NORA Manufacturing Sector Strategic Goals
92700AQ - Assessing the TB Education Needs for Hispanic Immig. WorkersStart Date: 10/1/2004
End Date: 9/30/2009
Principal Investigator (PI)Name: Donald Eggerth
Funded By: NIOSH
Primary Goal Addressed7.0
Secondary Goal Addressed
Attributed to Manufacturing
This study will investigate the feasibility of using the workplace to educate Hispanic immigrant workers about tuberculosis. Focus groups will be conducted with HIW from a broad range of industries. Participants will discuss their levels of knowledge, health beliefs, attitudes and cultural practices related to TB. Individuals who had an initial positive skin test reaction for TB will be interviewed to determine why they did or didn't comply with treatment recommendations. Employers of Hispanic immigrant workers regarding their willingness to provide TB education for their workers and about their training needs and preferences. This information will be used by future studies to guide the actual development and testing of the TB education materials for both employers and Hispanic immigrant workers
This proposal will build upon previous work by the investigators that established the feasibility of the proposed recruitment strategies and qualitative data collection methods with Hispanic immigrant workers. This project will interview Hispanic immigrant workers and their employers to accomplish the following specific goals: 1) To better understand the factors that would motivate the employers of Hispanic immigrant workers to provide TB-related training for their workers. 2) To better understand how to meet the training needs specific to the many small businesses that employ Hispanic immigrant workers. Both goals will be met by interviewing employers of Hispanic immigrant workers (half from small businesses) regarding their willingness to provide TB education for their workers and about their training needs and preferences. 3) To better understand Hispanic Immigrant Workers' knowledge of and attitude toward TB. Focus groups will be conducted with HIW from a broad range of industries. Participants will discuss their levels of knowledge, health beliefs, attitudes and cultural practices related to TB. The participants will be recruited through the Coalition for the Dignity and Rights of Immigrants, an advocacy group serving the local Hispanic community. 4) To better understand the factors contributing to TB test seeking and treatment adherence among Hispanic immigrant workers. The increasing incidence of multi-drug resistant tuberculosis (MDR-TB) presents a significant public health concern. MDR-TB results when individuals who are infected with tuberculosist begin but do not complete the course of treatment. Preliminary interviews with the Hamilton County TB Control Program indicated that there were significant numbers of HIW in the area who have tested positive on TB skin testing, but who did not return for follow-up tests. Working with the Hamilton County TB Control Program and other agencies/groups serving the local Hispanic community, we hope to identify three cohorts of individuals (1) Hispanic immigrant workers who had an initial positive skin test reaction (PPD+) and did not seek further tests, 2) Hispanic immigrant workers who started treatment for TB (active or latent) but did not complete treatment, and 3) Hispanic immigrant workers who completed treatment TB (active or latent)] to identify factors, which if addressed, could increase treatment follow through. 5) To develop recommendations for the development of TB educational materials for Hispanic immigrant workers and their employers.
The findings from the informational interviews with employers conducted for Specific Goals 1 & 2, the focus groups conducted for Specific Goal 3, and the interviews with individuals who tested positive for TB that were conducted for Specific Goal 4 will be reviewed by a panel comprised of the researchers, other NIOSH subject matter experts, the project consultants, and representatives from our community partners to generate recommendations for the development of the following:
• TB educational materials targeted at the employers of Hispanic immigrant workers,
• Strategies to meet the training needs of small businesses that employ Hispanic immigrant workers,
• Spanish-language TB education materials tailored to meet the needs of Hispanic immigrant workers.
The actual development and evaluation of the TB education materials for both employers and Hispanic immigrant workers is beyond the scope of the current study. Project timeline: Year 1 – Clearance; Year 2 – Complete clearance and data collection for Specific Goals 1, 2, 3 & 4; Year 3 – Specific Goal 5, dissemination of results.
• Conduct focus groups with Hispanic immigrant workers
• Interview Hispanic immigrant workers who had an initial positive skin test reaction for TB regarding treatment adherence
• Interview employers of Hispanic immigrant workers
• Develop recommendations for TB information materials for Hispanic immigrant workers
• Develop recommendations for TB information materials for employers of Hispanic immigrant workers
In keeping with the NIOSH WorkLife initiative to use the workplace as a forum to address broader public health concerns, this study will investigate the feasibility of using the workplace to educate Hispanic immigrant workers about tuberculosis (TB). Currently, TB is the leading cause of death from an infectious disease in the world. In the United States there are 10-15 million individuals with latent tuberculosis infection (LTBI), 10% of whom will develop the active form of the disease at some future point, if not treated. Although the rate of TB infections among all American workers is declining the rate among Hispanic workers remains elevated. TB was reported more frequently among Hispanics than any other ethnic group for the first time in 2004. Of Hispanics with TB, 74% were foreign born. Mexican-born workers account for the highest percentage (approximately 25%) of TB cases in the U.S. among foreign born individuals. The increased rate of immigration to the United States from Latin America, the high incidence of Hispanic immigrants infected with TB and high rates of non-adherence to TB treatment makes finding ways to more effectively reach the Hispanic immigrant community in the United States essential in controlling TB. Past work addressing TB in the workplace has focused on occupational groups that are at increased risk for contracting TB from the individuals they interact with in the course of performing their work duties. However, it may be of benefit to broaden this focus to address circumstances that concentrate large numbers of workers who are at elevated risk for having TB in a given workplace, thereby placing workers at risk of contracting TB from a co-worker. Due to barriers of language, education, and illegal immigration status, Hispanic immigrant workers tend to be concentrated within certain industries and often within particular companies within a given industry. This project is related to the NORA research priorities of Infectious Disease, Special Populations at Risk and Intervention Effectiveness Research and to the Healthy People 2010 objectives of Educational Programs (worksite setting), Occupational Safety and Health, and Infectious Diseases (emerging antimicrobial resistance).
Sector Programs: Services - Strategic Goal 1: Reduce the occupational health disparities between priority population workers in the services sector and the general population of workers.
IG2: In collaboration with community-based programs, increase the number of people with occupational injuries and illnesses receiving necessary medical treatment and develop methods to ensure that occupational injuries and illnesses are appropriately reported.
IG3: Increase the implementation of occupational safety and health practices for priority population workers in the services sector and their employers.
Cross-Sector Programs: Communications and Information Dissemination - SG2: Strengthen the development, application and evaluation of communication science and marketing strategies to maximize the effectiveness of moving research to practice.
IG2.1: Conduct a review of available literature concerning the application of communication theory to enhance successful occupational safety and health interventions.
Cross-Sector Programs: Respiratory Diseases - SG3: Prevent and reduce work-related respiratory infectious diseases.
IG1: maintain reductions in occupational TB incidence in high-risk work settings.
Coordinated Emphasis Areas: Occupational Health Disparities - IG2B: Promote the development of improved research through dissemination of research tools and approaches that better consider language, literacy and cultural differences among working populations.
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