By student from Miami, Rachel Becker

A paucity of literature provides an in-depth exploration of the mental and physical health of migrant workers. Researchers and clinicians have a variety of unanswered questions that could help them better serve this community, ranging from methods of health promotion to help-seeking behaviors to resiliency factors. High quality research will not only provide them with a better understanding of this population, but also assist them in tailoring their efforts and interventions.

Given the historical trauma, marginalization, and disenfranchisement of migrant workers, research frameworks must empower communities to have a strong voice in the focus, process, and dissemination of research. Without this type of paradigm, the best-intentioned research projects can maintain the status quo, silencing and pathologizing the community. Furthermore, without extensive community input the results of research might not have strong validity and applicability. In this article, we outline community-based participatory research (CBPR) methodology that privileges the needs and input of the community throughout the entire research process. We, undergraduate and graduate students at the University of Miami, are currently working with the Everglades Community Association (ECA; a migrant worker camp) and EnFamilia (a community organization that provides a wide range of services to ECA) to examine aspects of educational attainment and mental health.  We will use our experiences in our current work to illustrate the core elements of CBPR and to provide other practitioners with ideas on how to incorporate these principles into their clinical work and research.

Before initiating research, we focused on building relationships with different community partners.  By focusing on building alliances and identifying key stakeholders, CBPR ensures that researchers stay grounded in the community instead of locked away in ivory towers. The second step formalizes this process and provides a foundation of community input that will shape and guide the research throughout the project.  During this stage, we formed a community advisory board (CAB). For us, this group included the heads of EnFamilia, who are not only service providers, but are also on the board for ECA. The CAB is a core guiding force that helps to ensure that the community’s needs, not those of outside groups (e.g., a university) or those only perceived by service providers, are the focus of research. Additionally, the CAB co-creates the focus of the research, data collection methods, analysis, and how the data will be reported and used within the community. In a fully developed article, we will outline each of these steps in more detail and illustrate each phase with lessons learned from our own experiences.

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There is great concern from clinicians we talk to that many of the migrants we serve, specifically those who work for large agricultural companies that raise and slaughter pigs and chickens (CAFOs-- concentrated animal feeding operations) are at high risk for not only contracting H1N1 but also because of frequent migration and crowded living conditions they are likely to spread the virus rapidly. Even a greater “theoretical concern” that we have is that these workers may be a source of new novel more virulent strains of the H1N1 virus because of their constant daily close exposure to pigs and chickens. We have tried to explain to the CDC, NIOSH, OSHA that this group of workers should be in the category of “high risk” and therefore eligible for both early vaccine and treatment if illness occurs.

Unfortunately, we have been unsuccessful for a variety of reasons. This population, as you probably know, are for the vast majority, recent immigrants and frequently undocumented. So, it is always “controversial” when we try to highlight this population.

A recent article: http://www.ehponline.org/members/2009/117-9/focus.html more completely describes many of my concerns.

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