Mary K. Salazar

Hispanic women's beliefs about breast cancer and mammography.

Although breast cancer rates are lower among Hispanic women than among White women, Hispanics are more likely to die from this disease if they do get it. This may be related to the fact that Hispanic women are less likely to participate in mammographic screening. This study used a two-stage decision model to describe a group of rural, Hispanic womens beliefs and attitudes about breast cancer and mammography. The first stage consisted of exploratory interviews to identify factors, both positive and negative, that affect the mammography decision. The second stage will use a survey to weigh the identified factors in order to determine their importance to the decision. This article presents the stage 1 findings of this study. Twenty-nine rural, Hispanic women between the ages of 38 and 74 participated in the interviews. The majority had annual incomes of <

Hispanic adolescent farmworkers' perceptions associated with pesticide exposure

10,000, and 30% completed < or = 8 years of education. The subjects identified 18 factors, which fell into three general categories: Knowledge and Attitudes (How Well It Works, Personal Risk, Other Ways of Knowing, Fear of Cancer and/or treatment, Belief in Fate, Cultural Issues), Issues Related to Participation (Language, Getting There, Time, Cost, Radiation Exposure, Pain), and Social Concerns (Role Model, Responsibility to Self, Responsibility to Others, Influence of Family/Friends, Influence of Doctors, Influence of Society). Verbatim description of each of these factors are presented. The implication of the findings to health professionals is discussed.

Korean Women’s Breast Cancer Experience

The migrant farmworker population in the United States is a vulnerable and understudied population whose characteristics are constantly shifting. The number of youth involved in agriculture work is increasing, and they, in particular, may be at increased risk for occupational hazards, such as pesticide exposure. The present study utilized an ecological framework for focus group discussions with 33 adolescent migrant farmworkers in Oregon. Adolescents’ risk perception and health beliefs associated with pesticide exposure are examined on four levels of environmental influence: microenvironment, organizational environment, social/community environment, and macroenvironment. Adolescents provided insight on such topics as perceived vulnerability of illness due to pesticide exposure, attitudes toward farmwork, influence of their boss, knowledge of occupational hazards, safety training, and barriers to occupational choice. Cultural influences on occupational safety and health are discussed and increased attention to safety training is recommended.

An Evaluation of Factors Affecting Hazardous Waste Workers' Use of Respiratory Protective Equipment

The purpose of this study was to explore cultural meanings of breast cancer among Korean women in South Korea. A descriptive longitudinal study using methodological triangulation was conducted, and only qualitative findings are presented in this article. Ten Korean women who were newly diagnosed with a plan of surgery and subsequent chemotherapy, who did have severe fatigue at the time of recruitment, were recruited through Seoul National University Hospital. Data were collected using in-depth, 2-hour interviews and analyzed using thematic analysis. The themes emerged through the analysis process included: (a) “I did wrong,” (b) “I cannot ask male physicians,” (c) “I don’t want to show the operation site to my husband,” and (d) “I do household tasks by myself.” The overriding theme was marginalization of the women within the context of their patriarchal culture. The findings suggest that culture is an important context circumscribing women’s health/illness experience.

Occupational hazards and risks faced by Chinese immigrant restaurant workers.

The purpose of this study was to describe the perceptions of a group of hazardous waste workers about their workplace hazards and to understand their beliefs and attitudes about the use of respiratory protective equipment (RPE). There were two phases of data collection: (1) interviews to identify factors that influence respirator use and (2) a written survey to evaluate the importance of these factors. This article describes the findings from the written survey completed by 255 eligible respondents (return rate = 46.5%, 255/548). Subjects used a weighting system to score 18 identified factors that influence the use of RPE. Scores were compared according to type of respirator, frequency of use, and associated health symptoms. The factors that had the most positive influence on respirator use were concern about work exposure, fit-testing, and training. The most negative influences were communication, personal comfort, effect on vision, structural environment, and fatigue. More frequent users (once per month or more) were significantly more likely to view fit-testing, health effects, and effects on vision negatively than were less frequent users. Persons who reported health symptoms associated with respirator use had more negative scores than persons without health symptoms. Workers categorized as laborers were more likely to be frequent respirator users and to wear supplied-air respirators, and were significantly more likely to view vulnerability to disease negatively, than were other worker groups. The findings from this study indicate that respiratory protection programs must extend beyond training and education; to be maximally effective, health professionals must be responsive to the specific concerns of the workers.

Evaluation of a case management program. Summary and integration of findings.

Historically, Chinese immigrants to the United States have worked in restaurants to support their families. Hazards and risks associated with this populations work in restaurants are underrepresented in the literature. This ethnographic study used interviews, participant-observations, and follow-up focus sessions with 18 immigrants from China, Hong Kong, and Taiwan to identify potential physical, biological, enviromechanical, chemical, and psychosocial hazards that they face. Psychosocial hazards were most often mentioned by the participants; biological hazards were not identified in the data. Practice and research implications for addressing health disparities in this population are discussed.

Striving to provide opportunities for farm worker community participation in research.

1. Occupational health nurses can advocate for fair and equitable policies for both workers and employers. Assisting workers to understand and negotiate through the workers compensation system can minimize suspicion among workers and service providers, and can increase the effectiveness and efficiency of service provision. 2. Occupational health nurses can work with the team of service providers and the injured worker to develop appropriate and realistic goals for service provision. Make sure there is clarity related to the roles and responsibilities of all persons on the team (including the injured worker) is essential. Consistency and continuity of services throughout the life of the case is crucial. 3. The injury and its sequelae have personal meaning to the worker that may profoundly affect the outcome of their case. The OHN/CM must be sensitive and responsive to the workers issues and concerns, and respectful of their views. Workers must be assisted to identify and tap into their social support systems. 4. Occupational health nurse/case managers should take an active role in developing and advocating for strategies that will assure effective and meaningful communication among all parties involved in a case.

Occupational risk among orchard workers: a descriptive study.

Hispanic farm workers and their families in the U.S. face a number of environmental and occupational health risks, yet they are rarely given the opportunity to choose the focus of the research and interventions that take place in their communities. Community-based participatory research (CBPR) can be one effective approach to changing this situation. CBPR is an approach to research that makes community members partners in research rather than subjects of research. This article describes the experience of El Proyecto Bienestar (The Well-Being Project), a CBPR project in the Yakima Valley, Washington, with the aim of facilitating the Hispanic communitys involvement in the identification and prioritization of occupational and environmental health issues among farm workers. The project utilized three forms of data collection (key informant interviews, community surveys, and a town hall meeting) to create a list of environmental and occupational health issues of concern. Investigators strove to provide opportunities for community participation in the various stages of research: study concept and design, data collection, data analysis and interpretation, conclusions, and dissemination of results. This article describes the involvement that community members had at each stage of the three forms of data collection and outlines the basic findings that led the Community Advisory Board to prioritize four areas for future work. In addition, it describes the challenges the project faced from the researcher perspective. Using examples from this experience, we conclude that this model may be an effective way for farm workers and their families to have a voice in prioritizing health and safety issues for research and action in their communities.

Evaluating case management services for injured workers. Use of a quality assessment model.

Orchard workers are exposed to an array of occupational health and safety hazards that result in injury, illness, and, in some cases, death. The purpose of this qualitative study was to identify and explore factors that contribute to occupational risks related to orchard work. Twenty-five Hispanic orchard workers were interviewed. They reported that the most common type of accident was falls, usually from a ladder; and the most common injuries were strains and sprains. Three broad categories of factors that contributed to the occurrence of such injuries were Knowledge, Attitudes and Behaviors; Work-Related Factors; and Factors External to Work.

Ecological model of disaster management

An increasing number of employers and third party administrators are choosing case management as a strategy to coordinate services for workers who sustain an occupational injury or illness. The successful delivery of case management services requires the service provider possess special skills and knowledge. Occupational health nurses are uniquely qualified to provide case management services to injured and ill workers. The effectiveness of case management services is generally described in terms of costs and quality of services; thus, determining the effectiveness of a case management program requires an evaluation of costs and service quality.