Community-Based Participatory Approach to Farmworker Housing, Exposures & Health

说明(申请人提供)：适足住房是一项基本人权。然而，已经进行的有限研究表明，住房不足是北卡罗来纳州和美国东南部农场工人忍受的所有不公正和不公平条件中最基本的。这些研究都没有研究住房不足，作为一种环境健康风险，如何与农场工人或他们的家人的健康相关。拟议的研究直接建立在我们成功的少数民族农民职业性皮肤病项目(R01 ES012358)以及其他几个针对农场工人环境健康风险的社区参与性研究(CBPR)项目的基础上。我们的结果记录了农场工人经历的最普遍的皮肤问题，特别是传染病，是由房屋暴露引起的。其他分析表明，农场工人和他们的家庭成员在家中接触到杀虫剂。总而言之，这项工作表明有必要对农场工人住房进行研究。北卡罗来纳州农民倡导网络已将农场工人住房确定为一个主要问题。我们研究小组的CBPR方向要求重点关注农场工人的住房条件及其对农场工人健康的影响，以回应农场工人、农场工人医疗保健提供者和农场工人倡导者表达的主要关切。该项目基于农场工人、农场工人社区组织、农场工人倡导者和卫生科学研究人员之间长达15年的合作。在这项合作中，这项研究将实现五个具体目标：(1)描述农场工人对他们居住的住房质量的体验和看法，以及他们如何将住房质量与他们的健康联系起来；(2)评估农场工人的住房，并描述农场工人住房与受居民特征和行为控制的暴露之间的联系；(3)描述农场工人住房暴露与农场工人健康指标之间的联系；(4)以文化和教育上适当的形式向农场工人传播这项研究的结果，农场工人可以使用这种形式来改善他们的住房或减少他们的健康风险；以及(5)与农场工人倡导者合作，影响公共健康、职业安全和住房政策，以提高农场工人居住的住房质量，减少不合格住房的负面健康后果。该项目有四个主要组成部分。首先，它将使用系统的定性研究设计来记录农场工人对住房质量及其与健康的联系的经验和看法。其次，它将记录200个农场工人营地和200个农场工人家庭的住房质量，并审查住房质量与健康指标的关联。第三，将实施向农场工人返还信息的计划。第四，它将实施一项解决国家和国家农民工住房政策的计划。公共卫生相关性：移徙和季节性农场工人及其家人暴露在许多环境和职业健康危害中，他们的受伤和疾病发生率很高。农场工人及其家人面临的一个主要风险来源是他们居住的住房。这个以社区为基础的参与性研究项目将以北卡罗来纳州农民项目、农民学生行动、农民倡导网络、几个移民诊所和维克森林大学医学院的合作为基础。它将记录农场工人的住房条件，确定住房条件与健康结果的关联，向农场工人传播信息，他们可以利用这些信息来改善他们的住房，并解决改善农场工人住房所需的政策变化。

DESCRIPTION (provided by applicant): Adequate housing is a fundamental human right. However, the limited research that has been conducted demonstrates that inadequate housing is the most basic of all of the unjust and inequitable conditions that farmworkers in North Carolina and the southeast US endure. None of this research has examined how inadequate housing, as an environmental health risk, is related to the health of farmworkers or their families. The proposed research builds directly on our successful project Occupational Skin Disease among Minority Farmworkers (R01 ES012358), as well as several other community-based participatory research (CBPR) projects that have addressed the environmental health risks of farmworkers. Our results document the most prevalence skin problems experienced by farmworkers, particularly infectious diseases, are caused by exposures in houses. Other analyses document that farmworkers and the members of their family are exposed to pesticides in their homes. Together, this work indicates a need for research focused on farmworker housing. The North Carolina Farmworker Advocacy Network has identified farmworker housing as a major concern. The CBPR orientation of our research group requires a focus on farmworker housing conditions and their effects on farmworker health as a response to major concerns voiced by farmworkers, farmworker health care providers, and farmworker advocates. This project is based on a15 year collaboration among farmworkers, farmworker community-based organizations, farmworker advocates, and health science investigators. Within this collaboration, this research study will achieve five specific aims: (1) describe the experiences and perceptions of farmworkers concerning the quality of housing in which they live and how they relate housing quality to their health; (2) evaluate farmworker housing and delineate the associations of farmworker housing with exposures as moderated by resident characteristics and behaviors; (3) delineate the association of exposures in farmworker housing with indicators of farmworker health; (4) disseminate the results of this research to farmworkers in culturally and educationally appropriate formats that farmworkers can use to improve their housing or reduce their health risks; and (5) collaborate with farmworker advocates to affect public health, occupational safety and housing policy to improve the quality of housing in which farmworkers live and reduce the negative health outcomes of substandard housing. The project has four major components. First, it will use a systematic qualitative research design to document farmworker experiences and perceptions of housing quality and its association with health. Second, it will document housing quality in 200 farmworker camps and 200 farmworker family homes, and examine the association of housing quality with health indicators. Third, it will implement a plan to return information to farmworkers. Fourth, it will implement a plan to address state and national farmworker housing policy. PUBLIC HEALTH RELEVANCE: Migrant and seasonal farmworkers and their families are exposed to numerous environmental and occupational health hazards, and they experience high rates of injuries and illnesses. A major source of exposure for farmworkers and their families is the housing in which they live. This community-based participatory research project will be based on a collaboration of North Carolina Farmworkers Project, Student Action with Farmworkers, Farmworker Advocacy Network, several migrant clinics, and Wake Forest University School of Medicine. It will document the housing conditions of farmworkers, determine associations of housing conditions with health outcomes, disseminate information to farmworkers that they can use to improve their housing, and address policy changes needed to improve farmworker housing.