Sustaining a risk reduction and safety practices intervention model: A randomized control study Examining the effects of transferring the community health worker model to an occupational agricultural setting

Hispanic immigrants face numerous challenges in the US. In occupational settings, workers struggle between keeping their job, staying safe, and navigating the worker protection and health systems. As stated by David Michaels, OSHA Assistant Secretary, “Latino workers face the most dangerous working conditions and the fewest protections.” This is particularly challenging in high risk industries such as agriculture. Our comprehensive intervention is based on multiple approaches to reduce work-related injuries and diseases in dairy. It consists of a farm risk reduction component coupled with a worker educational component, and reinforced with a network of promotores de salud (PdS). The farm component consists of a hazard identification and remediation plan. The worker educational component addresses knowledge, attitudes and practices (KAP) and integrates concepts from the Health Belief Model, Risk Prevention, and the Taxonomy of Significant Learning. Finally, we applied the principles of the Community Health Worker (CHW) model to an occupational setting by creating a network of PdS to sustain the effects of the intervention, reinforce knowledge and practices, and serve as liaison between farmers and workers.

A randomized controlled study was designed to examine this model on 90 farms with an estimated total of 500 Hispanic workers. The effects of the intervention on risk reduction and safer practices were associated with the PdS component as an independent factor. Preliminary results show the effects on farm risk reduction practices, workers' injury reports and knowledge changes, and the analysis of the effectiveness of applying the CHW model to an occupational setting.