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

The Abysmal Organization of Work and Work Safety Culture Experienced by North Carolina Latinx Women in Farmworker Families

The occupational health of immigrant workers in the United States is a major concern. This analysis describes two domains, organization of work and work safety culture, important to the occupational health of Latinx women in farmworker families. Sixty-seven Latinx women in North Carolina farmworker families completed a baseline and five follow-up questionnaires in 2019 through 2021. Fifty-nine of the women were employed in the year prior to the Follow-Up 5 Questionnaire. These women experienced an abysmal organization of work and work safety culture. They experienced significant job churn, with most changing employment several times during the 18-month period. Most of their jobs were seasonal, paid less than $10.00 per hour, piece-rate, and almost all without benefits. The women's jobs had little skill variety (mean 1.5) or decision latitude (mean 1.1), but had high psychological demands (mean 2.0). Work safety climate was very low (mean 13.7), with 76.3% of women noting that their supervisors were "only interested in doing the job fast and cheaply" rather than safely. Women employed as farmworkers versus those in other jobs had few differences. Further research and intervention are needed on the organization of work and work safety culture of Latinx women manual workers.

Conventional and Complementary Therapy Use among Mexican Farmworkers in North Carolina: Applying the I-CAM-Q

Objectives: This analysis documents the use of conventional health-care providers, traditional healers, and complementary therapies by Mexican farmworkers; identifies the purposes and perceived helpfulness of these modalities; and delineates variation in the use of traditional healers and complementary therapies. Methods: Two-hundred Mexican farmworkers in North Carolina completed interviews May-September, 2017. The International Complementary and Alternative Medicine Questionnaire (I-CAM-Q) elicited use of conventional health-care providers, traditional healers, and complementary therapies in the previous 12 months. Results: Most of the farmworkers had been treated by a conventional provider (63.0%). One-in-five had been treated by any traditional healer; 19.5% had been treated by a sobador, 4.5% by a curandero, 2.0% by an herbalist, and 2.0% by a spiritual healer. Conventional providers (69.8%) and sobadores (84.6%) most often treated acute conditions; 62.5% had used an herb, 46.0% a vitamin, 57.0% an over-the-counter medicine, and 13.5% a home remedy. Participants used various self-care practices, including music (36.5%), sleep (18.0%), prayer for health (15.0%), and social media (14.0%). Education was inversely associated with the use of a traditional healer and herbs; treatment by a conventional health-care provider was positively associated with using a traditional healer and vitamins. Conclusions: Mexican farmworkers use conventional health-care providers as well as traditional healers and complementary therapies. Research on how use of complementary therapies and a system of medical pluralism affects farmworker health is needed. Health-care providers need to recognize complementary therapy use and provide patient education about ineffective or harmful therapies.

Child Feeding Style and Dietary Outcomes in a Cohort of Latino Farmworker Families

BACKGROUND

The high level of obesity in Latino children, especially in farmworker families, may be partly attributed to feeding styles of parents. Feeding styles used in Latino farmworker families have not been well characterized.

OBJECTIVE

This study sought to identify and describe feeding styles used by mothers in farmworker families with 2.5- to 3.5-year-old children, describe how styles change over time, and characterize the relationship of feeding styles to dietary outcomes and measures of overweight and obesity.

DESIGN

This was a longitudinal cohort study, with families participating for a 2-year period; surveys were administered to mothers with varying frequency depending on the instrument, and dietary measurements were collected at baseline and 12 and 24 months.

PARTICIPANTS/SETTING

Eligible participants were self-identified Latino women with a co-resident child aged 2.5 to 3.5 years old and at least one household member engaged in farm work during the previous year. The sample included 248 farmworker families enrolled between 2011 and 2012 in the Niños Sanos study, a longitudinal investigation of Latino mothers and their young children in rural North Carolina. Eleven families provided incomplete dietary data, so the analysis included 237 families. Fifteen families were lost to follow-up and 12 withdrew during the course of the study.

MAIN OUTCOME MEASURES

Feeding style was assessed using items from the Caregiver's Feeding Style Questionnaire, selected dietary components were assessed using the Revised Children's Diet Quality Index, and weight outcomes were determined using body mass index-for-age percentile. Performance on the Caregiver's Feeding Style Questionnaire items was used to assign mothers to one of four feeding style states.

STATISTICAL ANALYSES PERFORMED

Exploratory factor analysis was conducted on baseline data to verify the replicability of the factor structure of the instrument Caregiver's Feeding Style Questionnaire. Hidden Markov Model analysis was used to delineate different subtypes of feeding style. Multivariable mixed-effects regression models were used to assess the impact of feeding style on selected dietary components, energy intake, and body mass index-for-age percentile.

RESULTS

Four distinct states emerged from the Hidden Markov Model: low parent-centered (PC)/moderate child-centered (CC) feeding style (28% at baseline), high PC/CC without physical control (24%), high PC/CC (26%), and moderate PC/CC (22%). The low PC/moderate CC state increased in prevalence over time. Compared to high PC/CC, the low PC/moderate CC state was associated with greater intake of added sugars (P<0.01), lower intake of whole grains and vegetables (P<0.01), and lower overall diet quality (P<0.05). Children in low PC/moderate CC also had higher mean body mass index percentiles (76.2 percentile vs 66.7 percentile in high PC/CC; P<0.001).

CONCLUSIONS

High PC feeding along with high CC feeding is associated with improved diet quality and weight outcomes for children in the study.

Residential Environment for Outdoor Play Among Children in Latino Farmworker Families

Child health and development benefit from physical activity. This analysis describes the residential play environment for children aged 2-4 years in farmworker families, their parent-reported levels of play and media time, and the association of residential environment with play and media time. Mothers with a child aged 2-4 years in farmworker families (n = 248) completed interviews over 2 years. Outcome measures were daily outdoor play time and media time. Measures of the residential environment included physical and social components. The mean min/day for outdoor play was 81.8 (SD 57.3) at baseline, 111.4 (SD 90.1) at year 1 follow-up, and 103.6 (SD 76.2) at year 2 follow-up. The mean media min/day at baseline was 83.8 (SD 64.3), 93.7 (SD 80.3) min/day at year 1 follow-up, and 59.9 min/day (SD (45.6) at year 2 follow-up. One additional person per bedroom was associated with 6 fewer min/day with media. The addition of each age appropriate toy was associated with an additional 12.3 min/day of outdoor play. An additional type of inappropriate media was associated with 6.8 more min/day with media. These results suggest changes to the residential environment to improve physical activity among children in Latino farmworker families.