The nail salon industry is one of the fastest growing industries, generating approximately 8.5 billion U.S. dollars in 2014. The industry comprises nearly 380,000 nail technicians ? more than 51% of whom are Vietnamese refugees and immigrants of child-bearing age. These workers are exposed daily to an array of volatile organic chemicals (VOCs) and other chemicals from nail polish, polish removers, and artificial nail applicators that potentially could cause harmful acute and chronic health effects such as irritations to the skin and respiratory system and cognitive symptoms. The goal of this proposed research is to provide an effective, theory-based health training module that can be used by Vietnamese nail salon owners and workers who have limited/no access to in-person training. In the first aim, we will identify the knowledge gaps regarding the workplace hazards and perceived barriers to safe practices. Because the goal of this aim is to identify knowledge gaps, beliefs, and perceived barriers, qualitative methods (focus groups and interviews) will be used to collect in-depth behavior information.
The second aim focuses on developing the training module using a theory-based intervention-development framework. Technical information that will be included in the training module are: 1) chemicals of greatest concerns and their health effects and 2) hierarchy of controls, such as installation of local exhaust ventilation, use of personal protective equipment, and administrative controls. While addressing the barriers to adopting the recommended best practices, the module also will incorporate visual demonstrations, facts, interviews, and narratives of success stories from nail salon owners who operate healthy salons. In the third aim, we will conduct a pilot randomized intervention study to assess the feasibility of conducting a larger randomized study to evaluate the efficacy of our training module.
This aim serves to provide us feasibility outcomes (e.g., participation rate, retention rate), and develop outcome measures. Upon completion of the project, we will have tested the training module, survey questionnaire, and protocol for a larger randomized intervention study. The portability of the module and increasing use of the Internet and social media for information will allow our training module to be made available online in order to reach a larger percentage of Vietnamese nail technicians and reduce the disparities in access of health information in this population. This project is part of a larger mentored career- development plan in which the investigator will use the award period to take didactic classes to obtain additional training in 1) health promotion, intervention development, and evaluation and 2) occupational epidemiological methods. While the nail salon project will provide practical training in health promotion and intervention development, the investigator will also collaborate on projects with experts in the field to gain practical training in occupational epidemiology.

Public Health Relevance

The nail salon industry is a fast-growing industry comprising nearly 380,000 nail technicians, more than half of whom are Vietnamese immigrants of child-bearing age. This pilot project will develop a theory-based training module targeted at Vietnamese nail technicians and utilize mixed methods (qualitative and quantitative) to determine the feasibility of conducting a study to evaluate the efficacy of the training module in raising awareness of the hazards and addressing the barriers to adopting safe practices in nail salons to protect the health of nail technicians. The portability of this training format will allow the investigator to deliver health and safety training information to a large number of limited English-speaking nail technicians in a more cost- effective way than in-person training, helping to reduce the disparities in access of health information in many states that do not offer bilingual training programs.

National Institute of Health (NIH)
National Institute for Occupational Safety and Health (NIOSH)
Research Scientist Development Award - Research & Training (K01)
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Special Emphasis Panel (ZOH1)
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Lioce, Maria
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Drexel University
Public Health & Prev Medicine
Schools of Public Health
United States
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