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Rabin R. Community Health Workers Should be Worker Advocates. New Solut 2022; 32:100-105. [PMID: 35702044 DOI: 10.1177/10482911221107001] [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: 11/15/2022]
Abstract
Community health workers (CHWs) are frontline health workers who connect underserved populations to the health care system, provide health education, and advocate for their clients. CHWs can be particularly helpful to their clients in addressing social determinants of health that affect many chronic illnesses such as asthma, high blood pressure, poor mental health, and kidney and heart diseases. However, in one social determinant-the world of work-CHWs do not often play a role as facilitators and advocates. Low-income and other disadvantaged workers experience many hazards to their health and well-being, and knowledgeable CHWs could play a significant role in assisting them to confront such challenges.
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Affiliation(s)
- Richard Rabin
- Massachusetts Coalition for Occupational Safety and Health, Boston, MA, USA
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2
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Rhodes SD, Kuhns LM, Alexander J, Alonzo J, Bessler PA, Courtenay-Quirk C, Denson DJ, Evans K, Galindo CA, Garofalo R, Gelaude DJ, Hotton AL, Johnson AK, Mann-Jackson L, Muldoon A, Ortiz R, Paul JL, Perloff J, Pleasant K, Reboussin BA, Refugio Aviles L, Song EY, Tanner AE, Trent S. Evaluating Locally Developed Interventions to Promote PrEP Among Racially/Ethnically Diverse Transgender Women in the United States: A Unique CDC Initiative. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2021; 33:345-360. [PMID: 34370565 PMCID: PMC8565450 DOI: 10.1521/aeap.2021.33.4.345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
In the United States, transgender women are disproportionately affected by HIV. However, few evidence-based prevention interventions exist for this key population. We describe two promising, locally developed interventions that are currently being implemented and evaluated through the Centers for Disease Control and Prevention Combination HIV Prevention for Transgender Women Project: (a) ChiCAS, designed to promote the uptake of pre-exposure prophylaxis (PrEP), condom use, and medically supervised hormone therapy among Spanish-speaking transgender Latinas, and (b) TransLife Care, designed to address the structural drivers of HIV risk through access to housing, employment, legal services, and medical services, including HIV preventive care (e.g., PrEP use) among racially/ethnically diverse urban transgender women. If the evaluation trials determine that these interventions are effective, they will be among the first such interventions for use with transgender women incorporating PrEP, thereby contributing to the evidence-based resources that may be used to reduce HIV risk among this population.
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Affiliation(s)
- Scott D Rhodes
- Department of Social Sciences and Health Policy and CTSI Program in Community-Engaged Research, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Lisa M Kuhns
- Northwestern University, Department of Pediatrics, Feinberg School of Medicine, and the Ann & Robert H. Lurie Children's Hospital of Chicago, Potocsnak Family Division of Adolescent and Young Adult Medicine, Chicago, Illinois
| | | | - Jorge Alonzo
- Department of Social Sciences and Health Policy and CTSI Program in Community-Engaged Research, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | | | | - Damian J Denson
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kaiji Evans
- Chicago House and Social Service Agency, Chicago, Illinois
| | - Carla A Galindo
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Robert Garofalo
- Northwestern University, Department of Pediatrics, Feinberg School of Medicine, and the Ann & Robert H. Lurie Children's Hospital of Chicago, Potocsnak Family Division of Adolescent and Young Adult Medicine, Chicago, Illinois
| | | | - Anna L Hotton
- Department of Medicine, University of Chicago, Chicago, Illinois
| | - Amy K Johnson
- Northwestern University, Department of Pediatrics, Feinberg School of Medicine, and the Ann & Robert H. Lurie Children's Hospital of Chicago, Potocsnak Family Division of Adolescent and Young Adult Medicine, Chicago, Illinois
| | - Lilli Mann-Jackson
- Department of Social Sciences and Health Policy and CTSI Program in Community-Engaged Research, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Abigail Muldoon
- Ann & Robert H. Lurie Children's Hospital of Chicago, Potocsnak Family Division of Adolescent and Young Adult Medicine, Chicago, Illinois
| | - Reyna Ortiz
- Chicago House and Social Service Agency, Chicago, Illinois
| | | | - Judy Perloff
- Chicago House and Social Service Agency, Chicago, Illinois
| | - Kevin Pleasant
- Chicago House and Social Service Agency, Chicago, Illinois
| | - Beth A Reboussin
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | | | | - Amanda E Tanner
- University of North Carolina Greensboro, Greensboro, North Carolina
| | - Scott Trent
- Triad Health Project, Greensboro, North Carolina
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3
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Eggerth DE, Ortiz B, Keller BM, Flynn MA. Work experiences of Latino building cleaners: An exploratory study. Am J Ind Med 2019; 62:600-608. [PMID: 31104342 DOI: 10.1002/ajim.22986] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 04/19/2019] [Accepted: 04/24/2019] [Indexed: 11/08/2022]
Abstract
BACKGROUND There are roughly 3.8 million cleaning workers in the United States. The cleaning workforce is largely composed of women, immigrants, and ethnic minorities who receive low wages and have low education levels. They are exposed to physical, chemical, biological, and psychosocial hazards. METHODS Qualitative methodology was used to investigate how Latino immigrants experience work as building cleaners. A grounded theory coding approach was used to analyze focus group data from 77 participants. RESULTS Three major themes were identified: economic vulnerability, psychosocial stressors, and health and safety effects. Although workers are aware of the safety hazards associated with their jobs, they believe their immigration status limits employment opportunities leading them to accept poor working conditions. They work through injuries and cope psychologically through minimizing negative health impacts and normalizing work-related injuries and illnesses. CONCLUSIONS The findings suggest that interventions for these workers should recognize the hostile organizational and psychosocial contexts within which immigrants often work.
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Affiliation(s)
- Donald E. Eggerth
- Education and Information Division, Centers for Disease Control and PreventionNational Institute for Occupational Safety and HealthCincinnati Ohio
| | - Bermang Ortiz
- Education and Information Division, Centers for Disease Control and PreventionNational Institute for Occupational Safety and HealthCincinnati Ohio
| | - Brenna M. Keller
- Education and Information Division, Centers for Disease Control and PreventionNational Institute for Occupational Safety and HealthCincinnati Ohio
| | - Michael A. Flynn
- Education and Information Division, Centers for Disease Control and PreventionNational Institute for Occupational Safety and HealthCincinnati Ohio
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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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5
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Stuesse A. When They're Done with You: Legal Violence and Structural Vulnerability among Injured Immigrant Poultry Workers. ANTHROPOLOGY OF WORK REVIEW 2018. [DOI: 10.1111/awr.12148] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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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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7
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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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Arcury TA, Summers P, Carrillo L, Grzywacz JG, Quandt SA, Mills TH. Occupational safety beliefs among Latino residential roofing workers. Am J Ind Med 2014; 57:718-25. [PMID: 24006046 DOI: 10.1002/ajim.22248] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2013] [Indexed: 11/06/2022]
Abstract
BACKGROUND This analysis describes beliefs about work safety and personal protective equipment (PPE) among Latino roofing workers, it delineates their perceptions of work environment characteristics that affect work safety and PPE use, and it describes how they experience work injuries and the consequences of these injuries. METHODS In-depth interviews were completed with 10 current and former Latino residential roofers. Interview transcripts were subjected to systematic qualitative analysis. RESULTS Participants' valued productivity over safety, and this had a negative influence on their safety behavior and reduced their PPE use. They understood that roofing was hazardous. They limited use of PPE when they felt it reduced productivity and when it was uncomfortable. Work environment characteristics that affected safety included company size, the physical demands of the job, lack of training, the need for work, general life stress, and distractions at work. An injury had to result in lost work time to be considered significant. Access to health care is limited by employers not providing Workers' compensation. DISCUSSION Future research is needed to substantiate these descriptive results and to delineate factors that are associated with safety behavior and use of PPE. Interventions, based on a lay health educator model, are needed to improve safety in this population. Safety regulations need to be evaluated and their enforcement needs to be improved.
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Affiliation(s)
- Thomas A. Arcury
- Department of Family and Community Medicine; Wake Forest School of Medicine; Winston-Salem North Carolina
- Center for Worker Health; Wake Forest School of Medicine
| | - Phillip Summers
- Department of Family and Community Medicine; Wake Forest School of Medicine; Winston-Salem North Carolina
- Center for Worker Health; Wake Forest School of Medicine
| | - Lourdes Carrillo
- Department of Epidemiology and Prevention; Sciences; Division of Public Health Sciences; Wake Forest School of Medicine
- Center for Worker Health; Wake Forest School of Medicine
| | - Joseph G. Grzywacz
- Department of Human Development and Family Science; Oklahoma State University
- Center for Family Resilience; Oklahoma State University
| | - Sara A. Quandt
- Department of Epidemiology and Prevention; Sciences; Division of Public Health Sciences; Wake Forest School of Medicine
- Center for Worker Health; Wake Forest School of Medicine
| | - Thomas H. Mills
- Myers-Lawson School of Construction; Virginia Polytechnic Institute and State University
- Occupational Safety and Health Research Center; Virginia Polytechnic Institute and State University
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Baron SL, Beard S, Davis LK, Delp L, Forst L, Kidd-Taylor A, Liebman AK, Linnan L, Punnett L, Welch LS. Promoting integrated approaches to reducing health inequities among low-income workers: applying a social ecological framework. Am J Ind Med 2014; 57:539-56. [PMID: 23532780 PMCID: PMC3843946 DOI: 10.1002/ajim.22174] [Citation(s) in RCA: 105] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2013] [Indexed: 12/20/2022]
Abstract
BACKGROUND Nearly one of every three workers in the United States is low-income. Low-income populations have a lower life expectancy and greater rates of chronic diseases compared to those with higher incomes. Low- income workers face hazards in their workplaces as well as in their communities. Developing integrated public health programs that address these combined health hazards, especially the interaction of occupational and non-occupational risk factors, can promote greater health equity. METHODS We apply a social-ecological perspective in considering ways to improve the health of the low-income working population through integrated health protection and health promotion programs initiated in four different settings: the worksite, state and local health departments, community health centers, and community-based organizations. RESULTS Examples of successful approaches to developing integrated programs are presented in each of these settings. These examples illustrate several complementary venues for public health programs that consider the complex interplay between work-related and non work-related factors, that integrate health protection with health promotion and that are delivered at multiple levels to improve health for low-income workers. CONCLUSIONS Whether at the workplace or in the community, employers, workers, labor and community advocates, in partnership with public health practitioners, can deliver comprehensive and integrated health protection and health promotion programs. Recommendations for improved research, training, and coordination among health departments, health practitioners, worksites and community organizations are proposed.
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Affiliation(s)
- Sherry L Baron
- Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio
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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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Flynn MA, Check P, Eggerth DE, Tonda J. Improving occupational safety and health among Mexican immigrant workers: a binational collaboration. Public Health Rep 2014; 128 Suppl 3:33-8. [PMID: 24179277 DOI: 10.1177/00333549131286s306] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Latino immigrants are 50% more likely than all workers in the United States to experience a fatal injury at work. Occupational safety and health (OSH) organizations often find that the approaches and networks they successfully use to promote OSH among U.S.-born workers are ineffective at reaching Latino immigrants. This article describes the collaboration between the National Institute for Occupational Safety and Health (NIOSH) and the Mexican Ministry of Foreign Affairs (Secretaría de Relaciones Exteriores) to promote OSH among Mexican immigrant workers. The Ministry of Foreign Affairs operates 50 consulates throughout the U.S. that provide four million discrete service contacts with Mexican citizens annually. The focus of this ongoing collaboration is to develop the internal capacity of Mexican institutions to promote OSH among Mexican immigrants while simultaneously developing NIOSH's internal capacity to create effective and sustainable initiatives to better document and reduce occupational health disparities for Mexican immigrants in the U.S.
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Affiliation(s)
- Michael A Flynn
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Cincinnati, OH ; Michigan State University, Consortium for Multicultural Psychology Research, East Lansing, MI
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O'Connor T, Flynn M, Weinstock D, Zanoni J. Occupational safety and health education and training for underserved populations. New Solut 2014; 24:83-106. [PMID: 25053607 PMCID: PMC4540323 DOI: 10.2190/ns.24.1.d] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This article presents an analysis of the essential elements of effective occupational safety and health education and training programs targeting underserved communities. While not an exhaustive review of the literature on occupational safety and health training, the paper provides a guide for practitioners and researchers to the key factors they should consider in the design and implementation of training programs for underserved communities. It also addresses issues of evaluation of such programs, with specific emphasis on considerations for programs involving low-literacy and limited-English-speaking workers.
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Affiliation(s)
- Tom O'Connor
- National Council for Occupational Safety and Health
| | | | | | - Joseph Zanoni
- Chicago School of Public Health, University of Illinois
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13
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Arcury TA, Grzywacz JG, Anderson AM, Mora DC, Carrillo L, Chen H, Quandt SA. Personal protective equipment and work safety climate among Latino poultry processing workers in Western North Carolina, USA. INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH 2013; 18:320-8. [PMID: 23433293 DOI: 10.1179/2049396712y.0000000006] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Job-appropriate personal protective equipment (PPE) is important for decreasing the high rates of occupational injury experienced by poultry processing workers. OBJECTIVES This analysis describes the job-appropriate PPE provided to poultry processing workers by their employers and the PPE used by these workers, and it delineates the association of work safety climate with job-appropriate PPE. METHODS Data are from a cross-sectional study of 403 Latino poultry processing workers in North Carolina. RESULTS Most poultry processing workers are not provided with nor use job-appropriate PPE; however, more workers use PPE than are provided. The provision and use of PPE differs by employer. Work safety climate was associated with use of job-appropriate PPE. CONCLUSIONS Poultry processing workers should be provided with job-appropriate PPE. Workers' use of PPE is an indicator of safety climate. Further research about work safety climate and other work organization characteristics and job safety characteristics is needed.
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Affiliation(s)
- Thomas A Arcury
- Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA.
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14
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Quandt SA, Grzywacz JG, Talton JW, Trejo G, Tapia J, D'Agostino RB, Mirabelli MC, Arcury TA. Evaluating the effectiveness of a lay health promoter-led, community-based participatory pesticide safety intervention with farmworker families. Health Promot Pract 2013; 14:425-32. [PMID: 23075501 PMCID: PMC4116736 DOI: 10.1177/1524839912459652] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Pesticide safety training is mandated for migrant and seasonal farmworkers. However, none is required for family members, who implement home sanitation to protect against pesticide exposure and need to control pests in substandard housing. Controlled studies have demonstrated the efficacy of pesticide education programs for farmworker families, but no carefully evaluated demonstration projects have shown effectiveness in public health settings. This project evaluates a lay health promoter program to improve pesticide-related knowledge and practices. Promotoras from six agencies recruited families with children to deliver a six-lesson, in-home, culturally and educationally appropriate curriculum. Independently conducted pre- and posttests evaluated changes in knowledge and practices. Adults in 610 families completed the study. Most were from Mexico, with low levels of formal education. Significant improvements in knowledge were observed for all six lessons. Significant improvements were observed in practices related to para-occupational exposure and residential pest control. Lay health promoters with limited training and supervision can have significant impacts on families' knowledge and practices. They represent a workforce increasingly recognized as a force for reducing health disparities by providing culturally appropriate health education and other services. This study adds to the literature by demonstrating their effectiveness in a public health setting with rigorous evaluation.
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Affiliation(s)
- Sara A Quandt
- Wake Forest School of Medicine, Winston-Salem, NC, USA
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15
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Quandt SA, Arcury-Quandt AE, Lawlor EJ, Carrillo L, Marín AJ, Grzywacz JG, Arcury TA. 3-D jobs and health disparities: The health implications of Latino chicken catchers' working conditions. Am J Ind Med 2013; 56:206-15. [PMID: 22618638 DOI: 10.1002/ajim.22072] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2012] [Indexed: 02/01/2023]
Abstract
OBJECTIVES This study uses qualitative data to describe the tasks performed by chicken catchers, their organization of work, and possible health and safety hazards encountered. METHODS Twenty-one Latino immigrant chicken catchers for North Carolina poultry-processing plants were interviewed to obtain their perceptions of the job and its hazards. Interviews were recorded and transcribed (n = 10) or detailed notes recorded (n = 11). Transcripts and notes were subjected to qualitative analysis. RESULTS Chicken catching takes place in a highly contaminated and hazardous work environment. The fast pace of work, low level of control over work intensity, and piece rate compensation all result in high potential for work-related injury and illness, including trauma, electrical shock, respiratory effects, musculoskeletal injuries, and drug use. Workers receive little safety or job training. CONCLUSIONS Chicken catching is characterized by a work environment and organization of work that promote injury and illness.
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Affiliation(s)
- Sara A Quandt
- Division of Public Health Sciences, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina 27157, USA.
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16
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Spears CR, Summers PY, Spencer KM, Arcury TA. Informal occupational safety information exchange among Latino migrant and seasonal farmworkers. J Agromedicine 2012; 17:415-20. [PMID: 22994643 DOI: 10.1080/1059924x.2012.713830] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Latino farmworkers in North Carolina are a hard-to-reach population that faces diverse occupational health risks, including pesticide exposure. Health and safety education efforts often employ lay health advisor or promotor(a) de salud models in which farmworker community members are trained to provide health education. As a frequently tight-knit and isolated group, farmworkers may be well suited to serve as resident lay health advisors. This paper presents data collected from a nonrandom sample of Latino farmworkers living in North Carolina regarding the natural level of occupational safety information exchange among Latino farmworkers, specifically pesticide safety information. The data affirm that farmworkers informally exchange occupational safety information with one another, with the level of exchange increasing during the agricultural season. Consequently, if trained, the data suggest that farmworkers might be situated to provide in situ occupational health and safety education to their peers. This remains to be systematically tested and evaluated.
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Affiliation(s)
- Chaya R Spears
- Department of Family and Community Medicine, and the Center for Worker Health, Wake Forest School of Medicine, Winston-Salem, North Carolina 27157, USA
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Gorin SS, Badr H, Krebs P, Prabhu Das I. Multilevel interventions and racial/ethnic health disparities. J Natl Cancer Inst Monogr 2012; 2012:100-11. [PMID: 22623602 PMCID: PMC3482960 DOI: 10.1093/jncimonographs/lgs015] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
To examine the impact of multilevel interventions (with three or more levels of influence) designed to reduce health disparities, we conducted a systematic review and meta-analysis of interventions for ethnic/racial minorities (all except non-Hispanic whites) that were published between January 2000 and July 2011. The primary aims were to synthesize the findings of studies evaluating multilevel interventions (three or more levels of influence) targeted at ethnic and racial minorities to reduce disparities in their health care and obtain a quantitative estimate of the effect of multilevel interventions on health outcomes among these subgroups. The electronic database PubMed was searched using Medical Subject Heading terms and key words. After initial review of abstracts, 26 published studies were systematically reviewed by at least two independent coders. Those with sufficient data (n = 12) were assessed by meta-analysis and examined for quality using a modified nine-item Physiotherapy Evidence Database coding scheme. The findings from this descriptive review suggest that multilevel interventions have positive effects on several health behavior outcomes, including cancer prevention and screening, as well improving the quality of health-care system processes. The weighted average effect size across studies for all health behavior outcomes reported at the individual participant level (k = 17) was odds ratio (OR) = 1.27 (95% confidence interval [CI] = 1.11 to 1.44); for the outcomes reported by providers or organizations, the weighted average effect size (k = 3) was OR = 2.53 (95% CI = 0.82 to 7.81). Enhanced application of theories to multiple levels of change, novel design approaches, and use of cultural leveraging in intervention design and implementation are proposed for this nascent field.
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Affiliation(s)
- Sherri Sheinfeld Gorin
- SAIC, Outcomes Research Branch, Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Executive Plaza North, 6130 Executive Blvd, Bethesda, MD 20892-7344, USA.
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Familiar I, Borges G, Orozco R, Medina-Mora ME. Mexican migration experiences to the US and risk for anxiety and depressive symptoms. J Affect Disord 2011; 130:83-91. [PMID: 20934221 DOI: 10.1016/j.jad.2010.09.025] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2010] [Accepted: 09/19/2010] [Indexed: 11/19/2022]
Abstract
BACKGROUND Scant and contradictory information prevails on the risk for common psychiatric disorders in Mexican immigrants to the United States (US). Extension of these results in larger samples is needed to better address treatment needs. This study investigates the association between migration to the US and development of depressive and anxiety symptoms in four urban areas of Mexico. METHODS A cross-sectional survey in 2005 of individuals ages 12-65 from four cities formed a representative sample. Immigration-related experiences and prevalence of depressive and anxiety symptoms were recorded. Respondents were classified into three groups: (i) 'return migrants', (ii) 'relatives of migrants' and (iii) 'non-migrants' in the general population. Depression symptoms were assessed with the Center for Epidemiologic Studies Depression Scale (CES-D) and anxiety was determined using the Beck Anxiety Inventory (BAI). Prevalence of depressive and anxiety symptoms were estimated as the proportion of the entire sample reporting the outcome. Crude and adjusted OR's were estimated in logistic regression models. RESULTS A total of 1630 respondents, represent a 70.5% response rate. Overall prevalence of depressive and anxiety symptoms were both approximately 16%. Increased risk for depressive symptoms (OR=1.49 CI 95%=1.01-2.20) among return migrants and depressive (OR=1.48, CI 95%=1.07-2.05) and anxiety symptoms (OR=1.38, CI 95%=1.08-1.78) in relatives of migrants was found in comparison to those without a migration experience. LIMITATIONS Specific age and timing of migration experiences were not recorded. CONCLUSIONS Migration experiences produce important levels of anxiety and depressive symptoms that could be linked to psychopathology.
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Affiliation(s)
- Itziar Familiar
- Mental Health Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
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Arcury TA, Estrada JM, Quandt SA. Overcoming language and literacy barriers in safety and health training of agricultural workers. J Agromedicine 2010; 15:236-48. [PMID: 20665309 PMCID: PMC2914347 DOI: 10.1080/1059924x.2010.486958] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The workforce in all areas of United States agriculture and forestry is becoming increasingly diverse in language, culture, and education. Many agricultural workers are immigrants who have limited English language skills and limited educational attainment. Providing safety and health training to this large, diverse, dispersed, and often transient population of workers is challenging. This review, prepared for the 2010 Agricultural Safety and Health Council of America/National Institute for Occupational Safety and Health conference, "Be Safe, Be Profitable: Protecting Workers in Agriculture," is divided into five sections. First, we describe the occupational and demographic characteristics of agricultural workers in the United States to highlight their safety and health training needs. Second, we summarize current research on the social and cultural attributes of agricultural workers and agricultural employers that affect the provision of safety and health training. Worker and employer attributes include language, literacy, financial limitations, work beliefs, and health beliefs. Third, we review current initiatives addressing safety and health training for agricultural workers that consider worker language and literacy. These initiatives are limited to a few specific topics (e.g., pesticides, heat stress); they do not provide general programs of safety training that would help establish a culture of workplace safety. However, several innovative approaches to health and safety training are being implemented, including the use of community-based participatory approaches and lay health promoter programs. Fourth, the limited industry response for safety training with this linguistically diverse and educationally limited workforce is summarized. Finally, gaps in knowledge and practice are summarized and recommendations to develop educationally, culturally, and linguistically appropriate safety and health training are presented.
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Affiliation(s)
- Thomas A Arcury
- Department of Family and Community Medicine, Wake Forest University School of Medicine, Center for Worker Health, Winston-Salem, North Carolina 27157, USA.
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