Reaching Hard-to-Reach Workers - Success through MCN and HOPE Clinic’s Partnership

Immigrant workers confront a long list of risks and barriers in their search for a better life in the US. Employment in dangerous industries, language barriers, fear of retaliation or losing their job, fear of deportation, lack of understanding of their rights, and general mistrust make a population that is disenfranchised and hard-to-reach even harder to reach.

Organizations whose mission is to serve these populations are able to do so because they’ve created trust. Trust that has been built over time through good reputation, organizational excellence, strong networking, and dedicated staff. Migrant Clinicians Network has had many years of experience and strong partners in the area of agricultural worker health, but last year, we embarked on uncharted territory in the area of worker health: we wanted to bring health and safety trainings to Vietnamese nail salon workers via a partnership with HOPE Clinic in Houston, TX with support from OSHA’s Susan Harwood Training Grant Program. Nail salon workers face occupational hazards that can seriously impact their health. Recent media had underscored the need for health advocacy for nail salon workers and MCN was looking to expand EOH programs into more urban-based worker populations.

In January 2016, MCN’s Environmental and Occupational Health team (Amy Liebman, Juliana Simmons, and I) traveled to Houston, TX for a two-day, train-the-trainer workshop with HOPE Clinic’s Outreach Team. Our first day of training focused on the health and safety content for nail salon workers -- chemical and biological exposure, ergonomics, and workers’ rights. The next day focused on training administration including recruitment, documentation of training, evaluation (three levels of it), and foreseen challenges… of which there were many.

HOPE Clinic was committed to training 165 nail salon workers for three hours per worker.  Our first glaring challenge was how to help HOPE Clinic successfully recruit 165 workers to attend a three-hour-long, voluntary work training during which they likely would not get paid. Together, MCN and HOPE Clinic strategized about the marketing and the selling points; how to build enthusiasm and benefit from word-of-mouth. We had to build trust among this worker population and their employers. While other nail salon training programs succeeded in California and New York, there was fear that the climate in Houston would be tougher for this type of program. Successful community interventions with nail salon workers generally involved many years of targeted community engagement on this topic. We had less than eight months to reach our goal.

HOPE had an amazing team of outreach workers, one of whom had previously worked in nail salons, the others had strong linkages with the community.  One outreach worker offered an unlikely solution amongst a heap of challenges. What about approaching the beauty schools where workers are trained to become nail technicians? There, we would have a captive audience. Workers are required to attend school 9am to 5pm, Monday through Friday. Teachers would likely be receptive of content of this health and safety training for nail salon workers. So our team at HOPE Clinic, led by our trainers Yen Giai-Ly and Cathy Phan, started mapping out beauty schools and nail salons in their service area and set out to sell the program. Thanks to their dedication, the results have been an overwhelming success.

In four short months, the team at HOPE Clinic delivered three hours of training to 168 nail salon workers.  The training program has been written about in local Vietnamese newspapers and, most importantly, has been very well received by workers. Yen and Cathy feel that workers truly enjoy the training and appreciate the education, especially the health portion. They want to learn about the 3-free and 5-free nail polishes (safer alternatives with less ‘bad actors’ in the ingredient list). They’re also very engaged during the biological exposure content.  MCN and HOPE developed stretching videos to guide workers through quick stretches they can do at work to prevent musculoskeletal injuries. Workers seem to have fun during that part of the lesson. They have a lot of questions regarding how their work might impact their health, which is precisely the type of thinking that helps both MCN and HOPE Clinic meet our missions.

The trainings have been advantageous for HOPE Clinic in other ways, as well. The trainings provide a great opportunity for general health education and raising awareness about other programs at HOPE that help improve health for this population, including breast and cervical cancer screenings, Hep B testing and prevention, Affordable Care Act enrollment and beyond. Cathy and Yen bring vouchers to the trainings so workers can make follow up appointments if needed. Workers receive certificates upon completion of the training and they leave with a better understanding of how to protect their health in the workplace. They understand the why behind wearing gloves, using fans, doing quick stretches, disposing and storing chemicals safely, among other safe practices.

Yen Giai Ly (left) observes as nail salon workers practice correctly removing gloves

The success of programs such as these hinges on the relationship between the organization and the community it intends to serve. We were fortunate that HOPE has an incredible team of dedicated trainers who helped us bridge the gap between this new worker population and MCN’s expertise in the field of worker health and safety. The team at HOPE taught us a lot about their unique population of workers and how best to reach them. Their commitment and compassion has made this program a success.

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