Agriculture is an occupation with high death and injury rates. Children in rural American farm families are often a necessary and desired part of the workforce. Hmong farm families' values as they relate to work are not essentially different from their mainstream counterparts although their beliefs and practices may seem unusual to outsiders. Hmong children work or play alongside their parents in the field and at the market. It might seem appropriate to translate existing text-based safety information into Hmong to prevent childhood injury on the farm. However, current English-language materials do not include many tasks that Hmong children are doing, are in a format not understood by non-literate Hmong parents, and often use inappropriate imagery and colors. Safe work practices for children in the larger context of the families' enterprise are important in efforts to reduce work-related injury and illness. The purpose of this research project was to investigate culture-specific health behavior patterns and to develop culturally-appropriate health promotion methods for Hmong farming families. The specific aims of this research project were to: 1. Examine the extent and nature of child agricultural labor in farm families of Hmong origin in the Upper Midwest; 2. Investigate culture-specific health behavior patterns and culturally appropriate health promotion methods for farm families of Hmong origin; 3. Evaluate the North American Guidelines for Children's Agricultural Tasks (Guidelines) for applicability and appropriateness for farm families of Hmong origin; 4. Produce recommendations for adapting the Guidelines to be more culturally appropriate to Hmong farm families; and, 5. Design a prototype health education vehicle that presents at least three of Guidelines through messages and in media tailored specifically for Hmong audiences. Methods: Hmong farming families with children between the ages of 7 and 15 were recruited for this study. Qualitative and quantitative research methods were used, including extensive literature review; review of secondary data; semi-structured interviews; focus groups; field observations; and height and weight measurements. Text narratives, field notes and photographs were analyzed and organized using Atlas.ti version 4.2 and numerical data (demographics) were analyzed with SPSS version 11.5. Findings: Hmong farm children are engaged in different work tasks, roles, and responsibilities compared to mainstream North American farm children and are exposed to different hazards. Hmong children perform tasks in four time-related phases: pre-harvest, harvest, post-harvest, and at the market. Standard health and safety educational materials are not widely accepted by Minnesota Hmong farmers. Standard health and safety materials are not widely accepted by Minnesota Hmong farmers. An outcome of our NIH-funded research was the creation of culturally and contextually appropriate materials to address the health and safety needs of Hmong children working on their family's production acreage. These specific needs were identified by these authors and with the Hmong population farming in Minnesota: Safe Rototiller Operation, Hand Tool Safety (including knives, machetes, and other tools for harvesting and preparing crops), and Marketing Skills and Occupational/Public Health Concerns (food safety and personal hygiene, money-handling and security, communicating with the public, ergonomics, lifting, heat stress, and repetitive motion). Project participants helped develop culturally appropriate and relevant materials and were involved in the pilot tests and evaluation. A Safety and Health Education Development (SHED) Algorithm was developed and used to tailor existing health and safety guidelines and develop new guidelines for this project. The SHED Algorithm was further refined and clarified to be used to deliver information to other cultural, linguistic, or ethnic populations in the United States or abroad. Implications: Collecting qualitative, contextual data in order to design the most responsive and culturally competent solutions is essential to help meet the health needs of ethnic communities. The emic perspective is required to adapt health and safety strategies for the Hmong agricultural community in culturally/linguistically appropriate ways.
John M. Shutske, Professor, Biosystems and Agricultural Engineering Department, University of Minnesota, 1390 Eckles Avenue, St. Paul, MN 55108