Absence of conflict of interest.
Citation
Fernández-Esquer, M. E., Atkinson, J. S., Hernandez, R. A., Aguerre, C. F., Brown, L. D., Reininger, B., Ojeda, M. A., Field, C., Rhoton, J. M., Da Silva, C. E., & Diamond, P. M. (2022). Vales+Tú: A cluster-randomized pilot study to reduce workplace injuries among US Latino day laborers. Health Promotion International, 37, 1-12. https://doi.org/10.1093/heapro/daac163 [Comparison between Brief Motivational Interview group and Control]
Highlights
- The study's objective was to examine the impact of Vales+Tú on worker health and safety among Latino day laborers (LDL). The authors investigated similar research questions for a Group Problem Solving contrast, the profile of which can be found here.
- The study was a cluster randomized trial that randomly assigned participants to receive either the Group Problem Solving intervention, the Brief Motivational Interview (BMI) intervention, or the business-as-usual control condition. Using survey data, the authors compared the change in outcomes of LDLs in the Brief Motivational Interview group to LDLs in the control group.
- The study found that Latino day laborers in the Brief Motivational Interview group had significantly less favorable changes in health and safety outcomes than those in the control group.
- The quality of causal evidence presented in this report is high because it was based on a well-implemented randomized controlled trial. This means we are confident that the estimated effects are attributable to Vales+Tú, and not to other factors.
Features of the Intervention
LDLs are disproportionately at risk of occupational injury and death compared to nonimmigrant laborers working in similar roles in the construction industry. Immigration status, lack of financial resources, and difficulty reading or speaking English can all be significant challenges to LDLs seeking safe and dignified working conditions.
Vales+Tu is a culturally tailored workplace injury risk-reduction program delivered by peer "promotores" to LDLs seeking employment. Vales+Tu included brief motivational interviews, which were one-on-one discussions between a promoter and a randomly selected LDL. The promoter would ask the participant about their work and if they had any safety concerns on the job. The pair would then discuss the advantages and disadvantages of taking safer and less safe jobs. Finally, the pair would develop a safety plan to reduce workplace risks, with the participant signing a pledge to take steps to reduce workplace risks in the next two weeks. The control group received “standard of care” treatment, which involved distribution of safety cards developed by the Occupational Safety and Health Administration (OSHA).
Features of the Study
The study was a cluster-randomized trial that randomly assigned participants to receive either the Group Problem Solving intervention, the BMI intervention, or the business-as-usual control condition. The study was conducted in Houston, Texas. Eligible participants were 21 or older, self-identified as Latino, had previously been hired at a corner, and were looking for work when approached for recruitment. Exclusion criteria included being visibly impaired from alcohol or drug use. A total of 74 LDLs were recruited for the study. On average, participants were 43 years old, had lived in the USA for 14 years, had sought work at street corners for 4 years, and had 7 years of schooling. Two-thirds were from Mexico or Honduras while three-fifths spoke only Spanish. Three-quarters reported construction as their most frequent job in the past month.
Thirty-eight day-labor corners from a prior study were grouped into ten geographically close groups. The number of corners in each group varied. Treatment assignments were randomized at the group level, with an east-west freeway used to separate the groups to limit cross-group interaction. LDLs assigned to the Brief Motivational Interview intervention participated in a one-on-one interview with a promoter to discuss workplace safety and develop an action plan to address workplace risks. LDLs assigned to the control condition received a "standard of care" treatment in which they received safety cards in Spanish developed by the Occupational Safety and Health Administration (OSHA) providing basic information on common causes of workplace injury.
The authors collected survey data before the intervention and two weeks after the intervention. The authors compared the change in outcomes of LDLs in the Group Problem Solving group to LDLs in the control group, using one-way ANOVAs.
Findings
Health and Safety
- The study found that Latino day laborers in the Brief Motivational Interview group had significantly lower improvements in self-efficacy than those in the comparison group. The study did not find significant differences between Latino day laborers in the Brief Motivational Interview group and the comparison group in changes in exposure to workplace hazards, risk-reduction practices, or reduction in workplace dangers.
Considerations for Interpreting the Findings
Although the study was a well-implemented randomized controlled trial, this study has several issues that should be considered when interpreting the findings. The study had a relatively small sample size and examined a very short two-week follow-up period.
The study authors estimated multiple impacts on outcomes related to health and safety. Performing multiple statistical tests on related outcomes makes it more likely that some impacts will be found statistically significant purely by chance and not because they reflect program effectiveness.
Causal Evidence Rating
The quality of causal evidence presented in this report is high because it was based on a well-implemented randomized controlled trial. This means we are confident that the estimated effects are attributable to Vales+Tú, and not to other factors.