Logic Model – Research Project 3: Pesticide and heat stress education for Latino farmworkers that is culturally appropriate

Situation
Exposure to pesticides and extreme heat are among the dominant health threats to farmworkers in crop production in the Southeast. Farmworkers are a vulnerable, medically underserved and health disparate population. Many farmworkers in the U.S. are Latino (82%), are born in Mexico (74%), and lack legal authorization to work in the U.S. (50%). Rigorous evaluation of farmworker pesticide and heat stress training is scant. Additionally, changes in the Worker Protection Standards (WPS) necessitate substantial changes to existing training for farmworkers and these trainings require assessment.

Inputs
This project is guided by conceptual and operational models for community-based participatory research (CBPR) that both principal investigators have engaged in for over 10 years with immigrant Latino communities. At the core of this model is a shared commitment of community advocates and academic researchers. There are three major community partners on this project. The first is the Farmworkers Association of Florida, whose mission is to build power among farmworker and rural low-income communities to respond to and gain control over the social, political, workplace, economic, health, and environmental justice issues that impact their lives. The second community partner is the Migrant Farmworkers Clinic. Outreach from the Clinic staff play a fundamental role in meeting the health and social needs of the farmworker community in this region. Finally, Trejo Management, LLC adds the business perspective to this project. Trejo Management offers employment to over 600 immigrant Latino farmworkers annually in southern GA. Trejo Management is an essential community partner ensuring access to farmworkers in the region, and for providing guidance on designing curricula responsive to the needs of growers and agricultural owners/operators.

Activities
This study will be executed in three phases. Phase 1 of the study will involve 125 farmworkers. Recruitment will occur at advertised local training sessions held in farmworker communities. Farmworkers will be randomly selected from local training session participants, and randomly assigned to receive heat related illness (HRI) training or pesticide safety training outlined in Worker Protection Standard (WPS) curriculum designed by the research team. Participants will be interviewed by trained research staff before the training, and again after the training. Pre-interviews will collect baseline knowledge, attitude and behavior related to HRI and pesticide safety. Post-interviews will measure changes in knowledge, attitudes and behavior intentions regarding HRI and pesticide safety.

Phase 2 of the study will involve 325 farmworkers, recruited at random from local training sessions, as in Phase 1. They will be randomly assigned to receive HRI training, WPS training designed by the EPA, or regionally-specific, culturally-appropriate WPS training designed by the research team. Pre- and post-interviews will collect the same information as Phase 1, as well as demographic information and occupational characteristics. The same outcomes will also be analyzed. However, in Phase 2, follow up interviews will be conducted three months after the trainings to measure self-reported behavior regarding HRI and pesticide safety.

Phase 3 of the study will involve 400 farmworkers, recruited at random from local training sessions, as in Phases 1 and 2. They will be randomly assigned to receive either HRI training, or whichever WPS training was determined to be more effective in Phase 2. However, in Phase 3, local training sessions will be taught by promotoras, who are trained lay community health educators. The use of highly trained professional staff under controlled conditions is likely not sustainable, particularly in rural regions of the country. This phase of the project will determine the comparative effectiveness of changes in knowledge, attitudes and behavioral intentions resulting from promotora-based curriculum dissemination as opposed to professional trainer-based curriculum dissemination. These changes will be determined using pre- and post- interviews as in Phases 1 and 2.

Outputs
Current EPA WPS training on pesticide safety uses materials that are broad and generic, thus lacking relevance to farmworkers in Southeastern coastal region. This project will develop culturally-appropriate, regionally-specific trainings tailored to specific farmworker populations to maximize their effectiveness.
Additionally, this project will develop survey tools that will evaluate the effectiveness of these curricula and training delivery throughout all three phases of the study. These tools will measure knowledge, attitudes, behavior intentions and behavior regarding HRI and pesticide safety.

Pre-interview instruments will collect demographics and occupational information about farmworkers, including age, sex, educational attainment, tenure with current employers, and commonly performed farm tasks. This project will create a database to organize and track these characteristics.
Finally, this project will train laypeople in the community to participate in the study, and fortify the network of connections between researchers, farmworker organizations and farmworkers by training two community advocates and two promotoras.

Outcomes
Short-term outcomes of this project include changes in knowledge, attitude, and behavioral intentions in farmworkers regarding pesticide safety and HRI. Medium-term outcomes include changes in behavior in farmworkers regarding pesticide safety and HRI. Ultimately, the long-term outcomes of this project include reduced pesticide exposure, heat stress, and health disparities among farmworkers. This project will educate up to 3500 farmworkers during local training sessions over the course of the study.
Not only that, if the materials, curriculum and training delivery created in this project are certified for use in EPA WPS training, they can be distributed all over the Southeast, multiplying the effect of these outcomes.