A pilot project to increase health literacy among youth from seasonal farmworker families in rural eastern North Carolina: a qualitative exploration of implementation and impact

Israel M. Mendez, Mary Lisa Pories, Leah Cordova, Andreina Malki, Melinda F. Wiggins, Joseph G. L. Lee


Objective: There are substantial health inequalities for seasonal agricultural workers and their families in the United States. One identified inequality is in health literacy. The authors explored the implementation and impact of connecting youth from seasonal farmworker families who participated in a leadership and college pipeline program with Internet access by providing a tablet with a paid cellular data plan and university library–based health literacy training.

Methods: With the support of a National Network of Libraries of Medicine Health Information Outreach Award, we conducted a qualitative, utilization-focused evaluation by conducting semi-structured interviews from December 2017 through February 2018 with middle and high school age participants in the program (n=10). After parental consent and youth assent, we recorded interviews with participants at program activity locations or in their homes. We then utilized inductive thematic analysis with 2 primary coders.

Results: We identified four themes: (1) having access to the Internet can be transformative, (2) access resulted in increased knowledge of and interest in one’s own and others’ health, (3) “Google” is the norm, and (4) participant training increased self-efficacy to determine credible sources and resources.

Conclusion: Providing Internet access and iPads was possible to implement and resulted in increased utilization of health information. The combination of Internet access with training on information literacy was a key factor in achieving these positive outcomes. The findings suggest the importance of ensuring equitable access to the Internet in efforts to improve educational and health outcomes for seasonal farmworkers and their families.


Agricultural Workers’ Diseases; Farmworkers; Agricultural Workers; Health Literacy; Adolescent

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Thompson CD Jr., Wiggins MF, eds. The human cost of food: farmworkers’ lives, labor, and advocacy. Austin, TX: University of Texas Press; 2002.

Arcury TA, Quandt SA. Delivery of health services to migrant and seasonal farmworkers. Annu Rev Public Health. 2007;28:345–63.

Gwyther ME, Jenkins M. Migrant farmworker children: health status, barriers to care, and nursing innovations in health care delivery. J Pediatr Health Care. 1998 Mar–Apr;12(2):60–6.

NC Farmworker Institute. North Carolina farmworker health facts [Internet]. Durham, NC: The Institute [cited 18 Jun 2018]. .

Arcury TA, Feldman SR, Schulz MR, Vallejos Q, Verma A, Fleischer AB Jr., Rapp SR, Davis SF, Preisser JS, Quandt SA. Diagnosed skin diseases among migrant farmworkers in North Carolina: prevalence and risk factors. J Agric Saf Health. 2007 Nov;13(4):407–18.

Quandt SA, Clark HM, Rao P, Arcury TA. Oral health of children and adults in Latino migrant and seasonal farmworker families. J Immigr Minor Health. 2007 Jul;9(3):229–35.

Quandt SA, Arcury TA, Rao P, Snively BM, Camann DE, Doran AM, Yau AY, Hoppin JA, Jackson DS. Agricultural and residential pesticides in wipe samples from farmworker family residences in North Carolina and Virginia. Environ Health Perspect. 2004 Mar;112(3):382–7.

Weathers A, Minkovitz C, O’Campo P, Diener-West M. Access to care for children of migratory agricultural workers: factors associated with unmet need for medical care. Pediatrics. 2004 Apr;113(4):e276–82.

Chaney BH, Torres E. Covariates of identified stress and depression among seasonal farmworkers. Int J Environ Res Public Health. 2017 Jun 30;14(7).

Keim-Malpass J, Spears Johnson CR, Quandt SA, Arcury TA. Perceptions of housing conditions among migrant farmworkers and their families: implications for health, safety and social policy. Rural Remote Health. 2015 Jan–Mar;15(1):3076.

Quandt SA, Wiggins MF, Chen H, Bischoff WE, Arcury TA. Heat index in migrant farmworker housing: implications for rest and recovery from work-related heat stress. Am J Public Health. 2013 Aug;103(8):e24–6. DOI: http://dx.doi.org/10.2105/AJPH.2012.301135.

Arcury TA, Jensen A, Mann M, Sandberg JC, Wiggins MF, Talton JW, Hall MA, Quandt SA. Providing health information to Latino farmworkers: the case of the Affordable Care Act. J Agromed. 2017;22(3):275–81.

Price M, Williamson D, McCandless R, Mueller M, Gregoski M, Brunner-Jackson B, Treiber E, Davidson L, Treiber F. Hispanic migrant farm workers’ attitudes toward mobile phone-based telehealth for management of chronic health conditions. J Med Internet Res. 2013 Mar 30;15(4):e76.

Sandberg JC, Spears Johnson CR, Nguyen HT, Talton JW, Quandt SA, Chen H, Summers P, Arcury TA. Mobile and traditional modes of communication among male Latino farmworkers: implications for health communication and dissemination. J Immigr Minor Health. 2016 Jun;18(3):522–31.

National Library of Medicine, Selden CR, Zorn M, Ratzan S, Parker RM, eds. Health literacy (CBM 2000-1). Bethesda, MD: US Department of Health and Human Services; 2000.

Patton MQ. Utilization-focused evaluation: the new century text. 3rd ed. Thousand Oaks, CA: SAGE Publications; 1997.

Student Action with Farmworkers. Levante Leadership Institute youth program [Internet]. Student Action with Farmworkers [cited 23 Oct 2018]. .

Social Explorer. Social explorer tables: American community survey 2016 (5-year estimates) [Internet]. New York, NY: Social Explorer [cited 25 Jan 2019]. .

Adelante Education Coalition. Latino student success [Internet]. The Coalition [cited 14 Jul 2018]. .

Meriam Library, California State University, Chico. Evaluating information – applying the CRAAP test [Internet]. The University [cited 26 May 2018]. .

Patton MQ. Qualitative evaluation methods. Beverly Hills, CA: Sage; 1980.

Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007 Dec;19(6):349–57.

Arcury TA, Quandt SA, eds. Latino farmworkers in the eastern United States: health, safety and justice. New York, NY: Springer; 2010.

Vallejos QM, Quandt SA, Arcury TA. The condition of farmworker housing in the eastern United States. In: Arcury TA, Quandt SA, eds. Latino farmworkers in the eastern United States: health, safety, and justice. New York, NY: Springer; 2010. p. 37–69.

Latulippe K, Hamel C, Giroux D. Social health inequalities and eHealth: a literature review with qualitative synthesis of theoretical and empirical studies. J Med Internet Res. 2017 Apr 27;19(4):e136.

Nguyen A, Mosadeghi S, Almario CV. Persistent digital divide in access to and use of the Internet as a resource for health information: results from a California population-based study. Int J Med Inform. 2017 Jul;103:49–54.

Banks MA, Cogdill KW, Selden CR, Cahn MA. Complementary competencies: public health and health sciences librarianship. J Med Libr Assoc. 2005 Jul;93(3):338–47.

Johnson HA, Barrett L. Your teaching strategy matters: how engagement impacts application in health information literacy instruction. J Med Libr Assoc. 2017 Jan;105(1):44–8. DOI: http://dx.doi.org/10.5195/jmla.2017.8.

DOI: https://doi.org/10.5195/jmla.2019.560


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