Coccidioidomycosis Knowledge and Behaviors of California Hispanic Farm Workers

ABSTRACT

(1) Describe knowledge, attitudes, beliefs, and behaviors related to coccidioidomycosis (Valley fever, VF) reported by farm workers in a highly endemic area to design and evaluate prevention messages and (2) identify health information sources preferred by farm workers to disseminate VF prevention messages. There were 119 primarily Mexican-born residents of two migrant farm labor housing centers in Kern County, who completed an interviewer-administered survey on VF knowledge, attitudes, beliefs, and behaviors in 2017. The 73% of participants aware of VF demonstrated a knowledge score of 53%. Over 90% erroneously believed VF was associated with pesticide exposure; approximately two-thirds believed that wearing a bandana mask was protective. Over half of respondents believed that VF was contagious, could be contracted from contaminated food or water, and caused gastrointestinal symptoms. Of those aware of VF, 75% expressed concern about becoming infected because of where they lived and working outdoors. Working outdoors in dusty conditions was the most commonly reported risk-associated work practice. Among 67 participants reporting use of respiratory protection, 94% indicated they wear a bandana; most male participants did not wear face coverings in dusty conditions. The most frequent protective work practice was wetting soil. Preferred sources of health information included television; family, friend, or co-worker; healthcare provider; and radio. Farm workers reported multiple risk factors for VF. Results identified several areas of poor knowledge, risk behavior, and preferred channels of prevention messages. Important protective behaviors are not under the control of farm workers; engagement with employers is essential.

KEYWORDS:

• Coccidioidomycosis
• valley fever
• knowledge
• attitudes
• beliefs and behaviors
• prevention
• farm workers

Acknowledgments

With special thanks to the Kern County farm workers who participated in this study and the Housing Authority of the County of Kern for introducing us to the Migrant Housing Center managers who provided permission to post information and engage residents at the Centers. This work was sponsored by the Centers for Disease Control and Prevention and the National Institute for Occupational Safety and Health (U01 OH010839) and the Western Center for Agricultural Health and Safety (NIOSH U50 OH007550). Partial support was provided to one author by the U.S. National Institutes of Health through grant UL1 TR001860.

Disclosure statement

Other than the funding that is listed above under funding details, none of the authors have any relationships, activities, or interests that are related to the completion of this study or the content of this manuscript.

Data availability statement

Requests for data supporting the results or analyses presented in this paper can be made directly to the manuscript’s authors.

Additional information

Funding

This work was sponsored by the Centers for Disease Control and Prevention and the National Institute for Occupational Safety and Health (U01 OH010839) and the Western Center for Agricultural Health and Safety (NIOSH U50 OH007550). Heejung Bang was partly supported by the U.S. National Institutes of Health through grant UL1 TR001860.