Conventional and Complementary Therapy Use among Mexican Farmworkers in North Carolina: Applying the I-CAM-Q.

Objectives: This analysis documents the use of conventional health-care providers, traditional healers, and complementary therapies by Mexican farmworkers; identifies the purposes and perceived helpfulness of these modalities; and delineates variation in the use of traditional healers and complementary therapies. Methods: Two-hundred Mexican farmworkers in North Carolina completed interviews May-September, 2017. The International Complementary and Alternative Medicine Questionnaire (I-CAM-Q) elicited use of conventional health-care providers, traditional healers, and complementary therapies in the previous 12 months. Results: Most of the farmworkers had been treated by a conventional provider (63.0%). One-in-five had been treated by any traditional healer; 19.5% had been treated by a sobador, 4.5% by a curandero, 2.0% by an herbalist, and 2.0% by a spiritual healer. Conventional providers (69.8%) and sobadores (84.6%) most often treated acute conditions; 62.5% had used an herb, 46.0% a vitamin, 57.0% an over-the-counter medicine, and 13.5% a home remedy. Participants used various self-care practices, including music (36.5%), sleep (18.0%), prayer for health (15.0%), and social media (14.0%). Education was inversely associated with the use of a traditional healer and herbs; treatment by a conventional health-care provider was positively associated with using a traditional healer and vitamins. Conclusions: Mexican farmworkers use conventional health-care providers as well as traditional healers and complementary therapies. Research on how use of complementary therapies and a system of medical pluralism affects farmworker health is needed. Health-care providers need to recognize complementary therapy use and provide patient education about ineffective or harmful therapies.

Migrant Farmworker Nutritional Strategies: Implications for Diabetes Management.

OBJECTIVES: Diabetes is a chronic disease prevalent in Hispanic/Latino adults, including migrant farmworkers in the US. Its management requires that individuals follow dietary guidelines, which may be difficult for migrant farmworkers due to work and environmental constraints. This analysis is designed to explore potential barriers to and supports for migrant farmworkers' practice of effective dietary self-management. METHODS: Interviews were conducted with 200 Latino migrant farmworkers in North Carolina, including workers with and without diabetes, recruited at housing sites throughout the 2017 agricultural season. The survey instrument included questions designed to elucidate how workers obtain food, prepare and consume food, and maintain food security. RESULTS: Most purchased food is obtained once per week at large grocery stores, with most farmworkers depending on others for transportation. Less than 1 in 5 supplement with garden produce and food from food pantries, farmers markets, and hunting and fishing. About half of lunches and a quarter of dinners are purchased from vendors or other commercial sources. More than 2 in 5 workers report they have to compromise on or lack control of meal content. About 1 in 5 report issues with food security. CONCLUSIONS: The food-related practices of farmworkers would require change to accommodate effective dietary self-management of diabetes. Greater use of sources of fresh produce and other nutrient-dense foods, coupled with greater control over meal content and cooking techniques would be needed. While some accommodations could be encouraged through education, others would require policy change in housing or access to community resources.