n America, agriculture, a most dangerous industry, is a common employer of seasonal farmworkers, the majority of whom are Hispanic [8]. Transient employment, language barriers, cultural practices, higher levels of poverty (23%), lack of healthcare access, as well as lower literacy issues confront this population, making them an underserved population and more vulnerable to health disparity than other races [3]. Specifically, Hispanics are more likely to be overweight (70%), have a stroke (30%), and die from diabetes (40%) [6] Driven by the USA's national policy agendas [2,7,9], health promotion in underserved populations is a major emphasis among academic medical centers in the USA as they prepare the future provider workforce for community based inter-professional healthcare delivery. Shifting demographics and the economic burden associated with treating chronic illness and disease has propelled community partnerships that offer benefits beyond the traditional service-line model of care. Compelling evidence from the Community Preventive Services Task Force [4,5], and the American Heart Association [1], supports benefits of primary, secondary, and tertiary community based programs for cardiovascular health. Inter-professional Health Fair and Research Outreach Programs offer a mechanism to study and improve the disparity among this underserved population, in their own communities.
Nursing education has a long tradition of caring for and educating the poor and vulnerable. Worksite health fairs, useful for health screenings are also commonplace. The Annual Costa Layman Health Fair and Cardio-metabolic Risks in Hispanic Farmworkers (CHARM) study, with a full complement of interprofessional faculty and student teams has at its core mission: "To improve the health of the people in communities we serve". Having completed the tenth year anniversary as a comprehensive health fair screening program, and a three year IRB approved CHARM study, valuable insights into the dimensions of nursing and health scientists working together to achieve a common mission is crucial to inform academic policy and make necessary curriculum changes for community health delivery systems of the future. Inter-professional teams working closely with this nursing project include faculty and students from the I College of Medicine, College of Dentistry and Periodontal Medicine, Optometry, Georgia Prevention Institute, Premier Laboratory Services, Ryan White Community Outreach, Culturally and Linguistically Appropriate Services, GRU Cancer Center, Library Services, and Allied Health (Respiratory, Physical and Occupational Therapy Departments).An initial report on nursing student response to implementation of this project is helpful to continue to design meaningful clinical experiences and inter-professional team work.
This paper provides an initial review on nursing student response to participation at an inter-professional and business partnership health fair and research project that promotes the health of uninsured/ underinsured Hispanic farmworkers in the southeastern USA.
To identify reported competencies gained by graduate nursing student participants at a community outreach health fair and research project (CHARM Study) for Hispanic farm-workers, 2015 summer semester.
Nursing students were assigned responsibilities in various teams to prepare for the health fair, including the following: Community Assessment, Patient Education, Translation, Referral Directory, Consent and Labs, and Data Entry/Analysis. In addition, all students were assigned to specific screening tasks on the day of the health fair event. At least one nursing student was assigned to each interdisciplinary screening booth at the health fair. Upon project completion, an electronic Student Survey Questionnaire, consisting of 13 items with check boxes was distributed to the twenty-one nursing students (Masters Level Clinical Nurse Leader Program)enrolled for clinical credit at the annual interprofessional Costa Layman Health Fair and Research Project at a major academic nursing college in southeast USA. Results were coded, tabulated, and graphically represented to faculty by an assigned nursing student (team leader) who was also a class member. See Table 1: Survey Questions.
Fifteen students completed the survey. Of these, 64.3% reported spending six to ten hours weekly preparing and organizing for this inter-professional health fair and research project. There were no student absences for clinic or class.
Identified competencies and themes of questions as well as student responses are as follows:
? Respect for scholarship and professional etiquettes appropriate to academic/community work (100%) ? Personal pride of contributions made to promote health awareness (to the farmworkers) (100%) ? A recognized need for and beginning collaboration with other inter-professional groups (100%) ? Appreciation for complex project management skills (100%) ? Cultural awareness of the Costa Layman farm community (100%) ? Ability to assess and describe the demographics of the Costa Layman farm community (100%) Students reported, (100%), that the above acquired competencies enriched their academic experience. Overall, students reported the project to be excellent (100%), effective in improving their knowledge of population/public health (93%) and in learning useful strategies to work with disparate populations (86.7%).All students (100%) reported they would use these strategies as future health care providers and eleven out of fifteen (73.3%) thought they would use these strategies in their student roles within the next one month to six months. The student's reported reasons for completing the survey were: "requested by faculty" (28.5%); "for continued support of the project (50%); and "out of respect for their team's work" (21.4%).All students (100%), reported they believed that continued future health fair project activities are necessary.
Student training and feedback are essential components of all courses/programs and provides for clarification and critique points that inform, support, or signal a need for programmatic or project change and/or refinement. Positive response rates indicate students are favorable to the use of inter-professional health screening teams and recognize the unique skill sets required to work with disparate farmworkers, many of whom are non-English speaking. They also appreciate the cultural considerations of the population and the inter-professional etiquette and collaborations among the teams as an integral part of a successful outreach program. Because there were no answers of disagreement to survey questions, it is assumed that major changes in program/project implementation is not recommended, but further refinement and continued inter-professional team support for community health fair and research projects may enhance nursing student's learning needs within the community.
Community outreach and an emphasis on clinical evidence is transforming clinical practice for nursing students and generating new approaches for meeting the health care needs of disparate populations with barriers to traditional care delivery methods. This inter-professional health fair and research model promotes a sense of "community partnership" between the health delivery teams, the farmworkers, business owner and the academic university. Such partnerships become win-win situations and everyone benefits.


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United States Department of Health and Human Services. 15-0007. http://www.ahrq.gov/research/findings/nhqrdr/nhqdr14/2014nhqdr.pdf National Healthcare Quality and Disparities Report. AHRQ Publication 2014. May 2015.