A pilot project to increase health literacy among youth from seasonal farmworker families in rural eastern North Carolina: a qualitative exploration of implementation and impact

Objective There are substantial health inequalities for seasonal agricultural workers and their families in the United States. One identified inequality is in health literacy. The authors explored the implementation and impact of connecting youth from seasonal farmworker families who participated in a leadership and college pipeline program with Internet access by providing a tablet with a paid cellular data plan and university library–based health literacy training. Methods With the support of a National Network of Libraries of Medicine Health Information Outreach Award, we conducted a qualitative, utilization-focused evaluation by conducting semi-structured interviews from December 2017 through February 2018 with middle and high school age participants in the program (n=10). After parental consent and youth assent, we recorded interviews with participants at program activity locations or in their homes. We then utilized inductive thematic analysis with 2 primary coders. Results We identified four themes: (1) having access to the Internet can be transformative, (2) access resulted in increased knowledge of and interest in one’s own and others’ health, (3) “Google� is the norm, and (4) participant training increased self-efficacy to determine credible sources and resources. Conclusion Providing Internet access and iPads was possible to implement and resulted in increased utilization of health information. The combination of Internet access with training on information literacy was a key factor in achieving these positive outcomes. The findings suggest the importance of ensuring equitable access to the Internet in efforts to improve educational and health outcomes for seasonal farmworkers and their families

Health and Occupational Injury Experienced by Latinx Child Farmworkers in North Carolina, USA

Children as young as 10 years old are hired to work on farms in the United States (U.S.). These children are largely Latinx. Using interview data collected from 202 North Carolina Latinx child farmworkers in 2017, this analysis documents the heath characteristics and occupational injuries of Latinx child farmworkers and delineates characteristics associated with their health and occupational injuries. Latinx child farmworkers include girls (37.6%) and boys (62.4%), aged 10 to 17 years, with 17.8% being migrant farmworkers. Three-quarters reported receiving medical and dental care in the past year. Respiratory (15.8%) and vision (20.3%) problems were prevalent. Girls more than boys, and younger more than older children had greater health service utilization. Occupational injuries were common, with 26.2% reporting a traumatic injury, 44.1% a dermatological injury, 42.6% a musculoskeletal injury, and 45.5% heat-related illness in the past year. Age increased the odds of reporting work injuries and heat-related illness, and being a non-migrant reduced the odds of reporting work injuries. These results emphasize the need for greater documentation of child farmworker occupational health and safety. They underscore the need to change occupational safety policy to ensure that children working in agriculture have the same protections as those working in all other U.S. industries

Respiratory Health and Suspected Asthma among Hired Latinx Child Farmworkers in Rural North Carolina

The aim of this study was to evaluate respiratory health problems, including suspected asthma, and healthcare provider utilization among a sample of Latinx hired child farmworkers in rural North Carolina (n = 140). In 2018, a respiratory health questionnaire and breathing tests were collected from Latinx child (11–19 years) farmworkers (35.0% girls and 65.0% boys). Overall, 21.4% of children reported having been told by a medical provider that they had asthma, yet based on a combination of responses to respiratory survey questions, 36.4% or 15% more were identified as having suspected asthma. While 56.4% reported having a regular medical doctor, 38% had not had a medical exam in the past year. Respiratory dysfunction, including suspected, or uncontrolled asthma was prevalent among this group. Latinx children working in agriculture are vulnerable to occupational hazards and exposures and require assurances that they will receive access to high quality healthcare services that include routine respiratory health screenings

Sociopolitical Development among Latinx Child Farmworkers

The objectives of the present study were to describe civic attitudes and behaviors among Latinx child farmworkers in North Carolina, examine civic outcomes across relevant demographic characteristics, and discuss the implications for research on sociopolitical development among Latinx child farmworkers and for developmental theory. Descriptive statistics (count, percent, or mean, standard deviation as appropriate) were calculated for demographic and civic variables. Associations between the demographic variables and the four civic summary variables were calculated using Generalized Linear Models, the Kruskal–Wallis test, t-tests, or Chi-Square tests. Latinx child farmworkers in North Carolina (N = 169; ages 11–19, Mage = 15.8, 62.7% boys) endorsed relatively high levels of beliefs that society is fair and connections/efficacy in their communities. They reported relatively low involvement in volunteering and political activity. Future work should examine how the daily lives and experiences of child farmworkers inform their developing ideas about civic life in the US and their behavioral participation as they mature

Delivery Room Resuscitation and Short-Term Outcomes in Moderately Preterm Infants

ObjectivesTo describe the frequency and extent of delivery room resuscitation and evaluate the association of delivery room resuscitation with neonatal outcomes in moderately preterm (MPT) infants.Study designThis was an observational cohort study of MPT infants delivered at 290/7 to 336/7 weeks' gestational age (GA) enrolled in the Neonatal Research Network MPT registry. Infants were categorized into 5 groups based on the highest level of delivery room intervention: routine care, oxygen and/or continuous positive airway pressure, bag and mask ventilation, endotracheal intubation, and cardiopulmonary resuscitation including chest compressions and/or epinephrine use. The association of antepartum and intrapartum risk factors and discharge outcomes with the intensity of resuscitation was evaluated.ResultsOf 7014 included infants, 1684 (24.0%) received routine care and no additional resuscitation, 2279 (32.5%) received oxygen or continuous positive airway pressure, 1831 (26.1%) received bag and mask ventilation, 1034 (14.7%) underwent endotracheal intubation, and 186 (2.7%) received cardiopulmonary resuscitation. Among the antepartum and intrapartum factors, increasing GA, any exposure to antenatal steroids and prolonged rupture of membranes decreased the likelihood of receipt of all levels of resuscitation. Infants who were small for GA (SGA) had increased risk of delivery room resuscitation. Among the neonatal outcomes, respiratory support at 28 days, days to full oral feeds and length of stay were significantly associated with the intensity of delivery room resuscitation. Higher intensity of resuscitation was associated with increased risk of mortality.ConclusionsThe majority of MPT infants receive some level of delivery room resuscitation. Increased intensity of delivery room interventions was associated with prolonged respiratory and nutritional support, increased mortality, and a longer length of stay