Using Data to Respond to Farmworkers’ Needs across the State

Influencing State-Level Policy on Behalf of Farmworkers

Reaching Every Farmworker Home through Proyecto Puente

Providing Health Education on a Weekly Radio Program

Conducting Outreach in the Fields with a Lunchtime Celebration

Improving Diabetes Management

Emphasizing Behavior Change in Healthy Weight Management

Reinventing Delivery Options for HIV/AIDS Health Education

Where Health and Community Education Meet

Crew Chiefs as Advocates for Health Education

Community-Level HIV Prevention

Using Creative Skits to Deliver Health Education

Mid-Season Farmworker Appreciation Festival

“The Importance of the Father” Parenting Classes

Marketing Department Ensures Cultural Competence

Hosting a Health Fair with the Mexican Consulate

Columbia Basin Health Association emphasizes family-centered health care.

Delivering Health Education in a Culturally Appropriate Context

Using Novelas to Address Culturally Sensitive Health Topics

Newsletter Promotes Health Education

Family Support Group Meetings Encourage Networking and Promote Preventive Care

Migrant Health and Safety Fair for Children

Increasing Male Farmworkers’ Interest in Seeking Health Services

La Placita Bilingüe Radio Show

Successes of a Workplace Wellness Program

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Using Data to Respond to Farmworkers’ Needs across the State
2007, North Carolina Farmworker Health Program top

As a statewide voucher program, NCFHP developed a customized data tracking and documentation system, Farmworker Health Administration System Electronic Services (FHASES), in collaboration with a volunteer computer programmer, to ensure consistent tracking of services at its 14 voucher sites—including medical, enabling, and outreach services. Each of the voucher sites uses standardized health assessment and encounter forms during outreach and the data documented on these forms are then entered into the FHASES program. Because FHASES is web-enabled, data are updated immediately and they can be viewed in real time by staff at NCFHP’s office in Raleigh. NCFHP staff use the data to: 1) examine trends in the services being provided at each of the sites; 2) review the needs of each site and its respective farmworker population; 3) plan programs and services with each of its sites; and, 4) develop relevant health education lessons that respond to emerging farmworker health issues.

Because outreach staff can input data into FHASES wherever they have internet access, they have been able to more effectively keep pace with data entry which used to be difficult to manage in a timely fashion. As a result, NCFHP staff has a much truer picture of farmworker and service needs at each of the sites across the state. The program FHASES, which can be used by any organization with multiple sites, allows NCFHP to consistently and effectively track outreach and medical services and make data-driven decisions for increased funding and/or targeted health interventions, including health education that responds to local needs. Data-driven decision-making also facilitates the rationale and effective use of NCFHP’s limited financial resources and ensures that as many farmworkers as possible access health services in North Carolina.


Influencing State-Level Policy on Behalf of Farmworkers
2007, North Carolina Farmworker Health Program top

NCFHP participates in several state-level task forces in order to influence policy and be a voice for farmworker issues. Because farmworkers are not always included on certain policy and programmatic agendas, NCFHP strives to ensure that policymakers are aware of their presence in the state and their unique needs. In 2006, NCFHP made significant contributions to the North Carolina Office of Minority Health and Health Disparities’ (OMHHD) Hispanic Health Task Force and the North Carolina Emergency Management Human Services and North Carolina Department of Health and Human Services Disaster Coordinator's committees.

Through involvement on the Hispanic Health Task Force, NCFHP staff were able to inform the development of a Community Health Workers curriculum used for a Lay Health Advisor Program. Originally, the curriculum only addressed issues affecting Latinos in the state as a whole, overlooking farmworker-specific demographic data and cultural information. NCFHP staff highlighted the unique vulnerabilities of this population and shared information on popular education techniques that are effective with farmworkers. As a secondary and unexpected result of this effort, the OMHHD now collects and disseminates farmworker demographic data and health information on their Latino Fact Sheets.

As a result of increased advocacy and education with the two emergency management and disaster committees, consideration for the state’s farmworker population has been incorporated into emergency response plans. Before NCFHP’s participation on these committees, disaster response agencies were relatively uninformed or unaware about farmworkers and their unique lifestyles and living conditions that impact these organizations’ abilities to respond effectively. NCFHP recently trained state disaster coordinators on issues such as the barriers farmworkers face in accessing emergency shelters, the challenge of communicating with non-Spanish speaking emergency responders and how to provide financial reimbursements to farmworkers during the recovery period when they have already left the area. Though these efforts are relatively new, it is anticipated that the critical discussions started by NCFHP will ensure that North Carolina farmworkers are no longer overlooked when emergencies occur.


Reaching Every Farmworker Home through Proyecto Puente
2007, Northwest Michigan Health Services, Inc. top

Northwest Michigan Health Services, Inc. (NMHSI) Office of Public Outreach has created a specialized internship, Proyecto Puente or the Bridge Project, for four bilingual college students from the University of Michigan, Ann Arbor and Michigan State University’s College Assistance for Migrants Program. The goal of this pilot project was to reach every farmworker home in three of the seven counties covered by NMHSI. The interns work as part of the greater outreach program, and as such, undergo extensive training in cultural competence and lay health education using a popular education model. Working out of the main clinic in Traverse City, the interns travel to farmworker camps and perform three main activities: 1) conducting enumeration studies (which include a needs assessment component); 2) delivering health education based on farmworkers’ interests; and, 3) helping connect farmworkers to the clinic and other resources in the community.

By taking advantage of the extra staff members, NMHSI was able to conduct its first ever needs assessment and enumeration study last year. To date, the interns have completed 369 interviews with heads of households accounting for over 1,300 farmworkers and their family members. The information gathered has guided long-term program development based on new demographic data and farmworker input. The four interns—some of them former migrant farmworkers—have gained valuable insight into the issues facing the farmworker community in northwest Michigan. At the end of 2006, NMHSI saw a 31% increase in the number of clinic users. This increase, which surprised clinic staff, has been attributed in part to the strong relationships that the interns built with this segment of the farmworker population.


Providing Health Education on a Weekly Radio Program
2007, Columbia Basin Health Association top

In working with the farmworker population, most will agree that there is no single best way to reach out to this population. The idea of using the radio as a medium for conducting health education was suggested by one of CBHA’s outreach workers. She noticed that during lunch breaks, all of the farmworkers gathered as a group and listened to the radio.

CBHA collaborates with a local Spanish-language radio station who donates air time as a public service in order to provide listeners a weekly, one-hour radio talk show on health education and prevention. The talk show, La Caliente takes place once a week during the lunch hour. A staff member was trained to use the equipment and facilitate the show. Previous topics from the show have included diet and nutrition, depression, family planning, sexually transmitted diseases, dental care, diabetes, alcoholism, and health insurance programs. Typically there is an expert guest speaker, such as a doctor, nurse, social worker, or farmworker advocate that is very knowledgeable about the topic. The facilitator asks questions to engage in a discussion of the topic and listeners are able to call in and ask questions on the air.

The radio talk show has been an effective mechanism for reaching farmworkers with health information. Oftentimes, it is difficult to engage this population in an office environment or even in a community setting. The radio program provides a non-threatening and accessible way to share information. Over the past year, clients have come into the health center stating that they heard about CBHA on the radio, proving to staff that this program is also an excellent marketing tool. On one occasion when CBHA was not able to do the radio talk show, people called in to find out if it would be rescheduled to another day. This kind of feedback has let CBHA staff know that people rely upon the radio program for critical health and social services information.


Conducting Outreach in the Fields with a Lunchtime Celebration
2007, Clinica Sierra Vista, Bakersfield, California top

Clinica Sierra Vista (CSV) staff and promotores/as have implemented a special outreach and education project called the Cuadrillas de Mes or Farmworker Crew of the Month, which identifies a different crew of farmworkers to provide medical services to in the fields each month. At each event, CSV’s mobile medical unit staff—two physicians and four medical assistants or nurses—conduct glucose and blood pressure checks, provide minor treatment and consultations, cancer screening, and nutrition education. Rotating CSV staff representing some of the 30 health and social services programs housed within the health center such as Medi-Cal, WIC, and the local family resource center, provide critical information on the various services available to the farmworkers and their families. These staff members also routinely follow up with farmworkers after the event to ensure that they get connected with needed services even if the services are not provided by CSV’s respective programs.

In order to attract farmworkers and make the staff more approachable, this event is set up to be a lunchtime celebration with all of the fanfare of a mini-festival. CSV staff provide participants with information packets that include incentives such as water bottles and toothbrushes. A raffle is also held to give away larger prizes such as toasters and coffee makers. A local restaurant donates a delicious lunch that feeds upwards of 125-150 farmworkers at each event, while a live DJ also volunteers his time to provide the necessary entertainment to draw a crowd.

The Cuadrillas de Mes event is a fun and highly effective venue for providing the much needed health care for hardworking farmworkers in CSV’s area communities. This project was initially proposed because CSV had a difficult time getting area farmworkers to come in for services even though CSV and its satellite sites offer bus passes, extended hours, and weekend hours to mitigate some of the common barriers farmworkers face. Farmworkers are often not culturally accustomed to and financially able to seek medical care until it is too late. By targeting a different crew each month and making it fun to receive health care and information, CSV staff have been able to create trust with the crew leaders and the farmworkers who might otherwise never access services. As a result, not only have crew leaders become more open to hosting events, but farmworkers in need of further care have been more inclined to follow up after participating in one of these events.


Improving Diabetes Management
2007, Bluegrass Farmworker Health Program top

Bluegrass Farmworker Health Center (BFHC) collaborated with the Lexington Fayette Health Department to teach a series of diabetes self-management classes in Spanish to diabetic farmworker patients. The four-week class was based on the Living Well with Diabetes curriculum developed by the Kentucky Diabetes Prevention and Control Program, which is focused on giving patients the tools and knowledge to manage and control their diabetes. Two local health department staff developed and taught the classes and provided Spanish language support. The BFHC outreach program coordinated the advertising, registration, and child care as well as provided space for the classes.

Immediately preceding the classes, BFHC outreach specialists offered individual instruction on how to use glucometers and self-monitor blood glucose levels. Each class included a healthy snack and interactive instruction. A walk-in-place exercise tape was the highlight of many classes. Incentives such as glucometer strips, medication boxes, gift cards, calendars, exercise tapes, and recipe books were included as part of the program. BFHC also provided bus tokens and child care to participants to overcome some of the typical barriers farmworkers face in taking advantage of this type of program.

Diabetes continues to rank 2nd in all diagnoses seen at the BFHC and self-management is recognized as critical to the successful management of this illness. This program was the first Spanish-language diabetes self-management series to be taught in the state. In addition to barriers such as child care and transportation, this program alleviated the language barrier which has kept farmworkers from accessing classes such as this one in the past. By collaborating with the local health department, the BFHC was able to offer a valuable learning opportunity that was responsive to the needs of the patient population. The class was very successful, graduating 11 participants who attended all six classes in the series. Since the class series ended, the BFHC and health department have continued to provide follow-up activities with graduates through a monthly support group. In addition to the original participants, some of whom drive 70 miles to attend the monthly meeting, many interested family members and friends also attend to learn about diabetes prevention.


Emphasizing Behavior Change in Healthy Weight Management
2007, La Clinica del Cariño Family Health Care Center, Inc. top

Vida Entera y Sana (Whole and Healthy Life) is a three-year demonstration project of La Clinica del Cariño Family Health Care Center, Inc. (LCDC) to address overweight and obesity in the Latino farmworker community. LCDC created a healthy weight management health promotora program called Redes (Networks). Twelve obese Hispanic farmworker women were recruited to work on personal healthy weight management and met weekly for 20 classes, in a support group setting and using Popular Education techniques. The women who were successful in the program were trained as promotoras. They now work with their communities, both on the individual and group level, sharing key information on weight management. More importantly, they work with contacts that are ready to achieve long-term behavior change. The key messages for healthy weight and stress management are to: 1) exercise for 30 to 60 minutes per day; 2) eat a healthy breakfast every day; 3) eat three cups of vegetables per day; 4) eat two fruits per day; 5) drink 6 cups of water per day, and 6) do something besides eat when feeling sad, bored, or anxious.

The goal of the Whole and Healthy Life program is to change current cultural norms about exercise, food and stress management by delivering messages and guiding behavior change in a way that honors cultural heritage. New behaviors repeated for four consecutive weeks have the best chance of becoming habit. This health education program is innovative because it focuses on behavior change by helping participants to: 1) set reasonable goals; 2) recognize personal achievements and obstacles; and, 3) learn and practice individualized strategies to overcome obstacles. To date, 76% of contacts have kept their healthy weight management goal for four or more weeks. Pre and post intervention self-reported changes show an 83% increase in hours of exercise per week, and a 119% increase in cups of vegetables eaten per day.


Reinventing Delivery Options for HIV/AIDS Health Education
2006, Bluegrass Farmworker Health Center top

Bluegrass Farmworker Health Center began a pilot program based on the concept of “Tupperware Parties” as part of an effort to improve the effectiveness of HIV/AIDS prevention education. An Outreach Specialist makes arrangements with someone from the community to invite 6-10 friends to their home for a “party.” At the gathering, the Outreach Specialist begins by providing a general information session to the entire group. Following this session, the Outreach Specialist sets up office in a separate private room where each attendee can come and speak about personal concerns. If they so desire, they may also receive an HIV test.

The “Tupperware Party” model is effective because it engages people in a community setting with people that they know and trust while still respecting their need for privacy regarding a sensitive issue. These home-based health education sessions have been well received by members of the population who have tended to shy away from other types of HIV/AIDS education events that BFHC has offered in the past. The sessions are intimate and relaxed because of the small numbers of attendees who generally already know each other. Also, by offering one-on-one consultations, confidentiality is still maintained.


Where Health and Community Education Meet
2006, Quincy Community Health Center, Moses Lake Community Health Center top

Last year, Quincy Community Health Center (QCHC) was instrumental in organizing and carrying out a migrant parent leadership conference sponsored by the Educational Service District entitled “United, Educated and Success.” The program was guided by the desires and concerns of migrant farmworker parents. Nine of the sixteen speakers at the conference were related to QCHC’s health promoter program. Several of the speakers were clinicians and all discussed many traditionally touchy subjects: sexual health, mental health and drug and alcohol use.

This collaborative effort with the school district allowed QCHC to serve the whole family and for the clinic to become more fully integrated in the community. QCHC’s health promoters were chosen because of their status as leaders within the Latino/farmworker community. Their involvement in the conference helped to draw out the issues of most importance to the farmworker community. Since the event, QCHC has become a place where professional and non-traditional partners have been able to capitalize on the expertise of the health promoters and bicultural staff.


Crew Chiefs as Advocates for Health Education
2006, Quincy Community Health Center, Moses Lake Community Health Center top

Quincy Community Health Center staff and the Grant County Outreach Worker approached key crew chiefs working for local growers requesting their help in carrying out health education at their work sites. Crew chiefs in the area are required to teach certain occupational health and safety topics to farmworkers such as protective eyewear use and pesticide safety. QCHC’s outreach workers offered to teach some of these topics for them during convenient “down time” at the orchards in exchange for the opportunity to teach additional health topics such as STI prevention. Many of the crew chiefs were receptive to having the extra help in teaching classes and became very engaged in the effort. Some cleaned out their sheds for the classes, some provided food and some even provided an hour’s worth of pay to farmworkers who attended the sessions.

QCHC is exploring and developing many innovative alliances with a wide variety of community partners. In this case, outreach workers were able to effectively engage crew chiefs by meeting some of the crew chiefs’ needs as well as those of farmworkers. Outreach staff presented crew chiefs with certificates of appreciation for their collaborative efforts. This has generated interest among other crew chiefs who also want to get involved with QCHC’s health education activities.


Community-Level HIV Prevention
2006, Farmworker Justice Fund, Inc. top

Farmworker Justice Fund has implemented the Young Latinos Promotores (YLP) project which is a community-level HIV prevention project targeting 18-30 year old migrant men who have sex with men with HIV risk-reduction messages based on the Popular Opinion Leader model. At the suggestion and input of the YLPs, bilingual English/Spanish educational cards about STIs were developed. All YLPs were trained on how to use the education cards and rated them as their most useful health education tool. Participants who received the health education training shared that their lifestyles were never discussed in their communities or with their families, which was a cause for great stress, leading some of them to engage in high risk behaviors.

The YLP project, an adaptation of an intervention originally designed for homosexual white men in bar settings, addresses the health education needs of a marginalized subset of the farmworker population: migrant young men who have sex with men. The approach was innovative because the peer health education tools were developed with direct farmworker input. The interactions with this population generated a lot of useful information about their behaviors and the challenges they face. In addition, the project ensured that all participants had the option to be tested for HIV and other STIs. Those that were infected were immediately referred for treatment at the collaborating clinic, Vista Community Clinic in Vista, California.


Using Creative Skits to Deliver Health Education
2006, Valley Family Health Care top

The health promoters of Valley Family Health Care’s (VFHC) La Familia Sana Lay Health Promoter Program go out to farmworker housing areas to conduct interactive health education skits on a variety of health topics. All of these promoters come directly from the communities they serve and have been taught the popular education method. Using this method, the promoters try to create a relaxing environment and present the topics in a visually interesting manner using humor to break the ice. The skits are followed by a discussion with farmworkers regarding what they have seen in the presentation. At the end of the group discussion, health promoters stay behind to speak individually with those farmworkers who want to have their questions answered privately. The health promoters also have an open door policy and farmworkers are invited to visit their offices at any time.

This approach creates a fun and interactive environment for doing health education outreach and has proven effective with all age groups. The non-traditional and non-threatening manner in which the messages are delivered makes it easier for farmworkers to open up to receiving the information shared. Moreover, the facilitated follow-up discussions and the availability of the health promoters to speak to farmworkers one-on-one, just after the skits have finished or back in the lay health promoters’ office, provide appropriate and varied opportunities for farmworkers to get their specific health-related questions answered.


Mid-Season Farmworker Appreciation Festival
2006, Southern Jersey Family Medical Centers, Inc. top

Southern Jersey Family Medical Centers, Inc. organizes an annual farmworker festival that brings together over 1000 farmworkers and provides them with a social outlet in the middle of the busy picking season. The event is advertised as an appreciation day for the hard-working efforts farmworkers contribute to the community. Community organizations such as churches donate money and time and many items such as clothes, bikes, household and spiritual materials to support the festival. They also provide fun games for the children. Medical students conduct health screenings and provide health education while social service organizations distribute information about their services. Local DJs and Mexican folkloric groups provide the entertainment at the event. The biggest draw of all is the soccer tournament, in which prizes are awarded to the winning team.

Since many farmworkers suffer from depression and isolation, this event provides a much-needed opportunity for social interaction outside of the work setting. The festival sensitizes the community to the significant contributions of farmworkers while also mobilizing community members to donate their time, money and talents to express their appreciation for these contributions.


“The Importance of the Father” Parenting Classes
2006, La Clínica de Baldwin top

La Clínica de Baldwin collaborates with La Casa de Amigos, a local Migrant Head Start agency, to offer La Importancia del Padre parenting classes, the purpose of which is to strengthen the image of fathers and foster a positive impact on their families’ health. Quarterly, male clients with children are targeted to attend a one-hour class in the evening at La Clínica de Baldwin. Refreshments are provided and various topics related to health and the family are presented in a positive manner, displaying sensitivity to the “machismo” of Latin culture.

This interagency collaboration combines the strength of many professionals and disciplines resulting in a high quality learning outreach activity for migrant workers. By combining the collective knowledge of the two organizations about Latino culture, La Clínica de Baldwin is able to provide health education in a culturally sensitive manner. La Clínica hopes that families will be emboldened to practice healthy lifestyles as a result of targeting migrant fathers with positive health messages.


Marketing Department Ensures Cultural Competence
2005,Darin M. Camarena Health Centers, Inc. top

The Darin C. Camarena Health Center has its own marketing department that is responsible for designing all promotional and educational materials used by the outreach program. The marketing department ensures that materials are culturally, linguistically, and literacy-level appropriate. The department also oversees the field testing of all materials with the support and assistance of Darin M. Camarena’s Farmworker Advisory Committee and farmworker patients. Field testing methods include focus groups and individual data from patients.

The use of a marketing approach to the development of health education and promotional materials is unique in its effort to create products that will effectively communicate to the center’s target population, and that are shown to do so through field testing. Using an in-house marketing team, as opposed to an outside or contract team or individual, means that Darin M. Camarena has the input of a marketing perspective in planning for outreach services and outreach team meetings, and conversely, the marketing team is very familiar with the needs of the center and their farmworker patients and the surrounding community. Darin M. Camarena’s marketing department is ultimately responsible for making sure that the design of materials results in easy to read, easy to understand materials that promote successful health outcomes for migrant and seasonal farmworkers and communicate the services available through outreach and the health center.


Hosting a Health Fair with the Mexican Consulate
2005, Southern Jersey Family Medical Centers top

Southern Jersey Family Medical Centers (SJFMC) jointly hosts a health fair each year at the beginning of the migrant season with the Mexican Consulate, drawing participation from area farmworker serving organizations and over 300 farmworkers. Farmworkers in attendance receive health information and health screenings along with passports and identification documents needed for getting bank accounts, employment, and other necessities. SJFMC outreach staff and promotores de salud perform health education skits and provide screenings, health information, and materials from the health center while farmworkers wait in line to meet with consular officials.

Southern Jersey Family Medical Centers has successfully combined two important services for farmworkers, medical and consular services. Through their health fair, SJFMC introduces itself to farmworkers new to the area or previously unaware of all the services offered by SJFMC, as well as reestablishes a relationship with farmworkers who reside or have been in the area before. By providing health services while farmworkers are waiting in line for consular services, SJFMC takes a step further in brining outreach services to farmworkers and makes accessing health services and information even easier for attendees.


Columbia Basin Health Association emphasizes family-centered health care.
2005, Columbia Basin Health Association top

Rather than focusing on the individual patient in isolation, CBHA places special emphasis on the importance of the family in meeting health needs. With this purpose in mind, CBHA combines a number of outreach practices to focus and appropriately include family members in health care. These practices include extended hours so that patients don’t have to miss work to receive car for themselves or a family member; transportation services to bring families to the center; participation in community coalitions focused on providing a safety net for farmworkers; advocacy for farmworker families’ needs such as housing, employment, opportunities/training, educational opportunities and access to other community services; sponsorship of activities to help families in times of need such as an annual food basket drive during Thanksgiving and a toy drive during Christmas; and health presentations at schools, orchards/worksites, daycare centers, churches and other organizations that serve farmworkers.

Columbia Basin Health Association combines complimentary outreach services commonly offered, but does so with specific emphasis on the importance of the family and family support networks in preventive health care and disease maintenance and recovery. In doing so CBHA recognizes that many farmworker cultures are nuclear family centered, and individuals do not conduct personal and business affairs outside the family unit.


Delivering Health Education in a Culturally Appropriate Context
2005, Columbia Valley Community Health top

Columbia Valley Community Health delivers health education to farmworkers that is relevant and culturally appropriate. Health education topics are determined and prepared with input from farmworker focus groups, and planned in advance to maximize participation. On the day of the presentation outreach staff go out to the session location early and spread out across the camp to knock on doors and personally invite people to the session. The sessions are held in the camps’ central eating areas and usually attract 65-85 participants. In spite of their large size, sessions are interactive and participants have the opportunity to ask questions in the group or privately following the session. Participants receive an incentive for attending.

Columbia Valley Community Health uses essential principles of adult education and cultural appropriateness in its health education efforts. The program seeks to determine what farmworkers already know and what they want and need to know about key health topics through focus groups, and then use the experiences of participants to develop educational sessions. Additionally, since the majority of the area’s migrant population is Latino, CVCH responds to the important cultural concept of personalismo – personal interaction – by personally inviting each participant to the session, rather than just posting the information or making a general announcement. Finally, CVCH effectively uses community resources to help attract participants to health education sessions. For example, they always bring copies of the local Spanish language newspapers to the sessions, and, through a partnership with a local tienda, each participant receives a dozen tortillas.


Using Novelas to Address Culturally Sensitive Health Topics
2004, Terry Reilly Health Services top

As part of their outreach activities, outreach workers produced innovative educational materials such as an eight-part radio novella (soap opera) on sexual and physical abuse, Los Secretos del Abuso Sexual/Secrets of Sexual Abuse, and a short video presentation on common mental health situations of farmworkers, Cuentos Del Campo/Stories from the Field.

TRHS collaborated with a local radio station in the production of the radio novella and negotiated free airtime in return for ads placed with the radio station. In addition to using outreach workers, TRHS used specialists on the topics to review the radio novellas before presenting them to the public to ensure that the information provided was correct and clear.

TRHS identified an effective way to reach the farmworker community by using the radio media. Radio novellas are very popular among Hispanic families. Having a radio novella on topics such as sexual abuse or health situations provides health education in a widely accessible, informal and non-threatening way and in a language that can be easily understood by a broad audience.


Newsletter Promotes Health Education
2004, Golden Valley Health Centers top

Golden Valley Health Centers (GVHC) provides a Health Education and Outreach newsletter, Health Education News, every other month to all GVHC employees. The newsletter has articles about health education and the health center program, changes and information about the Outreach Staff, upcoming events, and a real-life story about a person that the Outreach Staff was able to assist.

In addition to their current practices of involving Outreach staff in site meetings and clinical committees, the Outreach and Health Education coordinators in management meetings, and providing an overview of Health Education/Outreach at Employee Orientation, this practice goes a step further to integrate Outreach/Health Education staff into the rest of the health care organization. Providing a newsletter to all GVHC employees is a creative way to foster cooperation and a sharing of information between the Outreach/Health Education department and the rest of the organization. It increases the overall awareness of farmworkers in the organization (through the use of real-life Outreach/Health Education impacts), thereby increasing the likelihood of providing culturally appropriate care to farmworkers and their families. This practice builds upon the base of integration already existing in the organization between the Outreach/Health Education department and the rest of the organization. It provides a creative venue for increasing cooperation and collaboration between the various GVHC departments, which in turn allows for continuity of care and increased culturally appropriate care for farmworkers and their families.


Family Support Group Meetings Encourage Networking and Promote Preventive Care
2008, Community Health Centers of the Central Coast top

In an effort to better communicate with their Spanish/Mixteco-speaking patients, Community Health Centers of the Central Coast (CHC) began to work closely with local organizers to develop El Pueblo Entero: Foro para los Campesinos (The Whole Community: Forum for Farmworkers), a monthly family support group addressing the concerns of farmworkers in the Santa Maria Valley. This grassroots outreach effort with non-traditional organizers provides an opportunity for farmworkers to network among themselves and to learn about local social service agencies.

Working closely with the United Farm Workers and local agricultural agencies, the monthly meetings were developed to address the importance of preventive health care as well as to facilitate discussion regarding health and social services to farmworkers. CHC recognizes the need to listen to farmworkers in order to effectively address their needs and break down barriers to health care.

The monthly gathering allows CHC to simultaneously focus on the health care needs of each individual family while also educating the entire group. Shortly after the forum, monthly bilingual (Mixteco and Spanish) health classes are held that address the needs expressed by participants in the forum. Personal health care needs are discussed with a specialized educator, addressing topics such as women’s health, sexuality, HIV, pesticide exposure, housing, labor laws, and cancer support. The health education sessions are conducted in a comfortable, non-threatening environment with many service organizations represented. CHC believes that the familia approach lets farmworkers know that CHC cares about their health and empowers them to make their own health care decisions while also facilitating leadership development within the community.


Migrant Health and Safety Fair for Children
2008, Eastern Shore Rural Health System, Inc. top

Eastern Shore Rural Health System, Inc. (ESRHS) partners with local schools to provide a Migrant Health and Safety Fair each summer for children ages 3-16. Approximately 190 children participate annually. Throughout the day, multiple organizations, such as the fire department, rescue squad, police, and the Coast Guard give presentations and lead hands-on activities on specific safety issues. The children explore ambulances and fire trucks while learning information such as the “stop, drop, and roll” technique, and where to go in a fire emergency. Representatives from 911 perform call simulations with the children where they practice relaying their name and emergency information to a dispatcher.

Separated by grade levels, the children also learn about vehicle and pedestrian safety such as how to properly fit a bike helmet or life jacket and the importance of buckling up. Younger children learn to look both ways before crossing the street and not to run into the street while playing. The children also get information on hygiene, lead poisoning, water, and smoking at various stations. Other activities involve making good food choices, taking care of their teeth, and the importance of exercise. Finally, children are given a toothbrush and educational materials printed in Spanish to take home to share with their parents.

The Migrant Health and Safety Fair is different from other area health fairs because it focuses primarily on children and their needs. ESRHS hopes to reduce the risk of accidents and injuries to children by teaching them how to avoid potentially dangerous situations and how to respond in an emergency. The children also come away with increased confidence in rescue personnel which is especially important for migrant children, whose parents may fear law enforcement officials due to their legal status. As an unexpected benefit, many children come away wanting to be rescue personnel or police officers when they grow up.


Increasing Male Farmworkers’ Interest in Seeking Health Services
2008, Vista Community Clinic top

The goal of Vista Community Clinic’s (VCC) Male Health Services Project is to increase access to reproductive health education and clinical services for male migrant farmworkers, ages 25 and older in north San Diego County. The bicultural and bilingual project staff provides age-appropriate, culturally and linguistically competent reproductive health education to male farmworkers in a variety of locations including farmworker residences and work sites. Another component is the male reproductive health exam, which includes vital sign screenings, screenings for testicular and prostate cancer, instruction on self-screening for testicular cancer, diagnosis and treatment of sexually transmitted infections (STIs), and information and referrals for fertility services.

Based on feedback from a needs assessment and asset mapping project carried out in collaboration with an advisory committee made up of members of the target population, VCC implemented a multi-faceted community awareness campaign to provide culturally and linguistically appropriate health education and referrals for male exams in a variety of settings. VCC also developed a clinic-based male health services enhancement plan that included provider training on recognizing and responding to male reproductive health and psychological needs, and recognizing and responding to cultural and social barriers that influence or impede patient-provider communication.

This project has enabled VCC to create a male-friendly service delivery environment. Male-oriented reading materials have been placed in the waiting rooms, and appointments are scheduled at the main clinic site away from where women and children are routinely seen. Male exams are scheduled primarily during VCC’s evening and weekend service hours to accommodate work schedules. Furthermore, project staff guide clients through the male exam process, helping them to fill out forms and providing interpretation services as needed. Men who receive the male reproductive health exam are encouraged to also access additional comprehensive health screenings, such as adult immunizations, TB testing, and diabetes and hypertension screening. Since implementing this program, the number of male farmworkers accessing health exams each month has more than doubled.


La Placita Bilingüe Radio Show
2008, Radio Bilingüe top

La Placita Bilingüe is a weekly live call-in Spanish program on Radio Bilingüe. The show is produced in Salinas, CA and is broadcast via its six network stations:

• KSJV 91.5 FM Fresno


• KMPO 88.7 FM Modesto


• KTQX 90.1 FM Bakersfield


• KHDC 90.9 FM Salinas


• KUBO 88.7 FM El Centro, and


• KVUH 88.5 FM Latonville.

The program was founded on the principles of building community and empowering immigrant farmworkers. It is grounded in a Communication for Social Change framework, which seeks to put farmworkers in leadership positions where they act as agents of change rather than objects of change. In addition, La Placita Bilingüe instills principles of tolerance, self-determination, equity, social justice, and active participation for all farmworkers.

The topics and themes discussed during the radio show come directly from representatives of the farmworker community such as parents, mothers, youth, etc. Oftentimes, the show invites special guest experts to provide their opinions and commentary about a variety of issues faced by the farmworker community. Some special guests have come from well-known community health centers and social service agencies in the San Joaquin Valley of California. Past topics addressed on the show include: asthma, education, nutrition, chronic diseases, overall preventive health practices, parenting, environmental health issues, and financial literacy.

Additionally, because of quality assurance standards set forth by Radio Bilingüe, La Placita Bilingüe programming is informed by continued research and evaluation of farmworkers’ reactions and feedback. Staff conduct focus group discussions and interviews at flea markets and community events to gain a better understanding of the effectiveness of the programming in addressing the farmworker community’s health and social needs. Overall, this radio program is an innovation in outreach because it gives the farmworker community a voice, and provides a medium for addressing the most pressing issues faced by the community, including health care access and utilization.


Successes of a Workplace Wellness Program
2008, La Comunidad Hispana top

Work Healthy is an innovative workplace wellness program organized by La Comunidad Hispana (LCH) offering primary care services and health education at three mushroom farms in rural Pennsylvania. Mushroom cultivation is the dominant year-round industry in the area employing thousands of Mexican farmworkers. The goal of the program is to improve the health status of area farmworkers and their families by providing clinical and health education services in the workplace setting.

The health education component of the program includes a monthly two-page bilingual Work Healthy newsletter and presentations by lay health promoters. The newsletter is placed in the farmworkers’ paycheck envelopes with the employers covering the costs associated with photocopying it. Each newsletter reaches 1,300 farmworkers and contains two articles based on topics found on the National Health Observance calendar and brief health tips which are presented in a simple, culturally and linguistically appropriate format. Information about the on-site clinics (hours of operation, locations, and payment methods) are also listed.

Work Healthy bulletin boards are strategically placed by entryways and time clocks and are updated regularly with issues highlighted in the newsletter. Ten lay health promoters, who are also mushroom workers, organize monthly lunchtime education talks at the farms on topics such as domestic violence and alcohol abuse.

An evaluation of the program showed that 216 visits were made by farmworkers to the Work Healthy clinics in the first year. More than one-third of workers believe that a promoter or nurse practitioner helped them to learn more about their health; another one-third intend to live healthier lifestyles because of the knowledge gained from their interactions with the Work Healthy team. The majority of workers read the newsletter and more than one-third talked to a promoter about their health. In addition, approximately 47% indicated the Work Healthy Newsletter is their preferred means of health education.