Building informed consent for cholinesterase monitoring among pesticide handlers in Washington State
Version of Record online: 10 AUG 2005
Copyright © 2005 Wiley-Liss, Inc.
American Journal of Industrial Medicine
Volume 48, Issue 3, pages 175–181, September 2005
How to Cite
Weyrauch, K. F., Boiko, P. E. and Keifer, M. (2005), Building informed consent for cholinesterase monitoring among pesticide handlers in Washington State. Am. J. Ind. Med., 48: 175–181. doi: 10.1002/ajim.20200
- Issue online: 10 AUG 2005
- Version of Record online: 10 AUG 2005
- Manuscript Accepted: 9 JUN 2005
- Department of Environmental Health, University of Washington and Department of Labor and Industries, Washington State. Grant Number: 10-5782
- cultural competence;
- informed consent;
- cholinesterase monitoring;
- pesticide handlers
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
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.
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).
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.