Cultural adaptation of interventions to reduce pesticide exposure among farmworkers: A systematic review

Tags: Poster
Karimi-Shahanjarini A1, Afshari M1, Besharati F2
1Hamadan University of Medical Sciences, 2Guilan university of Medical Sciences

Background:

Pesticide exposure among farmers and their families is a significant health concern worldwide. The agricultural system is a dynamic and complex system in which multilevel factors from individual preferences and motives of farmers to socio-cultural structures have a unique contribution to make farmers' behaviors. It seems that the success of health interventions in farmers needs to identify and integrating cultural differences into the interventions' development, implementation, and evaluation. However, little is known about the effectiveness of cultural adaptations in such interventions.

Objectives:

The purpose of this study was to systematically assess the cultural adaptation strategies in interventions addressing the reduction of pesticide exposure in farmworkers.

Methods:

A systematic literature search was performed of PubMed, Embase, ISI Web of Science, Scopus, NIOSHTIC, Agricola, Agris, as well as reference lists of identified articles for randomized controlled trials (RCTs) published in English from 2000 to 2019. Two independent reviewers assessed trial quality and extracted data. Disagreements were resolved by discussion or referring to a third reviewer.

Results:

A total of 7 trials (8 papers) involving 1371 participants met the review's inclusion criteria. The majority of these studies conducted in the USA and had a low- quality score. All except one study employed cultural adaptation strategies to varying degrees. Socio-cultural strategies were widely used in the interventions. Four studies were tailored for subgroups or individuals and reported improvements in the outcomes. It seems that cultural adaptations were related to intervention effectiveness.

Conclusions:

Our systematic examination revealed that cultural adaptation had a moderate effect on the reduction of farmworkers’ pesticide exposure. To improve health outcomes, it is necessary to employ a deep level of cultural adaptation in future investigations.

Patient or healthcare consumer involvement: