Engaging Ethnic Community Agencies in Adopting Basic Worker Health Education

描述（由申请人提供）：移民少数民族之间的健康状况和医疗保健获得的显着差异令人震惊，但美国公共卫生尚未解决的问题。与本土出生的移民相比，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，他们面临更大的危险暴露，受伤和疾病的风险。相对不成功的OH预防工作，旨在与低工资的移民工人的工地实施，迫使重新思考干预策略和优化新的社区为重点，网络为导向的方法。少数民族社区机构是重要的，但未充分利用的资产，能够提供必要的积木协作社区OH的方法。本研究将调查社区机构中的基本工人健康教育（WHEB）的整合，以达到广泛的华裔美国移民。研究目的是：目标1：通过与服务提供商组成的社区咨询小组合作，对WHEB材料的适当性、可理解性和可行性进行评论和改进，以供社区机构使用;目标2：描述与社区机构方案变更相关的组织内外因素，以及机构将WHEB作为服务创新的开放性;目标3：描述的实施过程（规划，交付模式的选择）和结果（适宜性，持续）的WHEB整合在不同的社区机构设置，使用试点实施试验。将在研究目的中使用混合方法设计。熟悉中国文化和机构工作流程（目标1）的双语服务提供者将对WHEB原型材料进行评论，这些材料基于OHSA，L & I和NIOSH制定的指南。以机构为观察单位，将采访来自21个华人社区机构和23个非华人社区机构的中/高层管理人员，了解与机构对项目变更的态度和采用WHEB（目标2）的开放性相关的因素。我们将随机选择八个机构表示有兴趣将WHEB整合到他们的服务中; OH教育工作者将与每个机构合作，为WHEB材料集（目标3）进行试点实施试验。通过每个机构两名代表完成的在线调查（实施后和后续行动），我们将收集有关具体实施过程和结果变量的数据。我们将把OH教育工作者的参与者-观察到的分析，整合定量和定性数据，以提供有关社区机构如何在采用新的方案思路为WHEB前进的直接和实用的知识。这个发展项目直接响应诺拉计划和NIOSH的呼吁，新的方法来解决OH的差距。结果，包括针对中国移民的WHEB材料，将用于开发更大的社区干预试验。所产生的知识将推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.