Implementing a community-based social marketing project to improve agricultural worker health

Examining Agricultural Workplace Micro and Macroclimate Data Using Decision Tree Analysis to Determine Heat Illness Risk

OBJECTIVE

This study was designed to examine the associations between regional weather data and agricultural worksite temperatures in Florida.

METHODS

Florida farmworkers (n = 105) were each monitored using iButton technology paired with simultaneous data from regional weather stations. Conditional inference tree models were developed for (1) regional environmental temperatures and iButton (worksite) temperatures, and (2) regional heat index (HI) and iButton HI.

RESULTS

Worksite temperatures were partitioned by regional temperature at the primary node of 29.1°C. Worksite HI was partitioned at nodes of 33.0°C, 36.0°C, 37.0°C, and 40.0°C. The nodes at 33.0°C and 40.0°C mirror the National Weather Service's category entry points for "extreme caution" and "danger" regarding the risk of developing heat-related illness.

CONCLUSION

Regional weather data have the potential to provide estimations of worksite environmental conditions allowing employers to quickly implement strategies to protect workers.

Engaging Youth Advocates in Community-Based Participatory Research on Child Farmworker Health in North Carolina

BACKGROUND

Wake Forest School of Medicine (WFSM) investigators and Student Action with Farmworkers' (SAF) Levante Leadership Institute, a farmworker youth program, are collaborating on a community-based participatory research (CBPR) study.

OBJECTIVES

1) Describe the collaborative process between WFSM investigators and the Levante advisory board during the strategic planning and implementation phase and 2) highlight practices that support the collaboration and project success.

METHODS

The longitudinal Hired Child Farmworker Study examines the health and safety of hired Latino child farm-workers in North Carolina. Two Levante alumni co- investigators lead research-related activities with the Levante advisory board.

LESSONS LEARNED

Challenges to CBPR with youth are overcome by the longstanding partnership between WFSM and SAF, attention to logistical details, power sharing, building on shared values, and assessment of youth preferences.

CONCLUSIONS

The partnership between WFSM and Levante demonstrates the mutual benefit of CBPR and will continue during the upcoming study phases.

Occupational safety and health education and training for underserved populations

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.

Female farmworkers' perceptions of heat-related illness and pregnancy health

Although agricultural workers have elevated risks of heat-related illnesses (HRI), pregnant farmworkers exposed to extreme heat face additional health risk, including poor pregnancy health and birth outcomes. Qualitative data from five focus groups with 35 female Hispanic and Haitian nursery and fernery workers provide details about the women's perceptions of HRI and pregnancy. Participants believe that heat exposure can adversely affect general, pregnancy, and fetal health, yet feel they lack control over workplace conditions and that they lack training about these specific risks. These data are being used to develop culturally appropriate educational materials emphasizing health promoting and protective behaviors during pregnancy.

Female farmworkers' perceptions of pesticide exposure and pregnancy health

Occupational pesticide exposure may be hazardous to pregnant farmworkers, yet few studies have focused on the health of female farmworkers distinct from their male counterparts or on the impact of agricultural work tasks on pregnancy outcomes. In the current community-based participatory research study, researchers conducted five focus groups with female nursery and fernery workers in Central Florida to enhance knowledge of attitudes about occupational risks and pregnancy health and to gather qualitative data to help form a survey instrument. This article presents the results from questions focused on pesticide exposure and its impact on general, reproductive, pregnancy, and fetal health. Workers reported a belief that pesticide exposure could be hazardous to pregnancy health; descriptions of symptoms and health concerns believed to be related to farmwork and to pesticide exposure; and descriptions of barriers preventing them from practicing safer occupational behaviors.

Qualitative environmental health research: an analysis of the literature, 1991-2008

Qualitative research uses nonnumeric data to understand people's opinions, motives, understanding, and beliefs about events or phenomena. In this analysis, I report the use of qualitative methods and data in the study of the relationship between environmental exposures and human health. A primary search for peer-reviewed journal articles dated from 1991 through 2008 included the following three terms: qualitative, environ*, and health. Searches resulted in 3,155 records. Data were extracted and findings of articles analyzed to determine where and by whom qualitative environmental health research is conducted and published, the types of methods and analyses used in qualitative studies of environmental health, and the types of information qualitative data contribute to environmental health. The results highlight a diversity of disciplines and techniques among researchers who used qualitative methods to study environmental health. Nearly all of the studies identified increased scientific understanding of lay perceptions of environmental health exposures. This analysis demonstrates the potential of qualitative data to improve understanding of complex exposure pathways, including the influence of social factors on environmental health, and health outcomes.

Qualitative environmental health research: an analysis of the literature, 1991-2008

BACKGROUND

Recent articles have advocated for the use of qualitative methods in environmental health research. Qualitative research uses nonnumeric data to understand people's opinions, motives, understanding, and beliefs about events or phenomena.

OBJECTIVE

In this analysis of the literature, I report the use of qualitative methods and data in the study of the relationship between environmental exposures and human health.

DATA SOURCES

A primary search on ISI Web of Knowledge/Web of Science for peer-reviewed journal articles dated from 1991 through 2008 included the following three terms: qualitative, environ*, and health. Inclusion and exclusion criteria are described.

DATA EXTRACTION

Searches resulted in 3,155 records. Data were extracted and findings of articles analyzed to determine where and by whom qualitative environmental health research is conducted and published, the types of methods and analyses used in qualitative studies of environmental health, and the types of information qualitative data contribute to environmental health.

DATA SYNTHESIS

Ninety-one articles met inclusion criteria. These articles were published in 58 different journals, with a maximum of eight for a single journal. The results highlight a diversity of disciplines and techniques among researchers who used qualitative methods to study environmental health, with most studies relying on one-on-one interviews. Details of the analyses were absent from a large number of studies. Nearly all of the studies identified increased scientific understanding of lay perceptions of environmental health exposures.

DISCUSSION AND CONCLUSIONS

Qualitative data are published in traditionally quantitative environmental health studies to a limited extent. However, this analysis demonstrates the potential of qualitative data to improve understanding of complex exposure pathways, including the influence of social factors on environmental health, and health outcomes.

Community collaborations for farmworker health in New York and Maine: process analysis of two successful interventions

We conducted a process evaluation of 2 successful farmworker community-based participatory research intervention development projects (in Maine and New York State). Participant surveys measured satisfaction with the program process. We used qualitative methods to analyze free-text responses. Respondents indicated high satisfaction levels overall. The main concern was long-distance project coordination. Community-based participatory research programs in which (1) the work team defines the target health issue, (2) agricultural employers are meaningfully included, and (3) interventions are carried through to completion, warrant further study.

Occupational behaviors and farmworkers' pesticide exposure: findings from a study in Monterey County, California

BACKGROUND

We studied the relationship between behaviors promoted through the US Environmental Protection Agency Worker Protection Standard (WPS) and other programs and agricultural pesticide exposures in 73 strawberry fieldworkers employed in Monterey County, California.

METHODS

Farmworkers' behaviors were assessed via self-report and organophosphorus (OP) pesticide exposure was measured using dimethyl alkylphosphate (DMAP) and malathion dicarboxylic acid (MDA) urinary metabolite levels.

RESULTS

Wearing WPS-recommended clothing, wearing clean work clothes, and the combination of handwashing with soap and wearing gloves were associated with decreases in DMAP and MDA metabolite levels. Despite these protective behaviors, however, participants had significantly higher levels of exposure as compared with a national reference sample.

CONCLUSIONS

Interventions that facilitate compliance with these behaviors may be effective in decreasing fieldworkers' pesticide exposures. However, further efforts are needed to reduce the exposure disparities experienced by farmworkers and decrease the potential for "take home" exposures to farmworkers' families.

Para niños saludables: a community intervention trial to reduce organophosphate pesticide exposure in children of farmworkers

BACKGROUND

Exposure to organophosphate (OP) pesticides is an occupational hazard for farmworkers and affects their children through the take-home pathway.

OBJECTIVES

We examined the effectiveness of a randomized community intervention to reduce pesticide exposure among farmworkers and their children.

METHODS

We conducted a baseline survey of a cross-sectional sample of farmworkers (year 1) in 24 participating communities. Communities were randomized to intervention or control. After 2 years of intervention, a new cross-sectional survey of farmworkers was conducted (year 4). Farmworkers with a child 2-6 years of age were asked to participate in a substudy in which urine was collected from the farmworker and child, and dust was collected from the home and the vehicle driven to work.

RESULTS

The median concentration of urinary metabolites was higher in year 4 than in year 1 for dimethylthiophosphate (DMTP) and dimethyldithiophosphate in adults and for DMTP for children. There were significant increases within both the intervention and control communities between year 1 and year 4 (p < 0.005); however, the differences were not significant between study communities after adjusting for year (p = 0.21). The dust residue data showed azinphos-methyl having the highest percentage of detects in vehicles (86% and 84% in years 1 and 4, respectively) and in house dust (85% and 83% in years 1 and 4, respectively). There were no significant differences between intervention and control communities after adjusting for year (p = 0.49).

CONCLUSIONS

We found no significant decreases in urinary pesticide metabolite concentrations or in pesticide residue concentrations in house and vehicle dust from intervention community households compared with control community households after adjusting for baseline. These negative findings may have implications for future community-wide interventions.

Public involvement in breast cancer research: an analysis and model for future research

Public involvement in health program planning has been taking place for many years, and has provided a precedent for the emergence of public involvement in research conducted since the early 1990s. Such involvement is now widely seen in breast cancer research, due to the large public concern and major social movement activity. This article reviews current practices and general models of public involvement in research and constructs a prototype. The authors interviewed researchers, program officers, and laypeople in order to understand the obstacles, processes, and benefits. They conclude that public involvement has major ramifications for the democratization of science and the construction of knowledge by teaching lay people about science and sensitizing researchers to concerns of the public. There is growing support on the part of scientists and government agents for public involvement.

Farmworker pesticide exposure and community-based participatory research: rationale and practical applications

The consequences of agricultural pesticide exposure continue to be major environmental health problems in rural communities. Community-based participatory research (CBPR) is an important approach to redressing health disparities resulting from environmental causes. In this article we introduce a collection of articles that describe projects using CBPR to address the health disparities resulting from pesticide exposure in agricultural communities, particularly the communities of migrant and seasonal farmworkers. The articles in this collection are based on a workshop convened at the 1999 American Public Health Association meeting. The goals in presenting this collection are to provide those endeavoring to initiate CBPR projects needed information, guidelines, and procedures to improve the quality of the CBPR experience; to increase the scientific validity of CBPR projects; and to reduce the potential difficulties and stress of these collaborations. In this introduction we discuss the context in which these projects operate, summarizing background information about farmworkers in the United States, what is known about farmworker pesticide exposure, and the concept of community-based participatory research. Finally, the articles in this collection are summarized, and major themes common to successful CBPR projects are identified. These common features are taking the time to interact with the community, using multiple approaches to engage the different parts of the community, understanding different participants often have different goals, appreciating each group's strengths, valuing community knowledge, and being flexible and creative in conducting research. The final article in this collection describes the translational research program at the National Institute of Environmental Health Sciences (NIEHS) highlighting activities pertinent to the health of rural communities, giving an overview of NIEHS-supported projects addressing health concerns of Native Americans and rural African-American communities in addition to farmworkers, and discussing future plans for CBPR at NIEHS.

Commitment of the National Institute of Environmental Health Sciences to community-based participatory research for rural health

The National Institute of Environmental Health Sciences (NIEHS) is the leading biomedical research institution in the United States whose mission is to support research that seeks to understand how environmental exposures affect human health. NIEHS possesses a longstanding interest in the health effects of agrochemical and other environmental exposures in rural America, including pesticides, to farmers and their families and to migrant farmworkers and their families. In recent years, NIEHS has begun augmenting traditional basic science investigations with innovative programs that translate findings from the laboratory to affected populations. It is through community-based participatory research that NIEHS strives to advance the public health field by fostering the development of culturally relevant interventions that will reduce exposures to environmental contaminants and the risk of environmentally induced disease. In this article, we describe the translational research program at NIEHS as it relates to the NIEHS mission and highlight activities pertinent to the health of rural communities, especially underserved populations. We provide an overview of NIEHS-supported projects addressing health concerns of Native American and rural African-American communities in addition to farmworkers. We conclude with a discussion of future plans for community-based participatory research at NIEHS.