A Mixed-Methods Evaluation of Heat-Related Illness Policy Implementation to Inform Practical Solutions for Farmworkers

The objective of this project is to conduct a timely evaluation of a new updated State occupational heat policy for agriculture (Ag) to inform practical implementation solutions. There is a substantial burden of heat-related illness (HRI) among outdoor Ag workers, who are largely foreign-born and Spanish-speaking, in the Pacific Northwest. While State and Federal policies have the potential to reduce inequities in occupational heat health effects for Ag workers, heat rules may be variably implemented in different local contexts, leading to variable impacts. There is a need to better understand if heat policies are being implemented as intended and how they are operating in practice. This project partners with Ag workers, growers, community-based organizations, and State agencies to accomplish the following aims: 1) Identify potential determinants of WA heat rule implementation feasibility and acceptability by Consolidated Framework for Implementation Research (CFIR) domain constructs through stakeholder key informant interviews, surveys of workers and direct supervisors, and characterization of WA Department of Labor and Industries (L&I) workers’ compensation (WC) HRI claims and heat rule inspection reports; and 2) Synthesize and disseminate results to Ag, policy, and scientific communities. We will use a mixed-methods participatory approach to accomplish our aims. We will first engage a multi-stakeholder regional advisory group that will provide input into the research approach, evaluation tool development, results interpretation, and dissemination. Guided by the CFIR framework, we will assess determinants that may influence implementation acceptability and feasibility. Quantitative and qualitative findings will be summarized, cross-verified, and synthesized to identify facilitators and barriers to implementation of heat rule elements in the Ag context. We will additionally explore the feasibility of assessing heat rule adoption and health impacts. To address NIOSH r2p, outputs, including practical implementation solutions and a policy brief, will be disseminated to stakeholders, including the Ag community and policymakers. This project will have substantial impact, as it will provide information needed to support practical solutions for successful heat policy implementation. Tools developed in this proposal will also be applicable to future heat rule implementation evaluations in other states and industries. We anticipate that this project will ultimately lead to outcomes of reduced adverse health effects from heat for Ag workers (NIOSH Strategic Plan Goal 7.17.2: understand intervention implementation factors to prevent HRI among Ag workers).

June T. Spector, MD, MPH and Maria Blancas, PhD, MPH, Principal Investigators, UW Department of Environment & Occupational Health Sciences (DEOHS)