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Examining Healthcare Providers’ Knowledge, Attitudes, and Practices in Supporting Pregnant Farmworkers to Mitigate Occupational Pesticide Exposure in California: A Qualitative Study

Year: 2025

Type: article

Abstract: INTRODUCTION AND OBJECTIVES: Pesticide exposure during pregnancy is associated with adverse outcomes, and farmworkers face disproportionate risk. In California, healthcare providers can help mitigate exposure through work accommodation notes and State Disability Insurance (SDI) certification. However, little is known about provider knowledge and practices in this area. This study explores how healthcare providers support pregnant farmworking patients in reducing occupational pesticide exposure and identifies key barriers, facilitators, and recommendations for healthcare systems. METHODS: We conducted 3 virtual focus groups and 6 interviews (July 2024-March 2025) with California healthcare providers and state agency staff. Discussions explored knowledge, attitudes, and practices around screening, counseling, and SDI certification for pregnant farmworkers. Transcripts were thematically analyzed using grounded theory with inductive and deductive coding. RESULTS: Key barriers included limited prenatal care access, inadequate provider training, limited culturally and linguistically appropriate resources, inconsistent screening and counseling practices, and uncertainty around SDI eligibility and certification. These contributed to variable practices: some providers facilitated early disability leave and others hesitated due to unclear guidance or perceived administrative burden. Facilitators included early prenatal care, staff support, knowledgeable providers, and exposure screening workflows. CONCLUSIONS: Standardized guidelines, improved provider education, and coordinated policy and clinic-level changes are urgently needed to ensure equitable care for pregnant farmworkers.

Source: Journal of Primary Care & Community Health

DOI: 10.1177/21501319251407545

Authors: S. Kathleen Steel, Carly Hyland

Institution: University of California, Berkeley

Language: English

Topic: Occupational Health and Safety in Workplaces

Subfield: Occupational Therapy

Field: Health Professions

Domain: Health Sciences

SDGs: Good health and well-being, Zero hunger, Decent work and economic growth, Reduced inequalities

Open Access status: gold

Estimated APC paid: $2,500