Farmers and farmworkers are at a high risk for development of musculoskeletal symptoms due to the physically demanding nature of their work environment, the repetitive nature of many agricultural tasks, and the time-dependent nature of agricultural work that often requires greater than full-time hours at various times of the year. The purpose of this dissertation was to gain a better understanding of musculoskeletal symptom prevalence in Iowa farmers, examine age-related effects, determine how those symptoms related to safety on the farm, and to determine musculoskeletal symptom prevalence in migrant farmworkers in Iowa on H-2A Visas. Study data of 438 Iowa farmers was examined retrospectively through a cross-sectional survey that examined musculoskeletal symptoms prevalence, safety scores of the farm environment, and health-seeking behaviors of this population. This study found prevalence rates that varied from 28% (elbow) to 73% (back) with 4.15 (S.D. = 2.75) average painful joints. More farmers in the older age category were in the lower safety category. Significant predictors of seeking healthcare due to musculoskeletal symptoms included arthritis, employee help on the farm, hip pain, or upper back pain. Migrant farmworkers who were in Iowa on an H-2A Visa for agricultural work were surveyed about their musculoskeletal symptom prevalence at the beginning of their work contract in Iowa. The data from these 180 migrant farmworkers was compared to the National Agricultural Workers Survey. A chart review was completed that provided information about musculoskeletal symptoms throughout the contracted work period and also information about the treatment provided through the non-profit migrant health clinic. Baseline prevalence varied from 1.4% (hip) to 15.9% (neck) with 56 (39.7%) workers reporting 1 or more painful joints. Throughout the contracted work, 33.6% of visits were attributed to musculoskeletal complaints with farmworkers over 35 being 2.5 times more likely to have musculoskeletal complaints (OR = 2.5; 95% CI: 1.1-5.5). The information from these studies provides support for the need to develop and test interventions to prevent musculoskeletal symptom development in agricultural worker populations.

The province of Ontario is the primary focus of a growing body of research discussing migrant agricultural labour in Canada. This thesis shifts the focus of inquiry to Quebec, a province that has not received the attention it warrants, given that it is “home” to the second largest temporary migrant population in Canada. Currently, Mexicans constitute the bulk of labourers contracted through the Seasonal Agricultural Worker Program (SAWP). With the establishment in 2003 of the Foreign Worker Program (FWP), however, the number of Guatemalans on the Quebec scene has increased significantly. The situation of workers from both countries is addressed in the form of a case study of St. Rémi. The thesis argues that the migrant experience in St. Rémi is characterized by a struggle to cope with: (1) an “unfree” labour status; (2) social and geographical isolation; and (3) lack of social assistance and community acknowledgement. An attempt is made to give migrant workers a voice, since their contribution for the most part is either unknown or unappreciated. The support system now in place in St. Rémi affords migrants some minimal rights, but much remains to be done, in Quebec and across Canada, to make the plight of workers better known and their situation improved. / Thesis (Master, Geography) -- Queen's University, 2007-09-27 22:28:11.532

This case study examined coping strategies and support systems utilized by 33 children of Hispanic migrant farmworkers from Fabens, Texas. The youth participated in the summer 2011 Creative Kids Incorporated Migrant Program in El Paso, Texas. The study examined how socio-ecological factors, specifically within Creative Kids Inc., help youth to cope with risk factors and aid in the resilience process. This study applied both qualitative and quantitative approaches. The qualitative portion consisted of 12 in-depth program participant interviews, ages 9-15, and observations at Creative Kids Inc. The quantitative portion consisted of a survey that utilized the Brief Adolescent Life Event Scale, the Children Coping Strategies Checklist, and the Multi-Dimensional Support Scale. Thirty-four surveys were distributed, and 33 surveys were analyzed from program participants ages 10-15. The study found the youth were affected by various risk factors within their environment, such as poverty, separation from family, and school. When adapting to stress, most youth utilized behavioral-based distraction strategies (i.e., listening to music and playing outside) and cognitive-based avoidance strategies (i.e., not thinking about their problem) to cope. The youth did not use active coping strategies as often as avoidance strategies. However, some support seeking strategies were mentioned. Most often, youth sought support from parents and older siblings. While the youth sought support from their teachers, it was mainly in regard to school work. Similarly, youth sought support from Creative Kids Inc. staff concerning their art projects. Families were beneficial to youth in the coping process, because they provided youth with opportunities for distracting activities as well as some support. Although the youth strongly enjoyed participating in the Migrant Program, they rarely sought support for personal stressors or problems from the staff. Yet, the program provided youth with opportunities to participate in distracting activities, express their feelings, and seek out support. Despite the lack of literature on children of Hispanic migrant farmworkers and the factors that influence their resilience, this study provided an in-depth description of how they cope with daily life events, what support systems are available to assist in overcoming risks, and provided a basis for understanding the role of support systems in facilitating resiliency among this adolescent group.

The present study examined the efficacy of two parent training programs in reducing perceived parental stress in a sample of Spanish speaking migrant farmworkers of Hispanic origin. Sixty-eight Spanish-speaking mothers, referred for parenting classes because one of their children was experiencing behavioral or emotional difficulties, were randomly assigned to one of four treatment conditions: (1) 1-2-3 Magic, a behaviorally-based program; (2) Systematic Training for Effective Parenting (STEP), an Adlerian-based program; (3) attention-placebo condition; and, (4) wait-list control group. All treatment conditions were presented in Spanish, and offered at convenient times and locations for participants. Parental stress was measured with the Spanish version of the Parenting Stress Index-Short Form (PSI-SF), using the Total Stress Score, and the three subscale scores: Parental Distress Score, Parent-Child Dysfunctional Interaction Score, and Difficult Child Score. Assessments were completed at pretest, posttest, and at a three-month follow-up. A repeated-measures multivariate analysis of variance on the dependent measures revealed significant differences for groups across the three assessment periods. Subsequent analyses indicated that the behaviorally-based program produced significantly greater reductions on the Total Stress Score and Parental Distress Score at posttest and follow-up than the Adlerian program, the attention-placebo group, and the wait-list group. The behaviorally-based program was also more effective in reducing parent-child dysfunctional interaction than the attention-placebo group at posttest and follow-up, and the wait-list control group at follow-up, but not in comparison to the Adlerian program. These results lend support for behaviorally-based parent training in reducing perceived parental stress in this migrant farmworker population. To ensure treatment integrity, a parent trainer validity check was used in which expert parent educators rated randomly selected videotaped segments of each parent training session on five criteria. Statistical analysis of treatment validity revealed no significant differences in mean scores of expert raters across parenting groups, suggesting that the parent trainer behaved consistently on the criteria across all treatment conditions. The results are also discussed in relation to the literature on parent training. In addition, the limitations of the present study, as well as future directions for research are discussed.

There are over 3 million seasonal and migrant farmworkers in the U.S. agricultural industry with a significant percentage of farmworkers documented or native to the United States. Migrant farmworkers live below the federal poverty levels at high rates and experience low health care access and utilization. Guided by the fundamental cause theory, the purpose of this phenomenological study was to examine the lived experiences of migrant farmworkers and identify the factors impacting their health care access and utilization. Face-to-face interviews were conducted with 12 migrant farmworkers who had worked in Southwest Texas agricultural stream. Data were analyzed and coded to identify themes. Findings indicated that although lack of health insurance was a decisive factor in whether migrant farmworkers accessed or utilized health care services, distance to services, inflexible working hours, and cultural factors related to seeking care also influenced participants' lack of access to and utilization of health care services. Results may be used to aid local, state, and federal agencies in assisting migrant farmworkers in bridging the gap in health care and obtaining needed services.

There are three to five million migrant and seasonal farmworkers in the United States that work in one of the most hazardous industries. They are exposed to numerous occupational and non-occupational injuries and illnesses daily, including but not limited to, pesticide and chemical-related health conditions, heat-related health conditions, muscle and joint pain, eye injuries, diabetes, high blood pressure, obesity, and depression. Furthermore, these farmworkers also experience multiple vulnerabilities including cultural and language barriers and low socioeconomic status. A survey was administered in interview setting to characterize farmworkers’ occupational and non-occupational health conditions, their healthcare-seeking behavior, and their use of preventive measures and health education. Muscle and/or joint pain and eye injuries were the most commonly reported occupational health outcomes, and diabetes and high blood pressure were the most commonly reported non-occupational health outcomes. Farmworker participants requested more information covering prevention, management, and care for these health outcomes. There were low reports of receiving health education regarding common occupational and non-occupational health conditions. Future research efforts and next steps should focus on creating networks between healthcare providers, employers, and other organizations that serve farmworkers as well as continue to host programs that directly involve farmworkers to understand their perceptions of their health and access to healthcare.

The growing number of minority populations living in the United States makes it mandatory that all health care organizations seek to be culturally sensitive. There is no consensus on the definition of the term cultural sensitivity. The goal of this thesis is to define what cultural sensitivity means in a rural health center, from the perspective of the staff as well as the Hispanic patient. Anthropological methods, such as participant observation, semi-structured interviews, and archival data analysis, show that the qualities that Hispanic patients value in a clinic are 1) attention, 2) availability of Spanish language, 3) financial assistance, 4) solution to their health problems, 5) presence of Hispanics around the clinic, and 6) clinic services. Furthermore, 90% of staff responses indicate acceptance and respect of patients health beliefs and practices. Results demonstrate that while the clinic is culturally sensitive, there are a few recommendations that would improve the quality of care that Hispanics receive. Based on the results of the data collection, a practical model for other rural health centers to build upon a culturally sensitive health care system is developed.

The concept of interprofessional practice and education is not new but has recently gained attention as the result of a paradigm shift in the future of healthcare and how it is delivered and financed. Universities are now addressing ways to incorporate interprofessional education and learning experiences into the curriculum to ensure graduating healthcare professionals are competent to collaborate as a team and deliver quality effective healthcare. A regional research university in East Tennessee with health programs across five Health Science colleges (Clinical and Rehabilitative Health Sciences, Medicine, Nursing, Pharmacy, and Public Health), Psychology, and Social Work has offered an interprofessional rural course for more than six years. The two-semester course is focused on vulnerable or underserved populations and rural communities in the south central Appalachian region. Each course section comprised of 8 to 10 students is led by a team of two or more faculty who represent a cross section of healthcare disciplines and focuses on a specific population or community. The student groups develop interprofessional working relationships among each other and faculty while partnering with rural communities. Using a community-based participatory research approach they prioritize health needs, and develop and implement evidence-based strategies to address the identified needs. Interprofessional education, cross cultural learning, and a university/community partnership within the context of the Hispanic migrant farmworker population are addressed in this paper. The course process, target population, cultural learning, and student outcomes are specifically discussed.