Reducing Pesticide Exposure in Farmworker Families: Research to Practice

描述（由申请人提供）：移民和季节性农场工人及其家庭通过职业和准职业途径接触农药。这些临时工人大多出生在拉丁美洲，与美国其他人口相比，他们接触农药的程度不成比例。研究已经确定了这种接触对健康的危害。儿童和妇女面临不利健康结果的特殊风险，由于他们在家中、在经处理的田地附近居住以及在不合标准的住房中使用杀虫剂，他们可能面临重大风险。这个拟议的示范项目建立在十多年来由大学-社区伙伴关系进行的社区参与性研究的基础上，该研究产生了有效的非专业健康顾问干预措施，以减少拉丁裔农场工人及其家庭接触农药的情况。该项目的目标是将一种有效的、文化上和教育上适当的、针对农场工人家庭的农药安全干预措施纳入公共卫生实践。具体目标是：(1)实施一个示范项目，将减少拉丁裔农场工人家庭农药接触的有效干预措施推广到更广泛的公共卫生领域；(2)评估该农药暴露干预的潜在可转译性和公共卫生影响；(3)通过地方、区域和国家各级的公共卫生项目传播该方案。干预的内容包括六个通用模块，采用主动学习方法，并辅以为低识字率成人设计的材料。这些模块涉及农药接触途径、防止农业农药进入家庭的程序、从家中清除农药的方法、使用住宅综合虫害管理而不是杀虫剂来控制害虫，以及说服他人改变行为的方法。第七个模块涉及怀孕期间的农药安全。10名非专业健康顾问（promotoras de salud）将被安置在北卡罗来纳州东部13个县地区的6个合作社区公共卫生机构。促进者将招募至少有一个12岁以下儿童的农场工人家庭，并提供农药健康和安全培训，使用先前证明可以改变对农药的知识和行为的课程。社区机构的联络员将协助推广人员从他们的客户中找到农场工人家庭并实施该计划。干预前和干预后的访谈将测量知识和行为。在逻辑模型的指导下，项目评估将侧重于短期结果（增加个人对农药安全的了解；更好地掌握减少农药接触的具体行为；提高当地公共卫生机构预防农药相关疾病的能力）和长期结果（减少农药相关疾病和将该项目推广到更广泛的公共卫生机构网络）。将评估干预措施的潜在可转译性和公共卫生影响。

DESCRIPTION (provided by applicant): Migrant and seasonal farm workers and their families are exposed to pesticides through occupational and para- occupational pathways. This population of contingent workers, largely born in Latin America, experiences a disproportionate level of pesticide exposure, relative to the rest of the US population. Research has established the health hazards of such exposure. Children and women are at special risk for adverse health outcomes, and may have significant risks due to their roles in the home, residence near treated fields, and use of pesticides in substandard housing. This proposed demonstration project builds on over ten years of community-based participatory research (CBPR) conducted by a university-community partnership which has produced an effective lay health advisor intervention to reduce pesticide exposure among Latino farm workers and among their families. The goal of this project is to move an effective culturally- and educationally- appropriate pesticide safety intervention for farm worker families into public health practice. The specific aims are: (1) to implement a demonstration project translating an effective intervention to reduce pesticide exposure among families of Latino farm workers to a broader public health context; (2) to evaluate the potential translatability and public health impact of this pesticide exposure intervention; and (3) to disseminate the program through public health programs at the local, regional and national levels. The content of the intervention includes six general modules using active learning methods supported by materials designed for low-literacy adults. These modules address routes of pesticide exposure, procedures for keeping agricultural pesticides from entering the home, methods for removing pesticides from the home, using residential integrated pest management rather than pesticides to control pests, and methods to convince others to change behaviors. A seventh module addresses pesticide safety during pregnancy. Ten lay health advisors (promotoras de salud) will be placed with six collaborating community public health agencies in a 13 county area of eastern North Carolina. Promotoras will recruit farm worker families with at least one child under 12 and provide pesticide health and safety training, using a curriculum previously demonstrated to change knowledge of and behaviors toward pesticides. Liaisons from the community agencies will assist promotoras in locating farm worker families from their clientele and in carrying out the program. Pre- and post intervention interviews will measure knowledge and behavior. Guided by a logic model, the program evaluation will focus on short term outcomes (increased individual knowledge about pesticide safety; greater mastery of specific behaviors to reduce pesticide exposure; increased the capacity of local public health agencies to prevent pesticide-related illnesses) and longer term outcomes (reductions in pesticide-related illnesses and the diffusion of this program into the broader network of public health agencies). The potential translatability and public health impact of the intervention will be assessed. PUBLIC HEALTH RELEVANCE: This project will provide an effective, educationally- and culturally-appropriate pesticide safety program to families of Latino migrant and seasonal farm workers. Because pesticide exposure has long-term health effects on children and adults, this program can result in decreases in the neurological, cancer, and developmental defects that have been associated with exposure.