Let's Talk about HIV: Designing an HIV Curriculum for Migrant Farmworkers in South Georgia Open Access

Thakore, Mitali A. (2016)

Permanent URL: https://etd.library.emory.edu/concern/etds/5t34sj89c?locale=en
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Abstract

Background: Farmworkers are a drastically underserved population in health care. This study is a part of a larger body of work that aims to provide farmworkers with appropriate access to health information and care. The goal of this feasibility study was to create and evaluate a culturally tailored HIV prevention curriculum for migrant and seasonal farmworkers who receive care through the South Georgia Farmworker Health Project (SGFWHP) clinic. The study had three aims: (1) Evaluate the educational needs and preferences of farmworkers (2) Evaluate the process of delivering the HIV curriculum, and (3) Evaluate the structure and content of the HIV curriculum.

Methods: This feasibility study was conducted in three stages between May 2015 and October 2015. The design stage consisted of a preliminary needs assessment survey of farmworkers, which identified the components necessary for an effective and culturally acceptable HIV curriculum. The curriculum was piloted through an iterative process evaluation conducted during the Fall 2015 clinic. Observations of education sessions and feedback from clinic staff and patients informed improvements to the curriculum protocol. The refinement stage consisted of a HIV Perceptions Survey of farmworkers and Feedback Survey of the Physician Assistant students who volunteered at the clinic. Data from the surveys were used to identify if any changes were needed to curriculum content and structure. Analysis was conducted by calculating descriptive statistics for all survey items. Significant differences in survey scores between farmworker demographic categories of age, sex, primary language, and marital status were determined by one-way ANOVAs and independent t-tests.

Results: The results of preliminary needs assessment guided the design of an HIV brochure utilizing the Teach Back Method (TBM) of patient communication. The brochure focused on HIV definitions, transmission, myths, and methods of self-protection from HIV and was available in English, Spanish, and Creole. The pilot study demonstrated that the TBM was useful in reducing and addressing miscommunication between patients and educators during the education session. No significant differences were found between demographic groups indicating similar perceptions of HIV across groups. Subsequent refinement stage evaluations identified opportunities for improvement of the content and education process.

Conclusions: The goal of this study, which was to create a culturally tailored HIV curriculum for the SGFWHP, was achieved by creating an HIV brochure in three languages and a Teach Back form to facilitate better health communication between patients and providers.

Table of Contents

CHAPTER 1: INTRODUCTION…….........… 2 Study Justification……………..…. 4 Statement of Problem………….. 7 Theoretical Framework…….…… 7 CHAPTER 2: LITERATURE REVIEW… ......12 US Farmworker Demographics 12 Farmworkers & HIV………………… 13 Structural Barriers to Health … 15 Designing an Effective Intervention 19 Theoretical Framework……………20 Summary…………………………………24 CHAPTER 3: METHODS…………….………... 25 Sample……………………….………… 27 Materials and Measures……... 27 Data Collection Procedures…. 35 Treatment of Data……………... 38 Data Analysis ……………………. 39 CHAPTER 4: RESULTS…………………………. 43 Overview of Results……………. 43 Aim 1 Summary………………….. 47 Aim 2 Summary……………...…. 54 Aim 3 Summary……………..….. 60 CHAPTER 5: DISCUSSION…………………… 62 Summary and Recommendations… 62 Limitations………………………………………66 Conclusion………………………………………67 REFERENCES……………………...……………… 69 APPENDICES………….………...………………. 72

Appendix 1: Preliminary Needs Assessment Survey 72

Appendix 2: Let's Talk About HIV (English)...……. 73

Appendix 3: Let's Talk About HIV (Spanish)...…… 75

Appendix 4: Let's Talk About HIV (Creole) ...……. 77

Appendix 5: Teach Back Form …………………………… 79 Appendix 6: HIV Perceptions Scale..………………… 80 Appendix 7: PA Feedback Survey..……………………………...……………………… 81

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