Challenges in evaluating a promotora program to reduce occupational injuries among Latino poultry processing workers

Evaluation is essential for identifying those occupational health interventions that are successful in improving worker health and safety. Designing evaluations of interventions that must be conducted outside the workplace or when workplace access is limited presents challenges. Poultry processing is one of the most dangerous industries in the US. Many of the 250,000 poultry processing workers are immigrants and lack unions to support their rights for safe workplaces. Workplace safety training for these workers is limited, and employers are reluctant to allow outsiders into the plants to conduct safety training or observe health-related conditions. This presentation reports on an attempt to evaluate outcomes related to knowledge and action among workers and their family members participating in a lay health advisor program (promotoras de salud). Promotoras, several of which were current or former poultry processing workers, were recruited from the community and trained in a curriculum that included (1) prevention and treatment of musculoskeletal injuries, (2) worker solidarity in avoiding injuries, and (3) workers' rights. Lessons were delivered to workers in community settings using a story-telling approach, supported with low-literacy flipcharts. A sample of persons who had received the promotoras' lessons were recontacted by project staff and asked a series of questions to measure knowledge retained about injury prevention and workers' rights. While this type of evaluation is less than ideal, occupational health researchers need to devise alternative ways of evaluating interventions for marginalized workers, like poultry processing workers. (NIOSH grant OH008335)