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

说明（由申请人提供）：适足住房是一项基本人权。然而，有限的研究表明，住房不足是北卡罗来纳州和美国东南部农场工人所忍受的所有不公正和不公平条件中最基本的。这些研究都没有审查作为一种环境健康风险的住房不足与农场工人或其家庭健康之间的关系。拟议的研究直接建立在我们成功的少数民族农场工人职业皮肤病项目（R01 ES012358）以及其他几个以社区为基础的参与性研究（CBPR）项目的基础上，这些项目已经解决了农场工人的环境健康风险。我们的研究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，是由室内暴露引起的。其他分析表明，农场工人及其家庭成员在家中暴露于杀虫剂。总之，这项工作表明需要对农场工人的住房进行研究。北卡罗莱纳州农场工人倡导网络已经确定农场工人住房是一个主要问题。我们研究小组的CBPR方向需要关注农场工人的住房条件及其对农场工人健康的影响，作为对农场工人、农场工人卫生保健提供者和农场工人倡导者所表达的主要关切的回应。该项目基于农场工人、农场工人社区组织、农场工人倡导者和健康科学调查人员之间长达15年的合作。在这次合作中，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经验和看法，以及他们如何将住房质量与他们的健康联系起来；(2)评估农场工人住房，并描述农场工人住房与暴露的关系，并通过居民特征和行为调节；(3)描述农场工人住房暴露与农场工人健康指标的关系；(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，农场工人可以利用这些形式改善他们的住房或减少他们的健康风险；(5)与农场工人倡导者合作，影响公共卫生、职业安全和住房政策，以提高农场工人居住的住房质量，减少不合格住房对健康的负面影响。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的经历和对住房质量的看法及其与健康的关系。第二，它将记录200个农场工人营地和200个农场工人家庭住宅的住房质量，并审查住房质量与健康指标的关系。第三，实施向农民返还信息的计划。第四，实施解决州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庭面临许多环境和职业健康危害，他们受伤和患病的比例很高。农场工人及其家庭的一个主要接触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基于北卡罗来纳州农场工人项目、农场工人学生行动、农场工人倡导网络、几个移民诊所和维克森林大学医学院的合作。它将记录农场工人的住房条件，确定住房条件与健康结果之间的联系，向农场工人传播可用于改善其住房的信息，并处理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.