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Cajas y conversaciones / Delivery and Discussion: Assessing needs and services related to type II diabetes management among farmworkers in Eastern NC


  • 2019: CHER Research Summer Program


At least 80,000 migrant and seasonal farmworkers call North Carolina home for at least part of the year.1 Despite forming a large, vibrant community in our state, farmworkers face unique challenges in accessing healthcare and experience an increased burden of chronic disease and food insecurity.2,3 In Benson, NC, several local organizations are working to address these health disparities. NC Farmworkers’ Project (NCFP) serves as a resource center and connection to healthcare for more than 3,000 farmworkers in five counties around Benson. Benson Area Medical Center (BAMC) is a primary care clinic that stays open late during the summer growing season to serve farmworkers who otherwise could not leave work to seek healthcare. In the summers of 2018 and 2019, NCFP and BAMC partnered with a community supported agriculture farm to provide weekly boxes of fresh produce to farmworkers with diabetes with the hope of facilitating access to healthy foods and improving blood sugar control. These boxes (cajas) were well-received by the community, with clinicians noting significant improvement in HbA1c among farmworkers participating in the program.

Inspired by the work of these organizations, this project utilizes a community-based participatory research approach to learn about the current needs of farmworkers living with diabetes in Eastern NC, as well as the resources that exist to meet those needs. This research relies on community engagement. Researchers work with community stakeholders to formulate research questions and assist NCFP in the planning and execution of the produce box/cajas intervention and other health outreach projects. It also involves data collection. Farmworkers diagnosed with type II diabetes are recruited by the research team throughout the community engagement process to complete surveys assessing diabetes self-management. Farmworkers and stakeholders are also recruited to participate in individual interviews. These interviews will be transcribed and qualitatively analyzed using thematic content analysis.


  1. Lambar, E. F., & Thomas, G. (2019). The Health and Well-being of North Carolina’s Farmworkers The Importance of Inclusion, Accessible Services and Personal Connection. North Carolina medical journal, 80(2), 107-112.
  2. Quandt, S. A., Arcury, T. A., Early, J., Tapia, J., & Davis, J. D. (2004). Household food security among migrant and seasonal Latino farmworkers in North Carolina. Public Health Reports, 119(6), 568-576.
  3. Arcury, T. A., & Quandt, S. A. (2007). Delivery of health services to migrant and seasonal farmworkers. Annu. Rev. Public Health, 28, 345-363.

Outcomes and Impact

By taking the time to hear farmworkers’ experiences living with type II diabetes, we get to celebrate this community’s successes and learn from their challenges. The interviews and survey data collected through this project will guide future research into the feasibility, effects, and replicability of efforts in Benson to enable farmworkers to self-manage their diabetes.

Study Team

  • Stephanie Hoover, PhD (PI)
  • Laura Villa-Torres, PhD (faculty advisor)
  • Andrew Marburg, medical student researcher, CRSP fellow
  • Emily Aarons, medical student researcher, CRSP fellow
  • Luis Sanchez-Ferrer, undergraduate researcher

Partner Organizations

Funding Sources

  • Sutton Medical Education Excellence Fund (UNC Medical Education; Medical Foundation)
  • UNC School of Medicine Office of Rural Initiatives


  • Cajas y conversaciones: Challenges and Opportunities in Engaging Farmworkers Living with Type II Diabetes.” NC TraCS Institute MURAL Multilingual Research Capacity Building lecture series. UNC School of Medicine, Chapel Hill, NC, October 2019.

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