Much of the medical home model is predicated on a relatively stable population that can access regular care at a single network of providers.  So how can this model effectively transfer to a mobile population?  One of the key elements needed is a more expansive vision of a medical home beyond a single geographic location.  This session will explore strategies to create a patient centered medical home for patients on the move.  The presentation includes an update and overview of MCN’s Health Network to manage critical health care issues such as infectious disease, Cancer, Diabetes and Pre-natal patient navigations.  The content highlights innovative promising practices in the creation of patient centered medical homes for migrant patients. 

An informative blog about workers' compensation, risk management, business insurance, workplace health & safety, occupational medicine, injured workers, and related topics.

This proposal will I) provide a profile of the agricultural industry and Farmworkers in Washington State II) propose a theoretical framework to understand farmworker housing accessibility III) describe prior legislative actions to address farmworker housing IV) and propose a set of recommendations to address farmworker housing.

Matthew C. Keifer, MD, MPH; Iris Reyes, MPH; Amy K. Liebman, MA, MPA; Patricia Juarez-Carrillo, PhD, MPH.  Abstract. Audience response systems (ARS) have long been used to improve the interactivity of educational activities. Most studies of ARS have addressed education of literate trainees. How well these devices work with low-literacy subjects is not well studied. Information gathering on the training audience is an important use of ARS and helpful in improving the targeting of training information. However, obtaining demographic information from vulnerable populations with reasons to be concerned about divulging information about themselves has not been tested. In addition, a culturally competent method to effectively collect demographic and evaluation data of this growing population is essential. This project investigated the use of ARS to gather information from Hispanic immigrant workers, many of whom are socially vulnerable and have limited English proficiency (LEP) and low-literacy. Workers attended focus groups and were asked to use ARS devices or clickers to respond to questions. Questions were both catergorical (multiple choice) and open-ended numerical (text entry), and varied from simple queries to more sensitive points regarding immigration. Most workers answered the one-key response categorical questions with little difficulty. In contrast, some participants struggled when responding to numerical questions, especially when the response required pressing multiple clicker keys. An overwhelming majority of participants reported that the clickers were comfortable and easy to use despite the challenges presented by the more complex responses. The error rate increased as question complexity increased and the trend across three ordered categories of response complexity reached statistical significance. Results suggest that ARS is a viable method for gathering dichotomous or higher-order categorical information from LEP and low-literacy populations in a group setting while assuring anonymity. However, it is recommended that clickers be developed and tested with fewer, bigger, and more widely separated buttons, and less printing on the buttons for these populations. Further research is needed to determine the effectiveness of using clickers with simplified configurations in the workplace as a tool to collect data for surveys and assessments and to better engage LEP and low-literacy workers in training sessions. 

A tool for health care providers and others to assist agricultural workers in accessing workers' compensation benefits. A Farmworker Justice/MCN resource.

Carlos Eduardo Siqueira, MD, ScD, Megan Gaydos, MPH, Celeste Monforton, Dr PH, MPH, Craig Slatin, ScD, MPH, Liz Borkowski, BA, Peter Dooley, MS, CIH, CSP, Amy Liebman, MPA, MA, Erica Rosenberg, JD, Glenn Shor, PhD, MPP, and Matthew Keifer, MD, MPH

Background This article introduces some key labor, economic, and social policies that historically and currently impact occupational health disparities in the United States.

Methods We conducted a broad review of the peer-reviewed and gray literature on the effects of social, economic, and labor policies on occupational health disparities.

Results Many populations such as tipped workers, public employees, immigrant workers, and misclassified workers are not protected by current laws and policies, including worker’s compensation or Occupational Safety and Health Administration enforcement of standards. Local and state initiatives, such as living wage laws and community benefit agreements, as well as multiagency law enforcement contribute to reducing occupational health disparities.

Conclusions There is a need to build coalitions and collaborations to command the resources necessary to identify, and then reduce and eliminate occupational disparities by establishing healthy, safe, and just work for all.