The goal of this project is to develop and test the effectiveness of a Lay Health Advisor program to teach migrant and seasonal farmworkers about pesticide safety in their homes. This is a community-based collaborative research project in which we first conduct in-depth interviews with farmworkers to learn about their knowledge and beliefs relative to pesticide exposure in the home, and, second, develop the content of the Lay Health Advisor program based on this formative information. We will evaluate this program by conducting pre- and post-test interviews with farmworkers, and comparing safety and knowledge to a control group who receive other important health education.
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?La Familia! extends collaboration between the North Carolina Farmworkers' Project (NCFP), a grassroots community based organization, and environmental health researchers at Wake Forest University School of Medicine to evaluate a Lay Health Advisor (LHA) model to reduce pesticide exposure among farmworker families. The proposed research builds on PACE, Preventing Agricultural Chemical Exposure among North Carolina Farmworkers (R21 ES08739), a highly successful workplace intervention to reduce migrant and seasonal farmworker pesticide exposure. With ?La Familia!, the PACE focus shifts to exposure of farmworker families, particularly children, and expands work with the North Carolina farmworker community to workers in the western region of the state. ?La Familia!'s specific aims are to: (1) document and assess farmworker knowledge, beliefs and perceptions of pesticide exposure of all family members, particularly as they relate to exposure of children; (2) identify pathways for environmental exposure of farmworker children to pesticides; (3) develop, implement, and evaluate a culturally appropriate LHA intervention to reduce pesticide exposure of children (aged 18-48 mo) in farmworker homes; and (4) compile and disseminate the final intervention program to other farmworker communities and farmworker service providers. A model of community participation will be implemented throughout the 5 project years. Formative research (in-depth interviews; pathway exposure assessment) will be completed in Years 1 and 2. Using the formative results in a PRECEDE-PROCEED framework, the content and format of the LHA intervention will be developed in Year 2. This intervention (and a revision) will be evaluated in Years 3 and 4 using a group randomized design. End-points will include change in knowledge of pesticide exposure routes for children and ways to reduce their exposure; change in exposure-related behaviors; and changes in household dust levels. In the final year, support will continue for the LHA program as part of the process of NCFP developing its health outreach mission in western NC., while the results of the project are disseminated to regional and national farmworker groups, to those providing health care to farmworkers, and in the research literature.