title: Why do farmworkers delay treatment after debilitating injuries? Thematic analysis explains if, when, and why farmworkers were treated for injuries.
abstract: BACKGROUND
  Farmworkers who delay treatment after workplace injuries may increase injury severity and experience longer recovery times. To understand why farmworkers delay treatment we employed a mixed-methods analysis of 393 farmworker injury narratives from the National Agricultural Workers Survey (NAWS).
  
  
  METHODS
  First, open-ended injury narratives were coded for attitudes related to injury timing and delay. Next, narratives were compared against demographic survey attributes to assess contextual information and patterns linked to treatment timing.
  
  
  RESULTS
  Four treatment timings were identified: immediate medical treatment (57.9%), delayed medical treatment (18.2%) self- administered treatment (14.9%), and no treatment at all (8.9%). Delay was primarily attributed to attitudes prioritizing work over pain, and when workers were able to work despite injury. However, immediate treatment was sought when workers were completely debilitated and unable to work, when a supervisor was notified, or when exposed to pesticides during injury. Timing choices varied by education, gender and migrant status.
  
  
  CONCLUSIONS
  Training on timely treatment, including notification of supervisors, may help reduce treatment delay for farmworkers.
authors.affiliation: Department of Biobehavioral Health, The Pennsylvania State University, Pennsylvania.
authors.forename: Amy Danielle
authors.initials: AD
authors.lastname: Thierry
authors.forename: Shedra Amy
authors.initials: SA
authors.lastname: Snipes
mesh_terms: D000293:Adolescent; D000328:Adult; D000383:Agriculture / Q000706:statistics & numerical data*; D001290:Attitude; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D033262:Narration; D016273:Occupational Exposure / Q000706:statistics & numerical data; D060051:Occupational Injuries / Q000523:psychology*; D010559:Personnel Management; D010575:Pesticides; D062707:Return to Work; D012648:Self Care / Q000706:statistics & numerical data; D012737:Sex Factors; D061665:Time-to-Treatment / Q000706:statistics & numerical data*; D014171:Transients and Migrants / Q000523:psychology; D016312:Treatment Refusal / Q000706:statistics & numerical data; D014481:United States
chemical_list: D010575:Pesticides
keywords: agricultural health; injury; occupational health; qualitative research; treatment-seeking