Recruitment, Methods, and Descriptive Results of a Physiologic Assessment of Latino Farmworkers: The California Heat Illness Prevention Study.
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ABSTRACT:
SUBMITTER: Mitchell DC
PROVIDER: S-EPMC5503787 | biostudies-literature | 2017 Jul
REPOSITORIES: biostudies-literature
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Recruitment, Methods, and Descriptive Results of a Physiologic Assessment of Latino Farmworkers: The California Heat Illness Prevention Study.
Mitchell Diane C DC Castro Javier J Armitage Tracey L TL Vega-Arroyo Alondra J AJ Moyce Sally C SC Tancredi Daniel J DJ Bennett Deborah H DH Jones James H JH Kjellstrom Tord T Schenker Marc B MB
Journal of occupational and environmental medicine 20170701 7
<h4>Objective</h4>The California heat illness prevention study (CHIPS) devised methodology and collected physiological data to assess heat related illness (HRI) risk in Latino farmworkers.<h4>Methods</h4>Bilingual researchers monitored HRI across a workshift, recording core temperature, work rate (metabolic equivalents [METs]), and heart rate at minute intervals. Hydration status was assessed by changes in weight and blood osmolality. Personal data loggers and a weather station measured exposure ...[more]
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Project description:BackgroundThe burden of adverse health effects from heat exposure is substantial, and outdoor workers who perform heavy physical work are at high risk. Though heat prevention interventions have been developed, studies have not yet systematically evaluated the effectiveness of approaches that address risk factors at multiple levels.ObjectiveWe sought to test the effectiveness of a multi-level heat prevention approach (heat education and awareness tools [HEAT]), which includes participatory training for outdoor agricultural workers that addresses individual and community factors and a heat awareness mobile application for agricultural supervisors that supports decisions about workplace heat prevention, in the Northwest United States.DesignWe designed the HEAT study as a parallel, comparison, randomized group intervention study that recruited workers and supervisors from agricultural workplaces. In intervention arm crews, workers received HEAT training, and supervisors received the HEAT awareness application. In comparison arm crews, workers were offered non-HEAT training. Primary outcomes were worker physiological heat strain and heat-related illness (HRI) symptoms. In both worker groups, we assessed HRI symptoms approximately weekly, and heat strain physiological monitoring was conducted at worksites approximately monthly, from June through August.DiscussionTo our knowledge, this is the first study to evaluate the effectiveness of a multi-level heat prevention intervention on physiological heat strain and HRI symptoms for outdoor agricultural workers.Trial registrationClinicalTrials.gov Registration Number: NCT04234802.
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Project description:BackgroundObservational burden of illness studies are used in pharmacoepidemiology to address a variety of objectives, including contextualizing the current treatment setting, identifying important treatment gaps, and providing estimates to parameterize economic models. Methodologies such as retrospective chart review may be utilized in settings for which existing datasets are not available or do not include sufficient clinical detail. While specifying the number of charts to be extracted and/or determining whether the number that can feasibly extracted will be clinically meaningful is an important study design consideration, there is a lack of rigorous methods available for sample size calculation in this setting. The objective of this study was to develop recommended sample size calculations for use in such studies.MethodsCalculations for identifying the optimal feasible sample size calculations were derived, for studies characterizing treatment patterns and medical costs, based on the ability to comprehensively observe treatments and maximize precision of resulting 95% confidence intervals. For cost outcomes, if the standard deviation is not known, the coefficient of variation cv can be used as an alternative. A case study of a chart review of advanced melanoma (MELODY) was used to characterize plausible values for cv in a real-world example.ResultsAcross sample sizes, any treatment given with greater than 1% frequency has a high likelihood of being observed. For a sample of size 200, and a treatment given to 5% of the population, the precision of a 95% confidence interval (CI) is expected to be ±0.03. For cost outcomes, for the median cv value observed in the MELODY study (0.72), a sample size of approximately 200 would be required to generate a 95% CI precise to within ±10% of the mean.ConclusionThis study presents a formal guidance on sample size calculations for retrospective burden of illness studies. The approach presented here is methodologically rigorous and designed for practical application in real-world retrospective chart review studies.
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Project description:Natural disasters including hurricanes, floods, earthquakes, tornadoes, and fires often involve substantial physical and mental impacts on affected populations and thus are public health priorities. Limited research shows that vulnerable populations such as the low-income, socially isolated migrant and seasonal farmworkers (MSFW) are particularly susceptible to the effects of natural disasters. This research project assessed the awareness, perceived risk, and practices regarding disaster preparedness and response resources and identified barriers to utilization of community and government services during or after a natural disaster among Latino MSFWs' and their families. Qualitative (N = 21) focus groups (3) and quantitative (N = 57) survey methodology was implemented with Latino MSFWs temporarily residing in rural eastern North Carolina to assess perceived and actual risk for natural disasters. Hurricanes were a top concern among the sample population, many participants shared they lacked proper resources for an emergency (no emergency kit in the house, no evacuation plan, no home internet, a lack of knowledge of what should be included in an emergency kit, etc.). Transportation and language were found to be additional barriers. Emergency broadcasts in Spanish and text message alerts were identified by the population to be helpful for disaster alerts. FEMA, American Red Cross, local schools and the migrant clinic were trusted places for assistance and information. In summary, tailored materials, emergency alerts, text messages, and news coverage concerning disaster threats should be provided in the population's native language and when feasible delivered in a culturally appropriate mechanism such as "charlas" (talks) and brochures.
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Project description:BACKGROUND:Type 2 diabetes (T2D) disproportionately impacts Latino youth yet few diabetes prevention programs address this important source of health disparities. OBJECTIVES:To address this knowledge gap, we describe the rationale, design, and methodology underpinning a culturally-grounded T2D prevention program for obese Latino youth. The study aims to: 1) to test the efficacy of the intervention for reducing T2D risk, 2) explore potential mediators and moderators of changes in health behaviors and health outcomes and, 3) examine the incremental cost-effectiveness for reducing T2D risk. Latino adolescents (N=160, age 14-16) will be randomized to either a 3-month intensive lifestyle intervention or a control condition. The intervention consists of weekly health education delivered by bilingual/bicultural promotores and 3 moderate-to-vigorous physical activity (PA) sessions/week. Control youth receive health information and results from their laboratory testing. Insulin sensitivity, glucose tolerance, and weight-specific quality of life are assessed at baseline, 3-months, 6-months, and 12-months. We will explore whether enhanced self-efficacy and/or social support mediate improvements in nutrition/PA behaviors and T2D outcomes. We will also explore whether effects are moderated by sex and/or acculturation. Cost-effectiveness from the health system perspective will be estimated by the incremental cost-effectiveness ratio using changes in insulin sensitivity at 12-months. CONCLUSIONS:The results of this study will provide much needed information on how T2D prevention interventions for obese Latino youth are developed, implemented and evaluated. This innovative approach is an essential step in the development of scalable, cost-effective, solution oriented programs to prevent T2D in this and other high-risk populations.
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Project description:ImportanceEssential workers in agriculture and food production have been severely affected by the ongoing COVID-19 pandemic.ObjectiveTo identify risk factors associated with SARS-CoV-2 infection among farmworkers in California.Design, setting, and participantsThis cross-sectional study invited farmworkers in California's Salinas Valley (Monterey County) receiving transcription-mediated amplification (TMA) tests for SARS-CoV-2 infection at federally qualified community clinics and community sites to participate. Individuals were eligible if they were not pregnant, were 18 years or older, had conducted farmwork since the pandemic started, and were proficient in English or Spanish. Survey data were collected and SARS-CoV-2 tests were conducted among participants from July 16 to November 30, 2020.ExposuresSociodemographic, household, community, and workplace characteristics.Main outcomes and measuresTMA- and immunoglobulin G (IgG)-positive SARS-CoV-2 infection.ResultsA total of 1107 farmworkers (581 [52.5%] women; mean [SD] age, 39.7 [12.6] years) were included in these analyses. Most participants were born in Mexico (922 [83.3%]), were married or living with a partner (697 [63.0%]), and worked in the fields (825 [74.5%]). Overall, 118 of 911 (13.0%) had a positive result on their TMA test for SARS-CoV-2 infection, whereas 201 of 1058 (19.0%) had antibody evidence of infection. In multivariable analyses accounting for recruitment venue and enrollment period, the incidence of TMA-positive SARS-CoV-2 infection was higher among those with lower than primary school-level education (adjusted relative risk [aRR], 1.32; 95% CI, 0.99-1.76; non-statistically significant finding), who spoke an Indigenous language at home (aRR, 1.30; 95% CI, 0.97-1.73; non-statistically significant finding), who worked in the fields (aRR, 1.60; 95% CI, 1.03-2.50), and who were exposed to a known or suspected COVID-19 case at home (aRR, 2.98; 95% CI, 2.06-4.32) or in the workplace (aRR, 1.59; 95% CI, 1.18-2.14). Positive results on IgG tests for SARS-CoV-2 infection were more common among those who lived in crowded housing (aRR, 1.23; 95% CI, 0.98-1.53; non-statistically significant finding), with children aged 5 years or younger (aRR, 1.40; 95% CI, 1.11-1.76), with unrelated roommates (aRR, 1.40; 95% CI, 1.19-1.64), and with an individual with known or suspected COVID-19 (aRR, 1.59; 95% CI, 1.13-2.24). The risk of IgG positivity was also higher among those with body mass index of 30 or greater (aRR, 1.65; 95% CI, 1.01-2.70) or diabetes (aRR, 1.31; 95% CI, 0.98-1.75; non-statistically significant finding).Conclusions and relevanceIn this cross-sectional study of farmworkers in California, both residential and workplace exposures were associated with SARS-CoV-2 infection. Urgent distribution of COVID-19 vaccines and intervention on modifiable risk factors are warranted given this population's increased risk of infection and the essential nature of their work.
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Project description:ObjectivesThis study aimed to determine thermoregulatory and cardiovascular responses as well as the occurrence of heat illness in children exercising outdoors in physical education class under hot and humid climate. Little information regarding this issue under real-life situation is available, especially in the Southeast Asia.DesignAnalytical, prospective descriptive study.SettingA primary school in Bangkok, Thailand.ParticipantsA total of 457 schoolboys (aged 5.5-12 years) were observed while exercising outdoors during their physical education classes throughout the academic year of 2009, including semester 1 (between July and September 2009) and semester 2 (between November 2009 and February 2010).Primary and secondary outcome measuresPrimary outcome measure was tympanic temperature. Secondary outcome measures included blood pressure, heart rate, hydration status and the occurrence of heat-related illness.ResultsOutdoor physical activity consisted of skill practice (duration 24.11±11.04 min, intensity <3 metabolic equivalent of tasks) and playing sports (duration 11.48±5.53 min, intensity 2.6-8.8 metabolic equivalent of tasks). After exercise, tympanic temperature increased by 0.66±0.41°C. There were 20 (4.4%) students whose ear temperature exceeded 38°C, 18 of whom did not consume water. The RR of increasing body temperature up to 38°C in overweight students was 2.1-fold higher than normal-weight students. The per cent change in mean arterial pressure and heart rate increased by 20.16±15.34% and 23.94±19.78%, respectively. Sweat and dehydration rates were 391.16±186.75 ml/h and 0.63±0.26%, respectively. No evidence of heat illness was found. Wet bulb globe temperatures of semesters 1 and 2 were 29.95±1.87°C and 28.32±2.39°C, respectively.ConclusionsThere is an increased risk for heat illness during outdoor activities in physical education class in primary school children, especially those who are overweight and have poor hydration status.
| S-EPMC3400060 | biostudies-literature