Transcript AgrAbility Outreach to Migrant and Seasonal Farmworkers: Fotonovelas and Beyond AgrAbility Webinar Series September 2, 2010

AgrAbility Outreach to Migrant
and Seasonal Farmworkers:
Fotonovelas and Beyond
AgrAbility Webinar Series
September 2, 2010
• AgrAbility: USDA-sponsored program that
assists farmers, ranchers, and other
agricultural workers with disabilities.
• Disability can include ergonomic/orthopedic issues,
arthritis, etc., as well as traumatic injuries, such as
spinal cord injuries or amputations.
– Partners land grant universities with disability
services organizations
– Currently 23 projects covering 25 states
– More information available at www.agrability.org
Basic Webinar Instructions
• Need speakers or headphones to hear the
presentation
• Meeting > Manage My Settings > My Connection
Speed
– Dial-up not recommended
• Questions about presentation – use chat window or
call 800# provided at the end
• Problems: use chat window or email
[email protected]
• 4 quick survey questions
• Session recorded and archived with PowerPoint file
at www.agrability.org Online Training link
Webinar Outline
• Arthritis fotonovela for farmworkers
• California AgrAbility outreach activities and
strategies
• Migrant/seasonal farmworker outreach by
Missouri AgrAbility
Background on Fotonovela Project
• 1980s: Arthritis and agriculture publications
produced by Breaking New Ground
• 2004: Update of Arthritis and Agriculture
• 2007: Partnership with California AgrAbility to
produce Spanish arthritis/agriculture resource
• Partnering Organizations
– Indiana AgrAbility
• Breaking New Ground, Purdue University
• Arthritis Foundation, Indiana Chapter
• Transition Resources Corporation
– California AgrAbility
• University of California-Davis
• Arthritis Foundation, California Chapters
– Western Center for Agricultural Safety and Health,
UC Davis
• Development Process
– Discussions of format
– Development of story/script
– Translation/editing
– Production = 2010
Spanish Fotonovela
¿Podrá ser la ARTRITIS lo que me causa DOLOR?
Could arthritis be what is causing my pain?
Información para las personas con dolor en las
coyunturas
Information for people with joint pain
Amber Wolfe
AgrAbility Project Coordinator
Arthritis Foundation-Indiana Chapter
National AgrAbility Project
• Fotonovelas are acceptable means of written/visual
communication in Latino communities
• Many of the second and third generation family members will
find health care information at health fairs or clinics and will
share it with their older family members
• Fotonovelas are also helpful for conveying health care
messages to areas of low-literacy as it focuses on the storyboard pictures more than the text
• Format- 24 page full color booklet, 69 photographs, 2 diagrams
• Characters:
– Rosa - older Woman
– Marcela - college age woman
– Sara - middle-aged woman
– Angelo - older man
– Jose - younger man
• Scene 1: kitchen with three women
sitting around the table chopping
vegetables for barbeque.
– Rosa’s hands are hurting her (she is
a vineyard worker) and Marcela
suggests that it may be arthritis by
sharing information she picked up at
a health fair.
– Marcela and Sara convince Rosa to
see her doctor.
Scene 2: Ladies go outside to
where the men are
cooking on the grill. Older
man attempts to pick up
child but has difficulty.
– Angelo has been a
dairy worker for over
20 years and now has
pain in his knees and
back.
Scene 3: Dr’s office/clinic:
– Angelo is seen by a nurse
practitioner who runs his
tests and talks to him about
his pain.
– Several days later- test
results show he has
osteoarthritis in his knees.
– The nurse practitioner talks
with him about modifications
that he can make around the
home and alternative
methods of working to help
manage his pain without
lessening his productivity or
pride.
Several weeks later…
– Conclusion shows the family as
they are playing soccer in the
back yard.
– It states that even though
Angelo still experiences joint
pain at times, it is much better
now that he has seen a doctor
and is following the
recommendations.
Other information included in the fotonovela
• Sources of Information
– Arthritis Foundation Spanish Assistance
• 1-800-283-7800
• www.arthritis.org/espanol
• [email protected]
– National AgrAbility Project
– CalAgrAbility
– National Center for Farmworker Health
• 12 Tips for Controlling Arthritis
• 5 Keys to a Healthy Life
• How to obtain the Fotonovela
– www.arthritis-ag.org (print order form) or
www.agrability.org
– Call or email Amber Wolfe at 1-800-783-2342 or
[email protected]
– Prices are as follows (shipping not included):
•
•
•
•
1-99 copies = $0.70 each
100-499 copies = $0.65 each
500-999 copies = $0.60 each
1,000+ copies = $0.55 each
CalAgrAbility Outreach to Migrant and Seasonal
Farmworkers: Fotonovelas and Beyond
September 2, 2010
Martha C. Stiles, Program Director
CalAgrAbility, University of California Davis, Dept. of
Biological and Agricultural Engineering Partnered with The
Arthritis Foundation
Project funded by the Cooperative State Research, Education, and Extension Service, USDA project number 2010-41590-02408. UC-Extension provides equal
opportunities in employment and programming including Title IX requirements.
SPEAKERS
MARTHA C. STILES, PROGRAM DIRECTOR
ESMERALDA MANDUJANO, BILINGUAL OUTREACH
REPRESENTATIVE
CRYSTAL MARTINEZ, BILINGUAL OUTREACH
REPRESENTATIVE
WHAT WE WILL DISCUSS
1. Why Use Spanish-language Materials,
Martha Stiles
2. Communication and Health Literacy,
Crystal Martinez
3. Reaching Migrant and Seasonal Farm workers,
Esmeralda Mandujano
WHY PRODUCE SPANISH-LANGUAGE MATERIALS?
1. Growing number of Hispanics in the US
2. To Communicate Critical Health & Rehab-Info
in Language(s) Appropriate for Consumers’ to
Increase Success in Accomplishing Goals
3. To Provide Same Level of Service that EnglishSpeaking Consumers Receive
WHY PRODUCE SPANISH LANGUAGE
MATERIALS?
Growing Hispanic Population in US
Total Hispanics
1980: 4,544,331 19.20%
1990: 7,687,938 25.83%
2000: 10,966,556 32.38%
Source: Census 2000 analyzed by the Social Science Data Analysis Network (SSDAN).
WHY PRODUCE SPANISH LANGUAGE MATERIALS?
1. Since 1980, the nonmetro Hispanic US
population doubled
and…
2. Is the most rapidly
growing demographic
group in rural & smalltown America
Source: USDA, Rural Development Research Report No. (RDRR-99) 49
pp, May 2004
WHY PRODUCE SPANISH LANGUAGE MATERIALS?
Agriculture has Annual Influx of Spanish-Speaking Migrant
& Seasonal Workers In Most States
Estimates in a few AgrAbility
States
• California = 1+ million
• Texas = 300,000 +
• Georgia = 100,000+
• Michigan = 90,000+
• New York = 47,000 +
• Missouri = 20,000+
• Oklahoma = 14,000+
Photo: Health Outreach Partners
Sources: www.ncfh.org & MIGRANT AND SEASONAL FARMWORKER ENUMERATION PROFILES STUDY
Any Spanish-language material is better
than nothing…WRONG!
• Poor quality materials in
Spanish may do harm
• Watch for: inaccurate
info, poor translations,
grammar, punctuation
(accents are important!), &
inappropriate reading
levels
• 3rd-6th grade level for
farm workers
May 12, 2010| By Whitney Woodward, Alejandra Cancino and
Julie Deardorff, Tribune reporters
Translated Prescriptions Often
Wrong
Half of automated Spanish
versions have errors: 'It's scary'
Source: http://articles.chicagotribune.com/2010-05-12/health/ct-x-cspanglish-prescriptions-20100512_1_error-rate-pharmacies-spanish
Use Formats Acceptable, Preferable &
Understandable to Audience
FOTONOVELAS
• Popular format began in
the 1940’s in Mexico &
Europe
• Used frequently today to
communicate health
messages, esp. for lowliteracy groups
IMAGES & ACTIVITIES & VENUES = Acceptable,
Preferable & Understandable
• Use images/faces
that look like target
audience
• Show images of
intended
activity/behavior in
familiar settings
• Use photos rather
than drawings
PRE-TEST IMAGES & ACTIVITIES & VENUES & LANGUAGE
• Acceptability:
accepted as
true/identifiable, useable
by audience
• Preferability: having
greater value or
desirability; it is preferred
• Understandability: all
messages understood by
audience
WHEN WE PROVIDE INFO (novelas, etc.), It …
• May be the 1st steps the person takes in getting
health & rehab care
• May be passed on to family, must be accurate
and trustworthy, and…
• Is often the only communication we have with
that person
CRYSTAL MARTINEZ
COMMUNICATION
Communicating Effectively:
Overcoming Miscommunication with
Farm Worker Consumers
Presented by: Crystal Martinez
Bilingual Outreach Representative
California AgrAbility Program
Modify use change
CalAgrAbility Uses Plain
Language
What is it?
Objective use aim, goal
Participate use take part
Provide use give, offer, say
Source: http://www.plainlanguage.gov/whatisPL/index.cfm
Plain language =
communication the audience
can understand the 1st time
they read or hear it
Language that is plain to one
set of readers may not be plain
to others
PLAIN LANGUAGE BENEFITS CALAG CONSUMERS
• Provides information that is easy to read & understand in
a simple format …
So Consumers can:
•find what they need
•understand the information they find
•use information to fit health and rehab need
Fotonovela: ¿Podrá ser la Artritis lo que me causa dolor?
Could Arthritis be what is Causing my pain?
•Word Usage
-Eliminating medical jargon, using
common words
-Using conyunturas instead of the
medical term articulaciones
(means joints)
•Accompanying images with
words
CalAgrAbility’s Cultural and Linguistic Challenges
Language Barriers
•We assist people who are predominately
Spanish speaking
•There’s an emergence of workers speaking indigenous
languages … other than Spanish
I.E., Mam, Ancient Mayan dialect used by CA consumers,
with limited Spanish, also Mixteco a pre-Colombian dialect
CALAGRABILITY RESPECTS CULTURAL NUANCES IMPACTING
CONSUMERS WITH DISABILITIES & ILLNESS
Beliefs, customs &
norms are part of their
way of life
• Head of household is
decision-maker
• Disability = shameful
• Religion
• Education = 3-6th
grade
Illiteracy Vs. Low Literacy
Some CalAgrAbility consumers are
Illiterate: not able to read or write
-Not able to write a signature; i.e., sign documents
with initials or an “X”
Low literate: limited reading & writing abilities
-Low education level: understanding is basic, NOT
complex
-Need assistance from others reading material
CalAgrAbility Outreach to Low-& Non-Literate Spanishspeaking Consumers
1. Read documents out loud to
them
2. Re-state what was said in
documents (apply simple
language strategy)
3. Ask them to repeat what
was said… or what they
understood was said
4. Ask if they have any
questions
5. Summarize next steps
It is often best to have a family member sit
in so 2 sets of ears are listening.
85% Of Workers Say They Have Difficulty Reading &
Understanding Written Info Even In Their 1st Language
We verbally present information
in Spanish, and …
• Non-literate Consumers must
trust what is said…and
• They don’t review it at that
time, esp. if they cannot read
• Non-literate consumers usually
don’t have help to review info
after we leave….FOLLOW-UP
Source: PCAR 2007
Health Literacy & CalAgrAbility
Health Literacy is the
degree that a worker or
farmer can find, process,
&understand basic health &
rehab information that s/he
needs to make important
decisions about her/his
rehabilitation and health.
These are skills that all
people need to navigate
the rehabilitation and
health systems
Source: 2010, Healthy People, US DHHS
Building Program Capacity: CalAgrAbility’s Steps
toward Improving Health Literacy
• Accompany consumer to doctor, rehab, workers comp,
& other Medical appointments
• Search for Adult literacy programs available for
consumers
• Conduct Bilingual outreach … translation and
interpretation services to our consumers
Now Esmeralda will speak specifically
about how we reach our migrant and
seasonal consumers
Reaching Migrant and Seasonal Farmworkers
Esmeralda Mandujano
Bilingual Outreach Representative
California AgrAbility Program
University of California, Davis
Ag Workers can be difficult to reach
•3+ million migrant & seasonal
farmworkers reside & work in the
US (National Center for Farmworker Health,
2007)
•75%-born in Mexico
•23%-born in US
•78% are immigrants
US Demographics
•61% live below poverty
level (<1% receive cash aid)
•Median family income
is <$10,000
•Farming = main income
source
Photo Source
http://www.edibleportland.com/2008/07/hand_picked_row.htm
Workers are Difficult to Reach & Communicate With
US Demographics
• 81% speak mainly Spanish
• 18% English
• 2% other dialects or
languages
•79% Male
• Average age=31yrs.
• Lived in US 10+ yrs.
Photo Source http://www.edibleportland.com/2008/07/
hand_picked_row.html
Many Workers Follow 3 Migrant Streams
AND Move Up To 13 Times Per Year
Permanent
Residents
Source: National Center for Farmworker Health
What is a Migrant or Seasonal Farmworker?
•Migrant farmworker works in seasonal agriculture
and travels 50+ miles from home and lives in
temporary housing.
•A seasonal farmworker works in seasonal
agriculture; is a permanent resident of a community;
does not move into temporary housing when
employed in farm work.
CA Reaches Workers in Migrant Camps &
Housing Centers
Camps & Housing Centers
•usually housing located on
outskirts of towns in isolated areas
•House workers from other
countries an from other states
•California: 24 migrant
camps/centers run by the state
Other States Have Private/Licensed
Camps & Housing
Michigan = 807 Private
Licensed
Texas = 31 Licensed
Photo Source
http://www.palmbeachpost.com/hp/content/moderndayslavery/photos/
CalAgrAbility Attends & Sponsors Community Events
• Health fairs = opportunities to
reach farmers & workers
• Health Events = only time
families receive medical attention
• Children & Community Events
-- 64% of migrant households
have children (Cinco de Mayo, Local
Tomato, Pear, Asparagus Festivals, etc.)
Community Sponsored Events
Promotional/Advertisement of the Program in Spanish
CA Produces/Disseminates Spanish Educational Materials
CalAgrAbility Develops Strong Collaborative Bonds
Examples
• Promotoras
• Employment Development
• RISE Service Center
• Migrant Health Clinics
• Migrant Housing Authorities
• Latino Network
• CA Voc Rehab
• ALBA (Latino Farmer Group)
• CA Small Farm Training
• Arthritis Foundation
• Coop Extension
• ILCs
• Bi-National Health Coalition
• Health Education Council
Serve as a supplemental critical connections to maintaining
communication with consumer
CalAgrAbility Conducts Spanish Educational Trainings
• Increases Program Visibility
• Topics: Arthritis, Chronic
Disease; AT; Rehabilitation;
Reduce Secondary Injury, etc.
• Conducted at camps,
community centers, on farms,
farm bureaus, Extension
offices, etc.
2010 Spanish-language CalAgrAbility Arthritis Leader Training,
Woodland, CA
CA Produces Spanish Radio Spots
• Public Service Announcements
• Farmworkers are radio listeners (i.e. as they drive/ride
to work, at work, and at lunch breaks)
• Radio is a type of liaison between old and new life
Farmworkers want to learn!!!
IN SUMMARY
10 Strategies in Reaching Migrant & Seasonal Workers
1. Outreach where workers live, work, access service, &
socialize; go to them … they might not be able to come to
you.
2. Develop relationships & credibility within migrant
community over time.
3. Develop materials that are culturally sensitive &
accessible to all literacy & educational levels.
4. Establish and/or participate in community task forces—
networking!
5. Know the rights & resources available to the migrant
community.
IN SUMMARY
10 Strategies in Reaching Migrant & Seasonal Workers
6. Raise awareness about the risk of injuries.
7. Cultivate relationships with employers & contractors of
workers.
8. Develop culturally competent outreach, prevention, &
advocacy services.
9. Recognize & strive to understand the diversity within the
culture and the unique experiences of individuals.
10. Work with your colleagues to bridge gaps in services for
the migrant community.
Team work!!!
Working with Lay Health Workers…
Promotoras de Salud
Missouri AgrAbility Project
Missouri Arthritis Rehabilitation Research
and Training Center (MARRTC)
National Center for Farmworker Health
Arthritis Program
Lay Health Workers…
Promotoras de Salud
• Community Lay Health Workers or Promotoras de
Salud
– utilized in the delivery of health education in various
region around the world since the 1900’s and in the U.S.
since the 1950’s.
• Members of the community who promote healthy
living
– provide education about disease and injury prevention to
individuals and groups in a culturally appropriate and
sensitive manner.
• Help members of the community access formal
health and human services system.
Arthritis Program
Why Promotoras de Salud?
• The educational team believed that the most promising
method of delivering Arthritis education is to work
through the network of migrant health clinics and
promotoras which is already supported by NCFH staff.
• Promotoras de Salud have proven to be an effective
link in communicating medical information and helping
to motivate workers to adopt healthy lifestyles.
Arthritis Program
“Focus Groups” on Methodology
• Focus group meetings were organized in Texas and
Missouri to determine what methods and
approaches would be best received by promotoras
and migrant/seasonal farmworkers.
Arthritis Program
Let's Talk About Arthritis
The Let’s Talk About Arthritis bilingual flipchart is developed for lay health workers
to use while they conduct arthritis educational sessions in the community. The
flipchart provides the most important messages on arthritis and self management
for the community.
Arthritis Program
For more information
Karen Funkenbusch,
University of Missouri-Columbia
Missouri AgrAbility
Phone: (800)-995-8503
[email protected]
Arthritis Program