Engaging Ethnic Community Agencies in Adopting Basic Worker Health Education

描述(由申请者提供)：少数族裔移民在健康状况和医疗保健方面的显著差距令人震惊，但对美国公共卫生来说仍未解决。与土生土长的移民群体相比，这一移民群体在低工资和本质上危险的工作中所占比例过高，在这些工作中，他们面临着更大的危险暴露、伤害和疾病。针对低工资移民工人的现场实施而设计的相对不成功的职业卫生预防工作，迫使人们重新思考干预战略，并优化以社区为重点、以网络为导向的新方法。族裔社区机构是重要但未得到充分利用的资产，能够为合作的社区职业卫生办法提供必要的基础。这项研究将调查基本工人健康教育(WHEB)在社区机构内和由社区机构整合的情况，以便接触到广泛的华裔美国移民。研究目标是：目标1：通过参与服务提供者的社区咨询小组，评价和加强WHEB材料在社区机构中使用的适当性、可理解性和可行性；目标2：描述与社区机构对计划变化的方法相关的组织内和组织外因素，以及机构参与采用WHEB作为服务创新的开放性；以及目标3：使用试点实施试验，描述WHEB整合在不同社区机构环境中的实施过程(规划、交付模式选择)和结果(适宜性、持续性)。将在不同研究目标之间采用混合方法设计。熟悉中国文化和机构工作流程的双语服务提供商(目标1)将对WHEB材料的原型进行评论，这些材料基于OHSA、L&I和NIOSH制定的指导方针。以机构为观察单位，21个华人社区机构和23个非华人社区机构的中高级管理人员将接受访谈，讨论与机构对项目变更的方法和采用WHEB的开放程度相关的因素(目标2)。我们将从八个表示有兴趣将WHEB纳入其服务的机构中随机抽取一个样本；一名OH教育者将与每个机构合作，对WHEB材料集进行试点实施试验(目标3)。随着在线调查(实施后和后续行动)由每个机构的两名代表完成，我们将收集关于具体执行过程和结果变量的数据。我们将把俄亥俄州教育者的参与者观察纳入分析，整合定量和定性数据，以提供关于社区机构如何推进WHEB采用新计划想法的直接和实用的知识。这一发展项目直接响应了Nora计划和NIOSH对解决OH差距的新方法的呼吁。结果，包括针对中国移民的WHEB材料，将被用于开发一项更大的社区干预试验。所产生的知识将促进社区合作伙伴选择和干预设计的转化研究，以增加OH计划在社区中的传播和可持续性。

DESCRIPTION (provided by applicant): Marked disparities in health status and health care access among immigrant ethnic minorities are alarming, and yet unaddressed issues for American public health. Compared to their native-born counterparts, this immigrant group is overrepresented in low wage and intrinsically dangerous jobs where they experience greater risks of hazard exposure, injury, and illness. Relatively unsuccessful OH prevention efforts, designed for worksite implementation with low-wage immigrant workers, compel re-thinking intervention strategies and optimizing novel community-focused, network-oriented approaches. Ethnic community agencies are important but underutilized assets capable of providing the essential building blocks for collaborative community OH approaches. This research will investigate the integration of basic worker health education (WHEB) in and by community agencies in order to reach a broad range of Chinese American immigrants. Study aims are: Aim 1: Critique and enhance WHEB materials for appropriateness, comprehensibility, and viability for use in community agencies, by engaging a community advisory panel of service providers; Aim 2: Characterize intra- and extra-organizational factors associated with community agency approaches to program changes, and agency openness to engage in adopting WHEB as a service innovation; and Aim 3: Describe the implementation process (planning, delivery model selection) and outcomes (suitability, continuation) of WHEB integration in diverse community agency settings, using a pilot implementation trial. A mixed-methods design will be used across study aims. Bilingual service providers familiar with Chinese culture and agency workflow (Aim 1) will critique the prototype WHEB materials, which are based on guidelines developed by OHSA, L&I and NIOSH. With agencies as observational units, middle/high level administrators from 21 Chinese and 23 non-Chinese community agencies will be interviewed regarding factors associated with agency approaches to program changes and openness to adopt WHEB (Aim 2). We will randomly select a sample of eight agencies that express interest in integrating WHEB into their services; an OH educator will work with each agency to conduct the pilot implementation trial for the set of WHEB materials (Aim 3). With online surveys (post- implementation & follow-up) completed by two representatives per agency, we will collect data on the specific implementation process and outcome variables. We will incorporate the OH educator's participant- observations into the analysis, integrating quantitative and qualitative data to provide direct and practical knowledge about how community agencies move forward in adopting new program ideas for WHEB. This developmental project responds directly to NORA programs and NIOSH's call for novel approaches to address OH disparities. Results, including Chinese immigrant targeted WHEB materials, will be used to develop a larger community intervention trial. Knowledge generated will advance translational research for community partner selection and intervention design to increase OH program diffusion and sustainability in communities.