Date of Publication


Project Team

Ellen Long-Middleton, PhD, APRN, Naomi Wolcott-MacCausland


Background/Purpose: Latino migrant farmworkers are a marginalized and medically underserved population in Vermont and nationally. They experience significant health disparities and barriers to healthcare access compared to others living in rural areas. Barriers include limited knowledge regarding available services and low general and health literacy. These barriers lead to poorer health outcomes. The purpose of this evidence-based project was to enhance health literacy and follow-up care for migrant farmworkers by improving health literacy in a community health outreach setting.

Methods: In northwestern Vermont, 33 outpatient migrant farmworkers were recruited following health screening visit and referred for follow-up. AHRQ Health Literacy Universal Precautions Toolkit (HLUPT) provided the framework for follow-up visit conducted in Spanish. Baseline health literacy was determined using the Short Assessment of Health Literacy. Qualitative data was obtained one month later by semi-structured phone interview to assess efficacy.

Results: Of the 33 workers, 17 volunteered for follow-up healthcare. 40% (n=10) workers met the cut-point for inadequate health literacy. Visits consisted mainly of education on medication doses and expected effects and non-pharmacological treatments for various conditions. Most common complaints were dermatologic, sleep-related, and gastrointestinal. Each intervention was tailored based on the HLUPT. The most highly utilized resources were Teach-Back Method and providing easy-to-understand printed materials. Stakeholders endorsed that visits were value-added to pre-existing farm health outreach program by providing the opportunity to reinforce health concepts and strengthen community ties outside farm.

Conclusions: Implementation of the HLUPT to guide follow-up care was an effective means of conducting visits with migrant farmworkers, as it allowed visits to be tailored to specific needs of client. Community outreach to migrant communities using the framework of health literacy helps strengthen ties to farmworker community and closes the loop between health outreach visits and need for further follow-up.

Document Type