Vales+Tú: a cluster-randomized pilot study to reduce workplace injuries among US Latino day laborers

Abstract

Summary Latino day laborers (LDL) are a vulnerable population of workers facing considerable risk for occupational injury. Under the guidance of our Community Advisory Board, we developed and tested the feasibility, acceptability and preliminary effects of Vales+Tú (You Are Worth More), a workplace injury risk-reduction program implemented by promotores on street-corners where LDL seek employment. The program was informed by theoretical perspectives emphasizing individual and group agency and self-determination. A pilot three-arm cluster-randomized community trial was conducted among 75 LDL. The intervention arms consisted of an individualized Brief Motivational Interview, a Group Problem Solving activity and a standard of care control (OSHA safety cards). We met our study goal of 25 LDL per intervention arm, and contacted 88% of participants post intervention. Participants evaluated the interventions favorably. At post-test, the Brief Motivational Interview group reported significant reductions in exposure to workplace hazards and increases in risk-reduction practices. The Group Problem Solving participants showed significant reductions in exposure to hazards (t-test −4.16, p < 0.001). Both intervention groups increased their reliance on corner peers, a measure of social support. Standard of care participants increased in self-efficacy to work safely. Overall, the only significant different between the three study conditions was in self-efficacy. These findings provide evidence of the feasibility and acceptability of Vales+Tú and show preliminary program efficacy. A large-scale replication trial will permit a more formal modeling of the study findings. Clinical Trial Registration (ClinicalTrials.gov): NCT04378348.

Development and refinement of a corner-based injury prevention programme for Latino day labourers

“…Rather than emphasising knowledge transmission, the Vales+Tú programme highlights workers’ ability to individually and collectively analyse their workplace problems and formulate an action plan that fits their priorities. In addition to encouraging findings from our pilot study (Fernández-Esquer et al, 2022), the two Vales+Tú intervention approaches, GPS and BMI, are grounded in previous health promotion research and practice. Popular education approaches within the small group context, which often incorporate group-based social learning games, brainstorming, simulation and problem-solving activities, have been found to improve health through the empowerment of individuals and communities, with evidence for increasing self-esteem, social support and sense of community across diverse populations and health issues (Martinez et al, 2014; Wiggins et al, 2012).…”

“…The development of Vales+Tú took place over two primary phases: (1) a pilot testing phase in 2015 (Fernández-Esquer et al, 2022), and (2) a cluster randomised controlled trial phase (2018)(2019)(2020)(2021)(2022)(2023). We used Intervention Mapping to organise and report our previous needs assessments efforts and pilot testing of Vales+Tú, and then to further refine and enhance the programme for the current trial.…”

“…CAB members voted on the priorities of the pilot programme and provided key input on the needs assessment approach, including identifying corners, selecting the name/logo of the programme, exploring LDL needs and prioritising the health outcomes to be targeted by the programme. et al, 2019b, 2020, 2021), and a rapid needs assessment conducted in 2019 of n = 149 LDLs based at n = 15 corners aimed at assessing current experiences of injury among LDLs and pilot testing measures developed for the community trial of Vales+Tú (Fernández-Esquer et al, 2022). Methods for these assessments align with the Intervention Mapping core processes (Bartholomew-Eldredge et al, 2016) and included the following: question posing about the problem (e.g.…”

From a Personal Commitment to a Safety Scale: Development and Validation of a Self-Reported Safety Practices Scale for Latino Day Laborers

“…Twenty-five interviews were conducted in Houston, Texas while pilot testing a Brief Motivational Interview (BMI) intervention promoting workplace safety among LDL. See Fernández-Esquer et al (2022) for more information regarding the pilot study. Motivational interviewing is an intervention technique through which a trained expert leads a discussion to promote the participant’s self-efficacy to perform a health behavior which is realistic and meaningful for their own socioeconomic and cultural context (Miller & Rose, 2009; Romo et al, 2009).…”

“I Use Sunglasses . . . the Sun Can Ruin the Eyes”: Latino Day Laborers’ Lay Strategies to Reduce Dangers at Work

“…Strategies to overcome workplace risks and injuries were spontaneously reported sometimes overtly, sometimes more subtly, in our conversations with LDLs. The initial focus of these conversations was to describe their perceived risks for injury to develop a pilot intervention to assist LDLs in reducing workplace injuries (Fernández-Esquer et al, 2022). However, in reviewing the transcripts of these conversations, we realized that every story of experienced risk was linked to a description of how they coped with a variety of abusive and dangerous situations.…”