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Building informed consent for cholinesterase monitoring among pesticide handlers in Washington State
Author(s) -
Weyrauch Karl F.,
Boiko Patricia E.,
Keifer Matt
Publication year - 2005
Publication title -
american journal of industrial medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 104
eISSN - 1097-0274
pISSN - 0271-3586
DOI - 10.1002/ajim.20200
Subject(s) - informed consent , medicine , focus group , comprehension , poverty , coercion (linguistics) , test (biology) , environmental health , family medicine , medical education , alternative medicine , law , pathology , sociology , paleontology , linguistics , philosophy , anthropology , political science , biology
Background Pesticide handlers in Washington State are predominantly Mexican and, therefore, require a culturally appropriate process of informed consent. In addition, members of this occupational group are vulnerable to coercion because of poverty, lack of insurance, inability to read, and employment status Methods To create a process of culturally competent informed consent for Washington State's cholinesterase monitoring program, we used focus groups to collect data about cultural beliefs, attitudes, knowledge, language, and traditions of Mexican‐American pesticide handlers. With this information, we developed a final consent form and evaluated it using a 10‐item test‐retest questionnaire in a sample of 103 handlers. Results Using qualitative methods, we created English and Spanish consent forms that incorporated culturally defined risk information. Both the written and audiotape formats significantly improved comprehension; but, for subjects with less than 7 years of schooling, audiotapes in Spanish yielded significantly higher scores (mean comprehension score 7.0 vs. 6.1, t = − 2.2, P = 0.03). Conclusions Culturally competent informed consent for particularly vulnerable populations of non‐native speakers of English is possible. It requires both knowledge of specific cultural elements and the application of appropriate technology. Am. J. Ind. Med. 48:175–181, 2005. © 2005 Wiley‐Liss, Inc.