - Carl Wilmsen
- Alliance of Forest Workers and Harvesters (Now the Northwest Forest Worker Center); Albany California
| | - Timothy Sasaki
- Labor Occupational Health Program; University of California Berkeley; Berkeley California
| | - Dinorah Barton-Antonio
- Labor Occupational Health Program; University of California Berkeley; Berkeley California
| | - Andrea L. Steege
- Division of Surveillance; Hazard Evaluations and Field Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention; Cincinnati Ohio
| | - Charlotte Chang
- Labor Occupational Health Program; University of California Berkeley; Berkeley California
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Trejo G, Arcury TA, Grzywacz JG, Tapia J, Quandt SA. Barriers and facilitators for promotoras' success in delivering pesticide safety education to Latino farmworker families: La Familia Sana. J Agromedicine 2014; 18:75-86. [PMID: 23540298 DOI: 10.1080/1059924x.2013.766143] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Despite widespread use of lay health advisor (LHA) programs, factors related to success of LHAs remain largely unexamined. This study describes experiences and personal transformations of LHAs (promotoras de salud) in a pesticide safety education program targeting farmworker families in North Carolina, using postintervention in-depth interviews conducted with 17 LHAs. LHAs identified assets and barriers that affected their success. LHAs also described increases in self-efficacy and empowerment resulting in perceived improvements in ability to teach and impact their community. Such positive changes are essential benefits to the LHAs. Evaluations that address these topics are needed to better understand continuity and attrition in LHA programs.
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Affiliation(s)
- Grisel Trejo
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina 27157, USA
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Frank AL, Liebman AK, Ryder B, Weir M, Arcury TA. Health care access and health care workforce for immigrant workers in the agriculture, forestry, and fisheries sector in the southeastern US. Am J Ind Med 2013; 56:960-74. [PMID: 23532981 DOI: 10.1002/ajim.22183] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2013] [Indexed: 01/11/2023]
Abstract
BACKGROUND The Agriculture, Forestry, and Fishery (AgFF) Sector workforce in the US is comprised primarily of Latino immigrants. Health care access for these workers is limited and increases health disparities. METHODS This article addresses health care access for immigrant workers in the AgFF Sector, and the workforce providing care to these workers. CONTENTS Immigrant workers bear a disproportionate burden of poverty and ill health and additionally face significant occupational hazards. AgFF laborers largely are uninsured, ineligible for benefits, and unable to afford health services. The new Affordable Care Act will likely not benefit such individuals. Community and Migrant Health Centers (C/MHCs) are the frontline of health care access for immigrant AgFF workers. C/MHCs offer discounted health services that are tailored to meet the special needs of their underserved clientele. C/MHCs struggle, however, with a shortage of primary care providers and staff prepared to treat occupational illness and injury among AgFF workers. A number of programs across the US aim to increase the number of primary care physicians and care givers trained in occupational health at C/MHCs. While such programs are beneficial, substantial action is needed at the national level to strengthen and expand the C/MHC system and to establish widely Medical Home models and Accountable Care Organizations. System-wide policy changes alone have the potential to reduce and eliminate the rampant health disparities experienced by the immigrant workers who sustain the vital Agricultural, Forestry, and Fishery sector in the US.
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Affiliation(s)
- Arthur L. Frank
- Department of Environmental and Occupational Health; Drexel University School of Public Health; Philadelphia; Pennsylvania
| | | | - Bobbi Ryder
- National Center for Farmworker Health; Inc.; Buda; Texas
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Grzywacz JG, Arcury TA, Talton JW, D'Agostino RB, Trejo G, Mirabelli MC, Quandt SA. "Causes" of pesticide safety behavior change in Latino farmworker families. Am J Health Behav 2013; 37:449-57. [PMID: 23985226 PMCID: PMC3997211 DOI: 10.5993/ajhb.37.4.3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To identify the source of behavior change resulting from a health education intervention focused on pesticide safety. METHODS Data were from the La Familia Sana demonstration project, a promotora-delivered pesticide safety education intervention conducted with immigrant Latinos (N = 610). RESULTS The La Familia Sana program produced changes in 3 sets of pesticide safety behaviors. Changes in the conceptual targets of the intervention and promotora attributes explained 0.45-6% and 0.5-3% of the changes in pesticide-related behavior, respectively. DISCUSSION The conceptual targets of the La Familia Sana program explained the greatest amount of change in pesticide-related behavior. Promotora attributes also contributed to intervention success.
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