Thompson 2008.
Methods |
Study design: cluster‐randomized trial Sampling frame: Participants were recruited through 3 approaches: (1) participants in previous research study in same area; (2) additional households identified in 16 communities with high rates of Hispanic agricultural workers, and (3) households in labor camps Sampling method: All previous participants and households from labor camps were contacted; additional households in 16 communities were randomly sampled Collection method: in‐person interview, urine samples of farmworkers and children age 2 to 6, environmental sampling (house and vehicle dust) Description of the community coalition: Community Planning Group, consisting of 18 individuals from 16 diverse organizations, including farmworkers, growers, health department, regulatory agencies, farmworker clinics, advocates, and local media |
|
Participants |
Communities: 16 communities and 8 labor camps in Yakima Valley, Washington Country: USA Ages included in assessment: adult farmworkers (n = 213) and their children age 2 to 6 (n = 211) Reasons provided for selection of intervention community: Agricultural communities in Yakima Valley of Washington State have a high percentage of Hispanic agricultural workers, many of whom work with organophosphates. 24 communities were randomly assigned to intervention or control condition Intervention community (population size): 300 to 11,000 Comparison community (population size): 300 to 11,000 |
|
Interventions |
Name of intervention: Para Niños Saludables Theory: not reported Aim: to reduce pesticide exposure among farmworkers and their children via a community‐based intervention trial Description of costs and resources: not reported Components of the intervention: Comprehensive intervention included activities at community (health fairs, festivals), organizational (schools and preschools, churches, English language and citizenship classes, orchards, farms), small group (lay health promotoras, home health parties), and individual (promotoras conducted individual outreach at community sites) levels. Main activities included information provision and education, distribution of educational materials, and media advocacy Start date: 1999 Duration: 2 years |
|
Outcomes |
Outcomes and measures: farmworkers’ and children’s urinary metabolite levels of pesticides (organophosphates) Time points: baseline (year 1) and follow‐up (year 4) |
|
Notes | No information provided regarding intervention and control community characteristics. Urinary metabolite concentrations were increased in both intervention and control communities Funder: National Institute for Environmental Health Sciences and US Environmental Protection Agency Funding source: government |
|
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Not reported |
Allocation concealment (selection bias) | High risk | Allocation not concealed |
Baseline outcome measurement similar | Low risk | No P values reported, but for urinary metabolites baseline measurements appear to be similar |
Baseline characteristics similar | Low risk | Study authors report no differences between intervention and control communities |
Blinding of outcome assessment (detection bias) All outcomes | High risk | Blinding not reported |
Incomplete outcome data (attrition bias) All outcomes | Low risk | High response rates, independent samples |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Blinding not reported |
Protection against contamination | High risk | Contamination was monitored by including questions in a final survey regarding awareness of and participation in intervention activities; estimated to be ˜20% |
Selective reporting (reporting bias) | Low risk | Questionnaire described in detail |