DESCRIPTION (provided by applicant): The broad objectives of the study are to examine the effect that underutilization of migrant health centers has on health center-based occupational injury and illness surveillance ongoing in several states. This will be accomplished by conducting an injury and health care utilization survey of 1,090 migrant and seasonal farm workers in labor camps in New York and Maine, while continuing and enhancing medical chart review-based farm worker injury and illness surveillance occurring at hospital emergency rooms and migrant health centers. The most important specific aims of the research are to:
A. measure the proportion of self-reported farm worker occupational illness/injury treated at migrant health centers and hospital emergency rooms;
B. identify predictors of the utilization of a source of care within the survey respondents;
C. compare and contrast farm worker occupational injury/illness incidence rates estimated first using self report data and then using medical chart data.
Researchers will use a cross-sectional research design, using cluster sampling for the farm worker survey. Survey research will provide insight into the extent of migrant health center underutilization as well as provide a comparison source of occupational injury and illness rate data. This information will answer key questions regarding the effect that migrant health center underutilization may be having on existing NYCAMH-NEC medical chart-based surveillance. In addition, this research will make important contributions to current knowledge about farm worker agricultural injury/illness and health care utilization, and will be of particular value to migrant health centers and other service agencies interested in improving service delivery to this population.
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