User Perceptions of ¡Protéjase!: An Intervention Designed to Increase Protective Equipment Use Among Mexican Immigrant and Mexican American Farmworkers

Abstract

BackgroundFarmworkers’ exposures to pesticides are reduced when they wear personal protective equipment (PPE), and mobile health (mHealth) platforms can potentially deliver information to farmworkers to help promote PPE use. However, little is known about the feasibility of using mHealth platforms to promote farmworkers’ use of PPE.ObjectiveThe objective of the study was to describe the development and feasibility-testing of Protect Yourself! (¡Protéjase!), an intervention designed to increase PPE use. As the vast majority of farmworkers in the United States are from Mexico, we examined the intervention in a primarily Mexican-origin farmworker population.Methods¡Protéjase was developed in several steps. First, we performed ethnographic observations to understand what prevents PPE use. Next, we developed program components that met the challenges uncovered in the ethnographic observations, seeking direct feedback from farmworkers on each component. Feasibility was assessed using surveys and focus groups. Material was provided in Spanish or English at the preference of the participant. Finally, we pilot tested each component of the intervention, including: (1) PPE that was provided to each worker for their personal use during the intervention trial, and (2) delivery of an application-based tool that promoted the use of PPE through daily individualized messaging.Results55 farmworkers enrolled in the study, but only 41 of 55 (75%) completed the entire pilot intervention trial. Results focus on the evaluation of the intervention, and include only those who completed the entire trial. Among farmworkers who completed the entire intervention trial, all but two farmworkers were born in Mexico and were Spanish speaking. Still, all study participants self-identified as Mexican or Mexican-American. When asked what changes were needed in the intervention’s messaging or delivery to increase user satisfaction, 22 out of 41 participants (54%) felt that no changes were needed. However, 16 of 41 participants (39%) suggested small changes to messaging (eg, refer to long pants as pants only) to improve their understanding of the messages. Finally, a small number (3 of 41 participants, 7%) felt that messages were difficult to read, primarily due to low literacy.ConclusionsThe ¡Protéjase! mHealth program demonstrated very good feasibility, satisfaction, and acceptance; potential improvements (eg, small modifications in messaging to increase farmworkers’ use) were noted. Overall, the PPE provided to workers as well as the mHealth platform were both perceived as useful for promoting PPE use.

Providing Health Information to Latino Farmworkers: The Case of the Affordable Care Act

“…These results suggest several generalizations about getting information about health programs to Latino farmworkers that reflect past farmworkers research and programs. 11,17 Health care providers, including hospitals, clinics, doctors, and nurses, are the preferred source of health information. Information from these sources is trusted by most farmworkers.…”

“…Price et al 8 and Sandberg et al 9 indicated that a large and growing number of farmworkers have smart phones. Snipes et al 11 reported a willingness among farmworkers to use mobile devices to receive health information (specific occupational safety information) and provide data through these devices. Grzywacz et al 21 found that other Latino workers (construction workers) would use mobile devices to provide daily diary research data.…”

The role of acculturation and training in personal protective equipment (PPE) use among Hispanic farmworkers: A follow-up from the ¡Protejase! study.

“…We provided participants with three PPE items (i.e., gloves, long-sleeved shirts, and safety glasses) that had been user-tested for functionality and comfort in a previous study as part of the ¡Protejase! study (Snipes et al, 2016). To model an environment in which PPE is recommended but not provided (i.e., workers must provide PPE themselves), we did not provide long pants, boots, and head coverings.…”

Promoting Culturally Tailored mHealth: A Scoping Review of Mobile Health Interventions in Latinx Communities

“…Snipes et al [43,44] published two studies exploring the potential for mHealth interventions to increase the use of personal protective equipment (PPE) among Mexican immigrant and Mexican American farmworkers. The ¡Protéjase!…”

“…A total of 55 farmworkers participated in the ¡Protéjase! mHealth program; 75% of participants completed the program with few noting difficulties in understanding the messages disseminated [44]. Individualized messages were perceived as helpful when they communicated health risks.…”