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原文传递 Promotoras and Hispanic Workers' Occupational Health in Post-Katrina New Orleans.

题名：	Promotoras and Hispanic Workers' Occupational Health in Post-Katrina New Orleans.
作者：	Lara, M.; Díaz, C.; Geschwind, S.; Han, B.; Calderón, J.; Tarver, M.
关键词：	Construction workers, Community health, Immigrant workers, Health disparities, Language barrier, Health promotion, Intervention effectiveness, Occupational health programs, National Institute for Occupational Safety and Health ( NIOSH)
摘要：	Hispanic construction workers, particularly foreign-born workers who have immigrated recently, experience a variety of adverse working conditions. They have lower rates of health insurance, lower rates of unionization, lower hourly wages, lower educational levels, fewer years of construction experience, and tend to be concentrated in lower skilled and more hazardous occupations such as day laborers and roofers. Immigrant Hispanic construction workers have been classified by the National Occupation Research Agenda as a vulnerable worker group. The New Orleans environment exemplifies the barriers faced by Hispanic workers in the US. Many of the Hispanic workers who helped rebuild after Hurricane Katrina stayed in the area as day laborers continuing to experience occupational risks and unmet health needs. Locals report how lack of employers' compliance with OSHA standards is common. After the hurricane, organizations such as Common Ground Health Clinic (CHGC) developed programs to address the needs of this population while obtaining their trust since fears of deportation among undocumented workers are common. The goal of this exploratory grant was to improve Spanish-speaking day laborers' knowledge and use of preventive behaviors regarding occupational health risks. The research question guiding the study was: Can a brief educational video featuring a male (promotor) and female (promotora) community health worker increase knowledge and intended use of preventive behaviors regarding occupational risks among Hispanic day laborers? To address this question, RAND Corporation collaborated with CGHC to successfully implement a randomized controlled trial to evaluate changes in worker's knowledge and use of preventive behaviors as a result of the video intervention. The project assessed pre- and post- knowledge about occupational health risks as well as workers' intent to change behaviors to reduce related occupational risks as a result of the intervention. After a baseline knowledge survey, 98 Hispanic day laborers were randomized into a video or control group. Day workers were recruited from CGHC main clinic site and its mobile clinic meeting day laborers at street corner locations where they congregate to wait for contractors to offer them jobs. The intervention was developed and piloted by a joint investigator-community team to promote its feasibility and acceptability. Focus groups of Hispanic workers were conducted as part of the formative assessment. The video promotor(a) intervention was associated with statistically significantly improved knowledge and intended behavior outcomes, compared to the control. In other words, once 'treated' (saw the video) participants reported significant improvements in survey measures related to knowledge about occupational risks and how to avoid them, as well as their intent to engage in preventive behaviors to reduce these risks. The results this pilot study increased our understanding of working conditions experienced by Hispanic day laborers and contributed new knowledge about the effectiveness of promotor(a) interventions, in general, and video interventions, specifically, to address occupational health disparities. Lessons learned about the efficacy of the video intervention can inform other interventions to reduce occupational risk in vulnerable workers nationwide. Based on these data, the research team is considering options for scaling up the intervention and conducting a larger-scale effectiveness trial.
报告类型：	科技报告