Worker produced health education material for the construction trades

Our plain-English summary of Worker produced health education material for the construction trades, by D.L. Roter, R.E. Rudd, J. Keogh, et al (International Quarterly of Community Health Education, 1986).

The study

• Authors: D.L. Roter, R.E. Rudd, J. Keogh, B. Robinson
• Journal: International Quarterly of Community Health Education
• Published: 1986;7(2):109-21
• Cited by: 13 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

There is broad acceptance of the philosophic foundations of health education as grounded in the collaborative model of client and professional partnership. In practice, however, this partnership is largely dominated by the professional side. Workers may be particularly sensitive to professional domination as issues associated with health promotion vs. safety and health programs at the workplace are often politicized. This polarization is particularly evident in the area of asbestos-related hazard prevention, reduction, and education. Using asbestos hazards as the unifying theme, we participated in a program to facilitate active participation of workers in the production of their own occupational health education materials through the use of the photonovel. Representatives from some seven building trade locals worked with a staff to produce a twenty-four-page photonovel for their co-workers. A random sample of 500 members of building trades locals received either a copy of the photonovel or a popular NCI asbestos pamphlet with an evaluation questionnaire. Differences between the groups were evident in favor of the photonovel in readability, factual recall, general credibility, and attitudes toward future involvement in health and safety issues.

In plain English

This article described a project in which Baltimore building trades workers created their own asbestos education booklet, a photonovel (a comic-book-style story using photographs) called Workers Take Action, and then evaluated it. A mailed pretest survey of 250 union members, 58 percent of whom responded, found that three-quarters did not know occasional light exposure may be sufficient for asbestos-related disease. For the evaluation, 500 members of ten union locals were mailed either the photonovel or a National Cancer Institute (NCI) asbestos booklet, with a questionnaire, and 21 percent returned it. Almost 60 percent of photonovel respondents, versus 40% of NCI booklet respondents, said they thought they would become more active in union health and safety activities. Photonovel readers were much less likely to confuse asbestosis and cancer. NCI booklet readers knew more about where to complain about asbestos hazards. The photonovel story tested at an eighth-grade reading level and the NCI booklet at a fifteenth-grade level. The authors concluded that the worker-produced photonovel matched and often surpassed professionally produced materials on a number of measures. They suggested that the lower response rate, compared with the pretest, might reflect the long questionnaire and the "test" impression of the mailing.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Health education project report: workers produced a photonovel, with a mailed knowledge pretest survey and a mailed questionnaire comparing the photonovel with an NCI asbestos booklet
• Who was studied: Baltimore building trades union members. Pretest: 25 randomly chosen members from each of ten union locals (N = 250), 58 percent response, mean age 44, average 20 years in the trade. Evaluation: 50 members from each of the same ten locals (N = 500), half given each booklet. Production group: eight men representing seven unions
• Exposure: Self-reported asbestos exposure in construction work. In the pretest, 2 percent reported never being exposed, 24 percent frequent exposure and 59 percent occasional exposure. No fiber types were named. The comparison studied was educational material (photonovel vs NCI booklet).
• Main results:
  • Pretest respondents: three-quarters did not know that occasional light exposure may be sufficient for asbestos-related disease
  • Evaluation response rate was 23 percent for photonovel recipients vs 19 percent for NCI booklet recipients (21 percent overall)
  • Almost 60 percent of photonovel respondents vs 40% of NCI booklet respondents said they thought they would become more active in union health and safety activities
  • Photonovel respondents felt more strongly that the booklet they read was a good teaching tool
  • Photonovel respondents were much less likely to confuse asbestosis and cancer
  • NCI booklet readers were more knowledgeable about where to complain about asbestos hazards
  • Three-quarters of respondents in both groups said the booklets contained information new to them
  • By the SMOG readability formula, the photonovel story and dialogue were at an eighth-grade level (fact sheets at ninth and eleventh grade); the NCI booklet was at a fifteenth-grade level
• The authors' conclusion: The authors concluded that the worker-produced photonovel matched and often surpassed professionally produced materials on a number of measures
• Limitations the authors state:
  • The evaluation return rate was low, less than half that of the pretest; the authors suggested this may be attributed to the long questionnaire and the test-like impression of the mailing
  • The evaluation respondents appeared more knowledgeable and aware of cancer and asbestos-related disease than the pretest group
  • Educational materials are only one element of a health education effort

Related studies

• Asbestos screening and education programs for building and construction trades unions — S. Tillett, P. Sullivan (1993)
• Airways obstruction among older construction and trade workers at Department of Energy nuclear sites — J.M. Dement, L. Welch, et al. (2010)
• Surveillance of respiratory diseases among construction and trade workers at Department of Energy nuclear sites — J.M. Dement, L. Welch, et al. (2003)
• Occupation and work-related ill-health in UK construction workers — S.J. Stocks, S. Turner, et al. (2011)
• Work-related respiratory health conditions among construction workers: a systematic narrative review — E.F. Boadu, S.R. Okeke, et al. (2023)
• Protest and survive, the U.K. Construction Safety Campaign: a case study of workers' and victims' family action and legal and regulatory inaction on construction health and safety — M. Holder, T. O'Brien (2007)

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