Agricultural chemicals pose health risks for farmworkers engaged in cultivating and harvesting crops. In a project to develop culturally appropriate interventions to reduce farmworker exposure to agricultural chemicals, formative research used in-depth interviews and focus groups to elicit beliefs and knowledge about exposure from farmers and migrant and seasonal farmworkers in North Carolina. Farmworkers were concerned about acute effects they attributed to exposure and had little knowledge of long-term effects of low-level exposure. They believe that some individuals are inherently more susceptibility to the health effects of exposure than others; most do not recognize the skin as a site of chemical absorption. They report instances of exposure that reflect the power relationships with farmers, indicating that lack of knowledge is not the only issue that must be addressed in an intervention. Farmers believe that farmworkers are not exposed to chemicals because they do not mix or apply chemicals. Such a belief is consistent with the training received by farmers. The PRECEDE-PROCEED planning model is used to identify predisposing and reinforcing factors on which an effective intervention should focus.

The participation of affected communities in the development of public health intervention research improves project sustainability and effectiveness by making projects more relevant and acceptable to the communities. This article presents a multimode, multidomain model approach for community participation in different project components, which ensures the benefits of participation without requiring the same level of participation in every activity or by every community sector. A case study is used to illustrate the model, describing procedures for establishing and maintaining farmworker participation in developing an intervention to reduce exposure to chemicals. Farmworkers are a poor and underserved population for which the empowering and culturally appropriate benefits of community participation are especially needed. However, this population presents challenges for participatory health projects: geographic dispersion, ethnic diversity, lack of organization, sense of powerlessness, and communication and transportation difficulties. The lessons learned in this case extend the method and theory of community participation.

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Farmworkers experience a lack of control over the conditions of their work environment. In trying to reduce the effects of exposure to pesticides, most health care providers give instructions to farmworkers about how to protect themselves. Outreach programs that target farmworkers focus on health education and recommend washing hands, wearing appropriate clothing, and avoiding direct contact. The research reported in this paper shows that farmworkers in North Carolina perceive many of these preventive measures to be outside their control. The ability of farmworkers to engage in safe practices depends on fair capability to communicate with their employer, have positive work relationships, and the availability of protective equipment. The perceptions of control identified in this paper are issues that service providers and policy makers should consider to provide programs that will effectively promote pesticide safety and healthier farmworkers.

Preventing or reducing exposure to agricultural chemicals is an important focus for health educators serving migrant and seasonal farmworkers and their families. The development of the US Environmental Protection Agency Worker Protection Standard requiring that farmworkers receive pesticide-related training created a demand for culturally appropriate and effective training materials, yet no compendium of such materials exists. This paper reports the results of a search for and evaluation of training materials designed for use with farmworkers. There is considerable redundancy in the training materials currently available to health educators. Few items address the health issue of chemical residues in the fields, an important source of low level chronic chemical exposure for farmworkers. There are no published evaluations of the effectiveness of any of the materials. Our review suggests the need for further development and testing of appropriate training materials to reduce the exposure of farmworkers to agricultural chemicals.