Marked disparities in health status and health care access among immigrant ethnic minorities are alarming, and yet unaddressed issues for American public health. Compared to their native-born counterparts, this immigrant group is overrepresented in low wage and intrinsically dangerous jobs where they experience greater risks of hazard exposure, injury, and illness. Relatively unsuccessful OH prevention efforts, designed for worksite implementation with low-wage immigrant workers, compel re-thinking intervention strategies and optimizing novel community-focused, network-oriented approaches. Ethnic community agencies are important but underutilized assets capable of providing the essential building blocks for collaborative community OH approaches. This research will investigate the integration of basic worker health education (WHEB) in and by community agencies in order to reach a broad range of Chinese American immigrants.
Study aims are:
Aim 1 : Critique and enhance WHEB materials for appropriateness, comprehensibility, and viability for use in community agencies, by engaging a community advisory panel of service providers;
Aim 2 : Characterize intra- and extra-organizational factors associated with community agency approaches to program changes, and agency openness to engage in adopting WHEB as a service innovation;
and Aim 3 : Describe the implementation process (planning, delivery model selection) and outcomes (suitability, continuation) of WHEB integration in diverse community agency settings, using a pilot implementation trial. A mixed-methods design will be used across study aims. Bilingual service providers familiar with Chinese culture and agency workflow (Aim 1) will critique the prototype WHEB materials, which are based on guidelines developed by OHSA, L&I and NIOSH. With agencies as observational units, middle/high level administrators from 21 Chinese and 23 non-Chinese community agencies will be interviewed regarding factors associated with agency approaches to program changes and openness to adopt WHEB (Aim 2). We will randomly select a sample of eight agencies that express interest in integrating WHEB into their services;an OH educator will work with each agency to conduct the pilot implementation trial for the set of WHEB materials (Aim 3). With online surveys (post- implementation &follow-up) completed by two representatives per agency, we will collect data on the specific implementation process and outcome variables. We will incorporate the OH educator's participant- observations into the analysis, integrating quantitative and qualitative data to provide direct and practical knowledge about how community agencies move forward in adopting new program ideas for WHEB. This developmental project responds directly to NORA programs and NIOSH's call for novel approaches to address OH disparities. Results, including Chinese immigrant targeted WHEB materials, will be used to develop a larger community intervention trial. Knowledge generated will advance translational research for community partner selection and intervention design to increase OH program diffusion and sustainability in communities.

Public Health Relevance

Health disparities commonly experienced by US immigrant workers are linked to workplace hazard exposure associated with their differential employment in high health risk jobs. Health disparities are exacerbated because of the generally reduced effectiveness of worksite intervention efforts for low-wage-earning immigrant workers. This project seeks to promote a healthy US workforce by investigating processes for the integration of basic worker health education into community agency settings, thereby generating knowledge necessary to develop alternative approaches for disseminating community-based preventive interventions.

National Institute of Health (NIH)
National Institute for Occupational Safety and Health (NIOSH)
Exploratory/Developmental Grants (R21)
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Safety and Occupational Health Study Section (SOH)
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Frederick, Linda J
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University of Washington
Other Health Professions
Schools of Nursing
United States
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