CHPPR’s Vales+ Tú Salud Project Works with Latino Day Laborers to Address COVID-19 Disparities

Published: October 2, 2023

The Vales+ Tú Salud project uses a community-based, “corner-level” approach to deliver an intervention to encourage Latino day laborers to prevent COVID-19 at street corners and other locations where they wait for work. This project builds on over a decade of work with Latino day laborers by Principal Investigator Maria Eugenia Fernandez-Esquer, PhD, and her team.

“This COVID project is based on our previous injury prevention study which for the first time tested in a cluster randomized trial an intervention to reduce Latino day laborers' risk for injury at work,” said Dr. Fernandez-Esquer. “The new project has taken the lessons learned in the previous study and adapted them to the current pandemic. More than 300 day laborers have participated in our program and so far it has received very positive reviews.”

Latino day laborers are a particularly vulnerable group. Compared to the general population, they have lower wages, limited access to health services, and worse working conditions. As the majority are undocumented immigrants, they often have little to no recourse to wage theft and underpayment by their employers and are more likely to work dangerous jobs that lack appropriate safety measures or oversight. During the COVID-19 pandemic, these and other factors have also left them more susceptible to misinformation, more likely to get infected and experience poor health outcomes, and less likely to get vaccinated.

Vales+ Tú Salud was designed as a three-phase cluster randomized trial to test the efficacy of a program to increase Latino day laborers’ adoption of COVID mitigation practices and vaccination. In the first or “rapid” phase of the project, the team worked alongside a community advisory board and advisors from the day laborer community to develop a group-focused, corner-level intervention. The intervention consisted of group problem-solving activities based on the “telenovela” story of a crew of workers who confront multiple ways to get COVID in their daily lives and at work.  The group activities were also designed to build a sense of group responsibility to encourage day laborers to practice better risk mitigation behaviors with each other and with people in their social network.

“We know that the laborers are the experts on their own situation, that they know better than us what they need and what works for them,” said Research Coordinator Gabrielle Longo. “We build the program around what we hear from them. That’s one of the most valuable and important aspects of our approach.”

The second phase of the project, currently in development, is being prepared to replicate the group strategies that worked in Phase 1 and to adapt the intervention to recent changes in the pandemic. This updated intervention will focus on providing access to resources commonly requested by the day laborers such as food assistance, health care at local clinics, and the Harris Health Financial Assistance Plan “Gold Card,” which provides financial assistance for medical care.

The Vales+ Tú Salud COVID project builds on Dr. Fernandez-Esquer and the team’s previous work with day laborers. The team has also developed dissemination activities to address rapidly emerging situations that threaten the health of these workers. During the recent heat wave this summer in Texas, the team provided laborers with hydration kits that included water, cooling towels, hydration powder, and brochures about staying hydrated and identifying heat-related illnesses. In just a couple of weeks, the team provided water and hydration kits to nearly 1,000 day laborers at 44 corners.

“Dr. Fernandez-Esquer has been working with day laborer populations since 2008,” said Research Coordinator Cesar L. Pinzon-Gomez, MD, MPH. “Those who have been out there for a while recognize our team, they’re excited to see us, they value what we do. This is a group that doesn’t have much of a voice, but they know that we are listening to them and that we’re working to raise their voice.”

Vales+ Tú Salud is a five-year grant funded by the National Institute of Health Disparities and the NIH Office of Population Health.