"We left the crop there lying in the field": Agricultural worker experiences with the COVID-19 pandemic in a rural US-Mexico border region.

California agricultural workers are predominately Latino/a, are medically underserved, and reside in larger households, placing them at elevated COVID-19 risk at work and at home. While some research has examined COVID-19 among agricultural workers in the interior of the United States, little research exists on experiences of COVID-19 along the US-Mexico border. Grounded in resilience thinking, this study aims to understand how agricultural workers navigated their heightened risk to COVID-19 at work and at home, and made use of available resources in the context of a bi-national community. Our study utilized qualitative interviews with 12 agricultural workers to understanding the COVID-19 experiences of resident and daily migrant agricultural workers in Imperial County, California, located along the US-Mexico border. Findings suggest that agricultural workers faced significant impacts and risks at work (work stoppages, stress about bringing COVID-19 home to family) and at home (contracting COVID-19, loss of friends and family, and mental health challenges). Agricultural workers and their employers often implemented COVID-19 precautions such as social distancing measures, personal protective equipment, hand washing and hand sanitizers, and isolation. Many agricultural workers did access testing resources on either side of the US-Mexico border and worked with US-based Spanish-speaking community-based organizations to register for vaccine appointments. To better support agricultural workers and their employers in the future, we recommend the following: 1. Prioritize agricultural workplace conditions to increase agricultural worker physical and mental health, 2. Extend public health services into agricultural work sites of transit and the workplace, and 3. Lastly, trusted Spanish-speaking community-based organizations can play a critical role in public health outreach.

Rural Hispanic/Latino cancer patients' perspectives on facilitators, barriers, and suggestions for advance care planning: A qualitative study.

OBJECTIVE: Hispanic/Latinos living in rural areas have limited healthcare resources, including palliative and hospice care. Moreover, little is known about advance care planning (ACP) among Hispanic/Latino cancer patients in rural areas. This study explores facilitators and barriers for ACP. It elicits suggestions to promote ACP among rural Hispanic/Latino cancer patients in a US/Mexico border region. METHODS: Hispanic/Latino cancer patients (n = 30) were recruited from a nonprofit cancer organization. Data were collected via in-person interviews. Interviews were transcribed and translated from Spanish to English. Data were uploaded into NVivo 12 and analyzed using thematic analysis. RESULTS: A common theme for facilitators and barriers for ACP was safeguarding family. Additional facilitators included (1) Desire for honoring end-of-life (EoL) care wishes and (2) experience with EoL care decision making. Additional barriers include (1) Family's reluctance to participate in EoL communication and (2) Patient-clinicians' lack of EoL communication. Practice suggestions include (1) Death education and support for family, (2) ACP education, and (3) Dialogue vs. documentation. SIGNIFICANCE OF RESULTS: ACP functions not only as a decisional tool; its utility reflects complex dynamics in personal, social, and cultural domains. ACP approaches with this underserved population must consider family relationships as well as cultural implications, including language barriers.

Effectiveness of education focused wraparound services to improve academic success for foster youth: A pilot study.

BACKGROUND: Youth with foster care experience are disproportionality burdened with poor academic outcomes compared to non-foster experience youth. The Fostering Academic Success in Education (FASE) pilot program provides comprehensive onsite educational case management services to foster care youth. OBJECTIVE: We used mixed methods to explore the effects of FASE on participating youth's academic performance and perceived self-efficacy to manage mental health services and support. PARTICIPANTS AND SETTING: Between 2020 and 2023, the FASE pilot program was delivered to 40 middle and high school students involved in child welfare services and out-of-home placements. METHODS: Quantitative data comprised pre-post FASE intervention academic outcomes (GPA, attendance, and tardies) and the Youth Efficacy/Empowerment Scale-Mental Health (YES-MH). Paired sample t-tests and one-way ANOVA were used to assess difference in time outcomes. Qualitative generating questionnaires were administered to FASE youth and school personnel annually. RESULTS: After participating in FASE for one academic year, youths' GPA significantly improved (mean 2.38-2.80, p = .001), tardies significantly reduced (mean 3.78-3.1, p = .011), unexcused periods significantly reduced (mean 17.30-9.51, p = .018) and there was a significant improvement in YES-MH scores (mean 46.9-55, p = .001). Female youth had larger GPA and YES-MH score increases than male youth. FASE youth and personnel attributed academic success to the comprehensive support received by the program's educational social worker. CONCLUSIONS: The FASE program holds promise in improving academic performance and mental health self-efficacy among foster care-involved youth.

Hearing Difficulties Among Farmworkers in the México-US Southwest Border Region.

Migrant and seasonal farmworkers are a vulnerable population with a potentially high risk for hearing loss due to farm-related noise exposures. Occupational noise-induced hearing loss (NIHL) is permanent, and it is associated with an increased risk for injuries on the job, as well as communication difficulties, isolation, and depression. The México/US border region is one of the most productive agricultural regions in the country, however, no known studies have explored hearing loss among farmworkers in this area. This pilot study was a first step toward measuring and addressing hearing loss and noise exposure among this region's farmworkers. We conducted a cross-sectional survey to estimate the prevalence of subjective hearing difficulties among Yuma County, Arizona farmworkers. Survey interviews took place during a late-night farmworker health fair from 2 am to 6 am to accommodate local farms' labor schedules. Multivariable regression adjusted for demographic and work covariates estimated subjective hearing loss prevalence ratios. Among 132 farmworker participants, 36% reported they have or might have hearing loss, and 62% reported no hearing loss. Subjective hearing loss prevalence was lower in farmworkers who report not working in noise compared to prevalence in farmworkers who work in noise [prevalence ratio, 0.44 (95% CI 0.23-0.82)]. This report contributes to understanding the perception of hearing-related health and occupational exposures among farmworkers in the México-US Southwest border region. The information from this line of research will inform appropriate safety measures known to lower the risk of experiencing occupational NIHL.

Pre and During COVID-19 Access to Rural Mental Health Care Among Agriculture Communities in the Rocky Mountain Region.

Death by suicide is the second leading cause of intentional injury incurred by foreign-born workers in the United States. Hispanic/Latino farmworkers are systematically excluded from important safety net programs. Drawing on interviews with 16 individuals representing various community organizations serving rural, agriculture-dependent regions in Colorado (n=9) and Utah (n=7), we describe Hispanic/Latino farmworkers' access to the mental health safety net in the Rocky Mountain Region post/during the COVID-19 pandemic. Findings inform the need for expanded safety net infrastructure and community collaborations to support farmworkers effectively now and in the case of future pandemics.

County-level analysis on occupation and ecological determinants of child abuse and neglect rates employing elastic net regression.

BACKGROUND: Occupation is a known determinant of worker physical and behavioral health risk, yet most previous studies have focused on unemployment, underemployment, and job satisfaction to understand child maltreatment risk. OBJECTIVE: This county-level study (n = 278) investigated the association between occupation and child maltreatment rates and community well-being in California, Colorado, Minnesota, Oregon, and New Mexico. PARTICIPANTS AND SETTING: States were selected due to having comparable, publicly available county-level data on substantiated child abuse and neglect rates within a five-year span between 2015 and 2020. METHODS: Using US Census Bureau American Community Survey data, we collected percentages of the employed population among 13 occupations. Five additional community health indicators came from the County Health Rankings and Roadmaps. Elastic net linear regression was used for variable selection and because of explanatory variables' interrelationships. Linear regression was used to model individual industries positively associated with child abuse rates. RESULTS: The elastic net model selected ten important variables in explaining child maltreatment rates. Important occupational sectors were agriculture, forestry, fishing (AFF), manufacturing, wholesale, retail, finance, and education. Important community indicators included housing, injury deaths, and poor mental health days. Only AFF and retail showed greater child abuse rates with increasing percentages of the workforce in these occupations in unadjusted models (AFF: ß = 0.03 SE = 0.01, p = 0.02; Retail: ß = 0.09 SE = 0.04, p = 0.02). CONCLUSIONS: Our findings suggest group-level effects of counties with a larger AFF and retail presence experiencing higher child maltreatment rates. Given that numerous prior studies of county economies note the strong associations of certain employment types with cultural attitudes, educational opportunities, regional biases, and other unmeasured variables, future studies should incorporate individual level data in a multilevel framework.

"We All Have a Job to Do in This World, It's up to Us": Farmworker and Farmer Mental Health in a Rural US-Mexico Border Region.

Improving mental health outcomes for agricultural populations is dependent on understanding the unique farming related stressors in context of the local culture and community. This study was designed to assess the prevalence of stressors and mental health risks among farmers and farmworkers in a rural, medically underserved US-Mexico border region. Of 135 study respondents, 55.6% (n = 18) farmers had clinical depression symptomatology based on the Center for Epidemiologic Studies depression screening scale (CES-D) and 40.2% (n = 117) farmworkers had stress levels that pose significant mental health risks based on the Migrant Farmworker Stress Inventory. Farmworker females were 2.3 times more likely to have a score of clinical concern. Results provide an understanding of the distinct sources of stress for both farmers and farmworkers and the mental health challenges across the industry. With an understanding that suicide is the third leading cause of injury death in Imperial County and depression associated with an increased risk of suicidality, the agricultural workforce in Imperial County is particularly vulnerable. Local farm organizations, employers, and community organizations can help increase mental health access, acceptability, and availability to achieve greater safety and health in the region's largest workforce.

Work-Life Stress during the Coronavirus Pandemic among Latina Farmworkers in a Rural California Region.

OBJECTIVES: To examine the type and severity of stressors experienced among Latina farmworkers during the COVID-19 pandemic. METHODS: A survey containing the Migrant Farmworker Stress Inventory was administered to 77 female-identifying Latina farmworkers working in a US-Mexico border region. A sub-sample of five participants participated in key-informant interviews. Data collection occurred in Summer 2021. RESULTS: Nearly 40% of Latina farmworkers reported high stress levels indicative of clinical mental health risks. Health and safety concerns and experienced stressors identified included visible substance abuse and poor bathroom conditions at the field site, language barriers, and balancing work and home life demands. CONCLUSIONS: Latina farmworkers have unique health and safety needs, and COVID-19 has contributed to the experienced stressors. Understanding the familial and working environment sources of stress specific to female agriculture workers is imperative to implementing culturally and gender-responsive strategies to better support the health and safety of farming populations in future pandemics.

Assessing Connections in an Agricultural Community Using Social Network Analysis.

Agricultural workers experience higher rates of injury and illness than other occupational groups. NIOSH-supported agricultural centers in the U.S. are funded to reduce injury and illness but require effective partnerships with other agricultural organizations to achieve this goal. Our purpose was to understand the structure of agricultural organization connections within six states in the western U.S., including how different types of organizations connect to one another, and specifically where the High Plains Intermountain Center for Agricultural Health and Safety (HICAHS) is positioned in the agricultural organization network. An electronic survey was distributed to contacts within organizations that had a previous history with HICAHS leadership and advisory board members. The survey asked respondents about their position in the organization, years with the organization and frequency of contact in the past year. A social network analysis was undertaken to assess the connections between agricultural organizations using measures of centrality (density, closeness, betweenness), cliques, clusters, and brokers. A two-tier structure was identified with a core group of 21 organizations and a peripheral group of 30 organizations. Influence was centered in the core group as evidenced by high centrality scores with minimal bridging between organizations. HICAHS was on the periphery, but on the cusp of being in the core. Agricultural producers, agricultural extension and insurance companies were central in the network. Centers are in a unique position to promote collaboration with stakeholders. The social network analysis identified missing connections that need further development in order to address agricultural safety and health.

The role of co-occurring intimate partner violence, alcohol use, drug use, and depressive symptoms on disciplinary practices of mothers involved with child welfare.

BACKGROUND: Evidence suggests intimate partner violence (IPV), substance use, and depression adversely affect the disciplinary practices of caregivers involved with child welfare; however, it remains uncertain whether the combined effects of these conditions are syndemic. OBJECTIVE: The purpose of this study was to examine the (1) associations between IPV, problematic drug use, problematic alcohol use, and depressive symptoms and self-reported disciplinary practices among a sample of mothers with child welfare contact; and (2) effect of co-occurrence of these conditions on child disciplinary practices. PARTICIPANTS AND SETTING: We used data from the second cohort of the National Survey of Child and Adolescent Well-Being (NSCAW II). The analysis focused on 965 biological mothers with children who were subjects of child abuse/neglect investigations between February 2008 and April 2009 in the United States. METHOD: We conducted multiple linear regression analyses. RESULTS: Our findings showed that IPV (B = .28; 95% CI = [.04, .53]) and depressive symptoms (B = .27; 95% CI = [.03, .52]) were independently associated with psychologically aggressive disciplinary practices. Also, IPV was independently associated with physically aggressive disciplinary practices (B = .64; 95% CI = [.18, 1.11]); and IPV (B = .21; 95% CI = [.06, .35]) and depressive symptoms (B = .22; 95% CI = [.07, .37]) were independently associated with neglectful parenting strategies. A significant effect was found for the interaction between problematic drug use and depressive symptoms with physically aggressive practices as the outcome. As the number of conditions caregivers had increased, so did their propensity for self-reporting each of the disciplinary practices (p < .05). CONCLUSIONS: The findings highlight the need for using a more holistic/multidisciplinary approach to child maltreatment prevention research, policy, and intervention.