Exploratory Research / Feasibility Studies

CT CBPR

NEC partnered with University of Connecticut (UCONN) to use community based participatory research (CBPR) as a means of reducing occupational injuries experienced by farmworkers employed at shade tobacco farms in the Connecticut River Valley. Focus groups, work team meetings and other face-to- face meetings with the workers and growers identified several occupational health issues. Three farms initially joined the coalition. Medical chart review data was collected from UCONN's mobile clinic which services these farms. Skin irritation (38%), musculoskeletal pain and strain (35%), and eye irritation (14%) were the most prevalently diagnosed occupational injuries. Intervention discussions by the CBPR Work Team revealed two opposing views of why skin and eye irritation were problems  problems with worker hygiene vs. adequacy of field sanitation stations. Initial field observations and reports of workers suggested that most farms did not reliably have soap and towels available in the fields. Education of both employers and workers became a focus to address these different perspectives.

The Work Team established and developed multidimensional interventions for both growers and farm workers. The primary objective of the interventions was reduction of work-related eye and skin irritation. Interventions for farmworkers included personal hygiene training (during work in the fields and after work at their barracks) and the provision of personal protective equipment incentives (no-cost protective glasses, sweat bands, gloves and other personal protection kits). Interventions for growers focused on ways to enhance and reinforce the availability of field personal hygiene for workers. Researchers created low cost solutions for paper towel dispensers and "soap on a rope" (bar soap tied in nylon socks). One participating farm modified their water stations with more spigots for easier worker access. Follow up shows high rates of field sanitation compliance.

Since 2006, the project has trained over 1,500 farmworkers on workplace health and safety practices to reduce eye and skin irritation. During 2010, the Work Team identified the need to continue health and safety trainings on farms once the research ends, and therefore, new collaborations were sought to introduce another training intervention. The Work Team contacted Eastern CT AHEC, a group that established several effective Promotores de Salud Programs for farmworkers (community health advocate programs). These programs train workers within their community to provide public health education. Scientific literature supports the community health worker model as an effective intervention to prevent and control chronic diseases and illnesses. Promotores increase access to health and social services; deliver culturally acceptable health education and advocate for individual and community health needs. Material development and promotores training has been completed.

Project Update:
In 2011, eleven workers at the largest participating farm received instruction as farm health and safety promotores. Low literacy, bi-lingual education material was developed by the site coordinator, research coordinator, AHEC student volunteers, and UCONN staff. The promotores participated in twelve hours of instruction. Over the course of six weeks, seven promotores delivered components of the safe work practice training to 114 workers. The promotores also reported they engaged an additional five groups of workers, but exact attendance was not accounted for. Outreach staff assisted the promotores in data collection. Promoters received compensation in the form of gift cards and an end of season celebration. Many of these promoters return to work in Connecticut tobacco year after year. They were interested in continuing as promotores and requested training in other health topics such as blood pressure monitoring and first aid.

The Farm Health and Safety Promoters program continued during the 2012 growing season at the same farm. A total of 13 workers participated, sharing safe work practices such as hygiene and hydration in 552 coworker encounters. One promotoro participated both years. They received the same twelve hour training but felt more training would assist them to be bettered prepared to help their coworkers. This group also became certified in first aid. Data collection and compensation were consistent with the first year of the program.