Assessment of Spanish-language heat illness health information materials for farmworkers
Abstract
Background: Heat exposure represents a major occupational hazard for the 2.9 million agricultural workers in the U.S.A. This vulnerable worker population faces barriers to health care, limited protections, and disproportionate occupational exposures. In the U.S.A., regulatory and workplace protections from heat are limited. Thus, high-quality information is important to reduce heat-related illness.
Methods: We used a quantitative content analysis method. We conducted systematic searching completed by 02/25/2026 and solicited materials currently in use. We developed a codebook and established reliability. Two trained bilingual and bicultural research assistants rated materials using the Patient Education Materials Assessment Tool (PEMAT), an item from the Suitability Assessment of Materials, and for depictions of protective apparel. Two expert coders in medicine and climatology separately evaluated materials.
Results: We identified 84 Spanish-language materials of which 66% were print materials. PEMAT understandability scores ranged from 53.4 to 100.0 (m = 91.9), and actionability scores ranged from 0 to 100 (m = 75.3). Only 65% of materials showed evidence of being culturally tailored. Many materials depicted apparel that is not recommended for agricultural work. Expert review suggested high accuracy of medical information (>80%), but a substantial number of materials had misinformation about climate and weather. The majority of materials did not mention structural solutions to reduce exposure to heat such as having ways of cooling overnight in housing (6%), acclimatizing to heat (26%), modified work schedules (21%), or legal rights to breaks, hydration, or shade (23%).
Conclusions: In general, materials did little to promote structural solutions such as air conditioning in houses, rest breaks, and modified work schedules. This research highlighted the need for improved, culturally resonant Spanish-language heat safety educational materials that leverage modern technology.
Key messages: • Spanish-language heat safety materials used in the U.S.A. often have climate/weather misinformation and weak guidance about protective apparel.
• Analysis of heat-safety materials reveals gaps with implications for equity—limited cultural tailoring and the absence of important actionable protections (shade, breaks, acclimatization, scheduling).
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BibTeX
@article{zahra2026assessment,
title = {{Assessment of Spanish-language heat illness health information materials for farmworkers}},
author = {AG Zahra and JGL Lee and JG Estrada and PA Acevedo and JE Bloss and IM Mendez and M Cawley and J Guzman and CE LePrevost},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.1175},
url = {https://doi.org/10.1093/eurpub/ckag169.1175},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Assessment of Spanish-language heat illness health information materials for farmworkers
AU - AG Zahra
AU - JGL Lee
AU - JG Estrada
AU - PA Acevedo
AU - JE Bloss
AU - IM Mendez
AU - M Cawley
AU - J Guzman
AU - CE LePrevost
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.1175
UR - https://doi.org/10.1093/eurpub/ckag169.1175
AB - Background: Heat exposure represents a major occupational hazard for the 2.9 million agricultural workers in the U.S.A. This vulnerable worker population faces barriers to health care, limited protections, and disproportionate occupational exposures. In the U.S.A., regulatory and workplace protections from heat are limited. Thus, high-quality information is important to reduce heat-related illness. Methods: We used a quantitative content analysis method. We conducted systematic searching completed by 02/25/2026 and solicited materials currently in use. We developed a codebook and established reliability. Two trained bilingual and bicultural research assistants rated materials using the Patient Education Materials Assessment Tool (PEMAT), an item from the Suitability Assessment of Materials, and for depictions of protective apparel. Two expert coders in medicine and climatology separately evaluated materials. Results: We identified 84 Spanish-language materials of which 66% were print materials. PEMAT understandability scores ranged from 53.4 to 100.0 (m = 91.9), and actionability scores ranged from 0 to 100 (m = 75.3). Only 65% of materials showed evidence of being culturally tailored. Many materials depicted apparel that is not recommended for agricultural work. Expert review suggested high accuracy of medical information (>80%), but a substantial number of materials had misinformation about climate and weather. The majority of materials did not mention structural solutions to reduce exposure to heat such as having ways of cooling overnight in housing (6%), acclimatizing to heat (26%), modified work schedules (21%), or legal rights to breaks, hydration, or shade (23%). Conclusions: In general, materials did little to promote structural solutions such as air conditioning in houses, rest breaks, and modified work schedules. This research highlighted the need for improved, culturally resonant Spanish-language heat safety educational materials that leverage modern technology. Key messages: • Spanish-language heat safety materials used in the U.S.A. often have climate/weather misinformation and weak guidance about protective apparel. • Analysis of heat-safety materials reveals gaps with implications for equity—limited cultural tailoring and the absence of important actionable protections (shade, breaks, acclimatization, scheduling).
SN - 1101-1262
SN - 1464-360X
ER -