Dataset Information

Harvesting Health Knowledge: Breast Cancer Perceptions in the South Florida Latinx Farmworker Community.

ABSTRACT: South Florida agricultural regions, home to Latinx immigrant farmworkers, report higher rates of late-stage breast cancer diagnosis than national, state, and county-level averages. We conducted a community-based qualitative study on the needs, health knowledge gaps, barriers to breast cancer screening, and the role of community health workers (CHWs) in supporting the community's access to early detection services. We conducted three CHW focus groups (FGs) (n = 25) and in-depth interviews (n = 15), two FGs (n = 18) and in-depth interviews (n = 3) with farmworker community members, and informal interviews with cancer clinicians (n = 7). Using a grounded theory approach, five core themes regarding the community's barriers to accessing health care services emerged: (a) lack of information; (b) social and economic barriers; (c) cultural factors; (d) fears and mistrust; and (e) psychosocial concerns. Findings yield implications for community health practice, the potential impact of CHWs, and the production of breast cancer education to improve health equity along with the care continuum.

SUBMITTER: Casanova F

PROVIDER: S-EPMC8277692 | biostudies-literature | 2021 Jul

REPOSITORIES: biostudies-literature

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Harvesting Health Knowledge: Breast Cancer Perceptions in the South Florida Latinx Farmworker Community.

Casanova Felicia F Knaul Felicia M FM Rodriguez Natalia M NM

Qualitative health research 20210409 8

South Florida agricultural regions, home to Latinx immigrant farmworkers, report higher rates of late-stage breast cancer diagnosis than national, state, and county-level averages. We conducted a community-based qualitative study on the needs, health knowledge gaps, barriers to breast cancer screening, and the role of community health workers (CHWs) in supporting the community's access to early detection services. We conducted three CHW focus groups (FGs) (<i>n</i> = 25) and in-depth interviews ...[more]

PMID: 33834911

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Project description:Personal pesticide exposure is not well characterized among children in vulnerable, immigrant communities. We used silicone wristbands in 2018-2019 to assess pesticide exposure in 8 year old Latinx boys and girls in rural, farmworker families (n = 73) and urban, non-farmworker families (n = 60) living in North Carolina who were enrolled in the PACE5 Study, a community-based participatory research study. We determined the detection and concentrations (ng/g) of 75 pesticides and pesticide degradation products in the silicone wristbands worn for one week using gas chromatography electron capture detection and employed gas chromatography mass spectrometry. Differences by personal and family characteristics were tested using analysis of variance or Wilcoxon Rank Sum tests when necessary. Pesticide concentrations above the limit of detection were analyzed, and reported as geometric means and 95% confidence intervals (CI). The most frequently detected pesticide classes were organochlorines (85.7%), pyrethroids (65.4%), and organophosphates (59.4%), with the most frequently detected specific pesticides being alpha-chlordane (69.2%), trans-nonachlor (67.7%), gamma-chlordane (66.2%), chlorpyrifos (54.9%), cypermethrin (49.6%), and trans-permethrin (39.1%). More of those children in urban, non-farmworker families had detections of organochlorines (93.3% vs. 79.5, p = 0.0228) and pyrethroids (75.0% vs. 57.5%, p = 0.0351) than did those in rural, farmworker families; more children in rural, farmworker families had detections for organophosphates (71.2% vs. 45.0%, p= 0.0022). Children in urban, non-farmworker families had greater concentrations of alpha-chlordane (geometric mean (GM) 18.98, 95% CI 14.14, 25.47 vs. 10.25, 95% CI 7.49, 14.03; p= 0.0055) and dieldrin (GM 17.38, 95% CI 12.78 23.62 vs. 8.10, 95% CI 5.47, 12.00; p= 0.0034) than did children in rural, farmworker families. These results support the position that pesticides are ubiquitous in the living environment for children in vulnerable, immigrant communities, and argue for greater effort in documenting the widespread nature of pesticide exposure among children, with greater effort to reduce pesticide exposure.

Project description:Exposure to pesticides in humans may lead to changes in brain structure and function and increase the likelihood of experiencing neurodevelopmental disorders. Despite the potential risks, there is limited neuroimaging research on the effects of pesticide exposure on children, particularly during the critical period of brain development. Here we used voxel-based morphometry (VBM) and diffusion tensor imaging (DTI) from magnetic resonance images (MRI) to investigate neuroanatomical differences between Latinx children (n = 71) from rural, farmworker families (FW; n = 48) and urban, non-farmworker families (NFW; n = 23). Data presented here serves as a baseline for our ongoing study examining the longitudinal effects of living in a rural environment on neurodevelopment and cognition in children. The VBM analysis revealed that NFW children had higher volume in several distinct regions of white matter compared to FW children. Tract-based spatial statistics (TBSS) of DTI data also indicated NFW children had higher fractional anisotropy (FA) in several key white matter tracts. Although the difference was not as pronounced as white matter, the VBM analysis also found higher gray matter volume in selected regions of the frontal lobe in NFW children. Notably, white matter and gray matter findings demonstrated a high degree of overlap in the medial frontal lobe, a brain region predominantly linked to decision-making, error processing, and attention functions. To gain further insights into the underlying causes of the observed differences in brain structure between the two groups, we examined the association of organochlorine (OC) and organophosphate (OP) exposure collected from passive dosimeter wristbands with brain structure. Based on our previous findings within this data set, demonstrating higher OC exposure in children from non-farmworker families, we hypothesized OC might play a critical role in structural differences between NFW and FW children. We discovered a significant positive correlation between the number of types of OC exposure and the structure of white matter. The regions with significant association with OC exposure were in agreement with the findings from the FW-NFW groups comparison analysis. In contrast, OPs did not have a statistically significant association with brain structure. This study is among the first multimodal neuroimaging studies examining the brain structure of children exposed to agricultural pesticides, specifically OC. These findings suggest OC pesticide exposure may disrupt normal brain development in children, highlighting the need for further neuroimaging studies within this vulnerable population.

Project description:Pesticide exposure remains a health hazard despite extensive study into adverse effects. Children in vulnerable populations, such as Latinx children in farmworker families, are particularly at risk for exposure. Several studies have demonstrated the detrimental cognitive effects of prenatal exposure to pesticides, particularly organophosphates (OPs) within this high-risk group. However, results from studies investigating the cognitive effects of early childhood pesticide exposure are equivocal. Most studies examining the effects of pesticide exposure have used correlative analyses rather than examining populations with expected high and low exposure. The current study compares 8-year-old children from rural families of farmworkers and urban, non-farmworker families. We used the Weschler Intelligence Scale for Children - Fifth Edition (WISC-V) to assess cognitive performance in these children. We designed this study with the expectation that children from farmworker families would have greater exposure to agricultural pesticides than urban, non-farmworker children. This assumption of exposure to agricultural pesticides was confirmed in a recent report that assessed exposure probabilities using life history calendars. However, data from passive wristband sampling of acute (1-week) pesticide exposure from these same children indicate that both study populations have considerable pesticide exposure but to different chemicals. As expected the children of farmworkers had greater OP exposure than non-farmworker children, but the non-farmworker children had greater exposure to two other classes of insecticides (organochlorines [OCs] and pyrethroids). Our analyses considered these findings. A comparison of the cognitive scores between groups revealed that children from farmworker families had slightly higher performance on the Visual-Spatial Index (VSI) and Verbal Comprehension Index (VCI) when compared to children from non-farmworker families. Regression analyses where pesticide exposure was included as covariates revealed that OC exposure accounted for the largest portion of the group differences for both VSI and VCI. However, a post-hoc moderation analysis did not find significant interactions. The main study outcome was that the non-farmworker children exhibited lower WISC-V scores than the children from farmworker families, and the analyses incorporating pesticide exposure measures raise the hypothesis the that pervasive and persistent nature of a variety of pesticides may have adverse effects on the neurodevelopment of young Latinx children whether living in rural or non-farmworker environments.

Dataset Information

Harvesting Health Knowledge: Breast Cancer Perceptions in the South Florida Latinx Farmworker Community.

Publications

Harvesting Health Knowledge: Breast Cancer Perceptions in the South Florida Latinx Farmworker Community.

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