Navigating the Waters of the US Healthcare System: Improving the Biopsychosocial Health of Fishing Industry Workers

项目摘要/摘要 研究表明，工伤可以预测身体疾病、精神健康和药物滥用， 众所周知，这些因素是导致高职业伤害率的因素。这种双向 对于暴露于社会健康决定因素(SDoH)的人来说，这种关系尤其强烈，比如危险 工作条件和有限的病假福利，以及那些无法随时获得预防措施的人 医疗保健。一个可能导致高伤害和物质滥用的职业是商业职业。 钓鱼。初级和二级预防干预措施，如增加使用医疗保健导航器 并强调SDoH已被证明有效地改善了 历史上被边缘化的人群。医疗保健导航员连接到社区(例如，妻子或孩子 渔民)，并与接受医疗保健的参与者建立和保持关系 或者需要帮助寻找社会服务。可以在以前的SDoH基础上构建更细微的范例 让医疗保健导航员参与的研究，以促进渔民的生物、心理和社会福祉，包括 研究工作场所危害和物质滥用之间的关系；筛查身体状况， 心理和行为健康问题；并参考相关的医疗保健专业人员或 职业辅导员。具体地说，我们将1)检查职业之间的联系和潜在的机制 通过进行半结构化访谈和参与者了解伤害和物质滥用以了解临床需求 观察2)通过确定和解决以下问题来实施和研究医疗保健导航员的可行性 导致伤害和物质滥用增加的生物、心理和社会因素，以及3)评估是否以及如何 商业渔民使用和使用医疗保健导航器，以减少伤害和物质使用。在……里面 除了扩大渔业伙伴机构之间在处理伤害和物质问题上的合作外 误用，这是首批实施和评估使用医疗保健导航器可行性的项目之一 与墨西哥湾沿岸的捕虾渔民合作，以改善生物心理社会健康。

PROJECT SUMMARY/ABSTRACT Work-related injuries have been shown to predict physical illness, mental wellbeing, and substance misuse, and these latter factors are known contributors to high rates of occupational injury. This bidirectional relationship is particularly strong for people exposed to social determinants of health (SDoH) like dangerous work conditions and limited sick leave benefits, as well as those who lack ready access to preventive healthcare. One occupation suspectable to potentially high rates of injury and substance misuse is commercial fishing. Primary and secondary prevention interventions, such as increasing the use of healthcare navigators and emphasizing the SDoH have been shown to effectively improve biopsychosocial health disparities among historically marginalized populations. Healthcare navigators are connected to the community (e.g., wife or child of fishermen) and establish and maintain relationships with the participants who are receiving healthcare services or need assistance finding social services. A more nuanced paradigm can build on previous SDoH research that engages healthcare navigators to facilitate biopsychosocial well-being for fishermen, including studying the relationship between workplace hazards and substance misuse; screening for physical, psychological, and behavioral health problems; and referring to relevant healthcare professionals or paraprofessionals. Specifically, we will 1) examine the link between and mechanisms underlying occupational injuries and substance misuse to inform clinical needs by conducting semi-structured interviews and participant observation 2) implement and study the feasibility of healthcare navigators by identifying and addressing biopsychosocial factors that lead to increased injury and substance misuse, and 3) evaluate whether and how commercial fishermen use and access the healthcare navigators to reduce injury and substance use. In addition to extending collaborations among fishing partnership agencies on addressing injury and substance misuse, this is among the first projects to implement and evaluate the feasibility of using healthcare navigators with Gulf Coast shrimp fishermen to improve biopsychosocial health.