The proposed R15 project will investigate the use of the juramento among Mexican immigrant farmworkers in
southeastern Pennsylvania. The juramento is a ritualized pledge that Catholics make to a saint for divine intervention in
abstaining from alcohol. It is a religious-based alcohol intervention with origins in Mexico and a strong and growing
presence in Mexican immigrant communities. Mexican farmworkers have been identified as a high-risk group for
developing substance use disorders (SUDs), and too often experience extraordinary barriers that keep them from formal
alcohol treatments, when available in their communities. Unable to access treatments, they turn to alternative
interventions in their communities, such as immigrant-specific and Spanish-language Alcoholics Anonymous meetings
and anexos, including juramentos.
The Latino Immigrant SUDs Help-Seeking Model, currently under development in another study, drives our R15
project. It will help us to explain why Mexican immigrant farmworkers do not use conventional treatments, as a
consequence of individual-level, treatment and intervention-level, and structural factors in and beyond their communities
that produce inequitable access to treatment services; and to explain how the farmworkers learn about the juramento and
use it to initiate sobriety, to stay sober, and to work on their recovery. We modify the model to include the religiosity of
the farmworkers, opening the model’s aperture and increasing our understanding of a religious-based indigenous alcohol
intervention. That is, an alcohol intervention with origins in the homeland of the immigrants and adopted in the United
States. With the data gathered, our model will be developed into an empirically-informed indigenous recovery systems
paradigm that includes the juramento and other indigenous alcohol interventions and treatments in farmworker
communities. It will also allow us to generate scientific knowledge of an indigenous and religious-based alcohol
intervention not addressed in the ethnic-specific alcohol treatment literature. The extant literature highlights farmworker
and other migrant laborers’ alcohol prevalence and the many barriers to alcohol and other SUDs treatment, but tends to
ignore their help-seeking pathways and the indigenous interventions and treatments available in their communities.
The specific aims of this exploratory study are:
1. To establish who in the Mexican immigrant farmworker population (e.g., age, marital status, migration history)
makes a juramento and why;
2. To identify the individual-level factors (e.g., age, marital status, immigration background), treatment and
intervention-level factors (e.g., program language and rituals), and structural factors (e.g., immigration policy, health
access policy, and labor conditions) that shape the help-seeking pathways of Mexican immigrant farmworkers that
include juramento use.
3. To examine the sobriety and recovery practices of the juramentos (e.g., prayer, prayer cards, church attendance);
4. To ascertain the farmworkers’ perceptions of the juramento’s benefits (e.g., faith-based intervention and cultural
familiarity) and possible drawbacks (e.g., short-term sobriety and lack of continuous support).
The proposed project is designed around the qualitative method—an appropriate approach for exploratory studies
such as ours—and the preparation of students for qualitative health research through field praxis. We will use semi-
structured interviews to collect qualitative data on juramento use among Mexican immigrant farmworkers in Southern
Chester County, PA, who will be recruited using purposive sampling. First, we will use semi-structured interviews to
query two priests, who perform juramentos in the region, about the juramentos and the farmworkers who use them.
Second, we will conduct exploratory semi-structured interviews with 30 farmworkers: 15 who made juramentos,
irrespective of if they are in an alcohol treatment program or not, and 15 who did not but are in alcohol treatment. We
will use these interviews to gather information on their use of juramentos, their religious background, their personal
histories of alcohol use, and their experience with other interventions and treatments, if any. Third, we will conduct two
focus groups with farmworkers with anywhere from eight to 12 participants per focus group. One focus group will be
comprised of men who have made juramentos and the other with men who have not made juramentos but are in alcohol
treatment. The focus groups will help us to gain a more nuanced understanding of how and why they use juramentos, and
what they believe in regards to how the juramento contributes to their sobriety and recovery. The exploratory interviews
and focus groups will also include the DUREL and the AUDIT instruments. All interview transcripts will be analyzed
using standard qualitative data analysis and the instruments, together with basic demographic characteristics from
exploratory and focus group samples, will be analyzed using basic statistical analyses. From our findings, we expect to be
able to: (1) identify who in the Mexican farmworker population use juramentos and why; (2) describe the juramento and
how it contributes to sobriety; (3) inform cultural competence efforts in alcohol treatments of the religious and spiritual
elements of the juramento; and (4) develop novel research on religious recovery practices.
Our short-term goal is to learn more about the juramento and farmworker use of the juramento and to advance a
student-centered qualitative health research program at Indiana University of Pennsylvania. Our mid-term goals are to
prepare an R01 study on efficacy of the juramentos in regards to sobriety and recovery to sustain the qualitative health
research program and to improve a burgeoning public health research infrastructure on campus. Our long-term goal is to
generate new scientific knowledge on these sobriety promoting features that will inform alcohol treatment services for
Mexican and other Latino immigrants.
