LAWRENCE — Migratory agricultural workers have dangerous jobs that pose threats to their health. Yet little is known about their access to medical care beyond the challenges that make it difficult for both migrant workers and health care providers to ensure needs are met. The University of Kansas is leading a project to build capacity for involving migratory workers and the people who serve them in the research process.
KU’s School of Social Welfare, along with co-partners Migrant Farmworkers Assistance Fund and the National Center for Farmworker Health, has secured a two-year, $240,000 Eugene Washington Engagement Award from the Patient-Centered Outcomes Research Institute. The goal is to help prepare migratory agricultural workers to be involved as partners in research and to identify and expand networks through which researchers and organizations share and obtain information.
Cheryl Holmes, project lead and research project director in the social welfare school, said they will work with laborers through an orientation to prepare them for the research phase.
“We’ll focus on how we can support workers to partner in research. We know that if we don’t engage workers and providers and hear what is truly important, we won’t be able to provide improvements that are needed,” Holmes said. “We want to make sure that when research is done that the populations we are working to serve have been involved throughout the process. This means starting at the beginning when study questions are identified to the end with workers helping us understand what it means to their daily lives and in sharing the results.”
In addition to working with migratory workers and rural health care providers in two states, organizers will connect and build networks to support the dissemination of research findings with guidance from a national advisory council. Outreach will also be conducted with funders to share information about patient-centered outcomes research, encourage funding of such research related to migratory and seasonal agricultural workers and identify information gaps that funders may be experiencing.
Current funding will help researchers build on previous work begun two years ago to identify a research agenda in relation to health care access for migratory and seasonal agricultural workers. That project identified topics farmworkers say providers need to better understand, such as the importance of family, workplace risks, health practices, system and legal policies, and access. It also identified topics for providers and key stakeholders to better serve farmworkers, including transportation, interpretation services, changing policies and addressing behavioral health.
“Without a very clear understanding of the challenges and needs, health care providers are trying to address a wide range of needs with limited resources. Health care providers need assistance in understanding the range of health care challenges of the populations they serve,” said Hannah Britton, director of KU’s Center for the Study of Injustice. “Given that many of the workers are in one area for only a short time, health care providers also want to understand how to provide comprehensive care without the benefit of more traditional long-term relationships.”
The work will produce several products, including a project website, training and orientation for migratory and seasonal agricultural workers, funder outreach materials and an increase in the focus on research discussion and dissemination at the national level.
A particular strength of the program will be working to translate research findings to help guide policy and health care access for workers.
“Research in and of itself has limited value; rather, it is in the implementation of what has been learned or gained through research where the value to the community is realized. Participation and engagement not only as the ‘focus audience,’ but as partners or collaborators in the development of the research design, methods and implementation is critical for the results to have meaning and relevance to the community,” said Sylvia Partida, chief executive officer of the National Center for Farmworker Health.
Despite being a vital part of the American economy and food production system, research still has much to learn about migratory agricultural workers’ health care needs.
“Farmworkers are an important link in the food chain. Keeping farmworkers and their families healthy and strong is important to them and to all of us. They are working in rural areas where health care is limited for everyone,” said Suzanne Gladney, immigration attorney and migrant advocate with the Migrant Farmworkers Assistance Fund. “It's important to use scarce resources wisely to serve farmworkers. Understanding how to best serve their needs must involve listening to farmworkers and removing barriers to their access to health care services. PCORI's awards are required to be ‘patient-centered’ and involve listening and engaging with the patients. We are honored to be part of this second PCORI award to continue listening to farmworkers and their families.”
The capacity-building project will be a partnership between KU’s School of Social Welfare, the Dell Medical School at the University of Texas-Austin, Juntos Center for Advancing Latino Health, Migrant Farmworkers Assistance Fund, National Center for Farmworker Health, REACH Healthcare Foundation, University of Nebraska Medical Center, KU Center for the Study of Injustice and KU Center for Migration.
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