Cognitive-behavioral approaches to farm community safety education: a conceptual analysis

For many years, farm health and safety education efforts have focused on the presentation of safety rules and guidelines. This method of instruction tends to ignore the contingencies that influence the actual behavior of farmers. Consequently, while most farmers understand the safety instruction messages they receive, they frequently continue to engage in risky behaviors. They do so even when they are aware of the injury consequences that can result from engaging in risky behaviors during farm work. Consequently, educational programs for the delivery of farm health and safety knowledge have been judged to be of questionable effectiveness. Yet, current political, social, and economic realities suggest that safety and health education will remain a favored methodology for the foreseeable future. These observations suggest that farm safety education efforts may need to be reconceptualized. This article examines the learning of safe and unsafe work practices from three historical learning theory perspectives: behaviorism, constructivism, and socioculturalism. The conceptual analysis is illustrated through case study examples. The analysis may provide insights into why transmission of knowledge by itself is not effective for replacing risky behaviors with safe work practices. It may also assist the design of farm health and safety education programs that impart knowledge, as well as change attitudes and behavior that support safe work practices.     

Validity of photographs for food portion estimation in a rural West African setting

OBJECTIVE: To validate food photographs for food portion size estimation of frequently consumed dishes, to be used in a 24-hour recall food consumption study of pregnant women in a rural environment in Burkina Faso. This food intake study is part of an intervention evaluating the efficacy of prenatal micronutrient supplementation on birth outcomes. SUBJECTS: Women of childbearing age (15-45 years). DESIGN: A food photograph album containing four photographs of food portions per food item was compiled for eight selected food items. Subjects were presented two food items each in the morning and two in the afternoon. These foods were weighed to the exact weight of a food depicted in one of the photographs and were in the same receptacles. The next day another fieldworker presented the food photographs to the subjects to test their ability to choose the correct photograph. RESULTS: The correct photograph out of the four proposed was chosen in 55% of 1028 estimations. For each food, proportions of underestimating and overestimating participants were balanced, except for rice and couscous. On a group level, mean differences between served and estimated portion sizes were between -8.4% and 6.3%. Subjects who attended school were almost twice as likely to choose the correct photograph. The portion size served (small vs. largest sizes) had a significant influence on the portion estimation ability. CONCLUSIONS: The results from this study indicate that in a West African rural setting, food photographs can be a valuable tool for the quantification of food portion size on group level.     

Observation study of students who completed a high school agricultural safety education program

The Agricultural Disability Awareness and Risk Education Project (AgDARE) is a research-based curriculum of agricultural safety instruction based on Prochaska and DiClemente's Transtheroetical Model of Change. The program uses eight reality-based psychomotor and narrative modules to teach safe farm work behaviors. In addition to in-class pencil and paper assessments on safety attitudes and behavior intention, farm visits were made to assess the longer term influence of AgDARE. Visits were made between 11 and 20 months (mean = 14.24 months) after completion of the classroom instruction to 29 students who worked on farms and completed at least one-half of the AgDARE instruction. All but one of the visited students exhibited safe work behaviors addressed by the AgDARE instruction. In addition, 76% of the visited students had made positive changes in their farm work behavior since participating in AgDARE. Changes extended beyond the instruction that students received in class to include other aspects of farm work and other family members. The use of farm visits to evaluate students' safety behaviors was tempered by the challenge of contacting students and obstacles associated with observing work in an environment where little is routine or regular.     

Safety-related knowledge and behavior changes in participants of farm safety day camps

Significant resources are devoted to conducting farm safety day camps throughout North America, but the impact and effectiveness of these programs has not been systematically demonstrated. This project assessed changes in safety-related knowledge and behaviors among participants in the Progressive Farmer Farm Safety Day Camp program. A written pre-test and a three-month telephone post-test were administered to three samples of participants, ages 8 to 13, in camps held in 1999, 2000, and 2001. A sample of 20 to 30 camps was included in each year of the study, with a total sample of 1,780 participants for all three years. The pre-test and post-test contained questions related to first aid and to safety around animals, ATVs, farm equipment, flowing grains, and tractors. Three scores were computed from responses to 20 knowledge and behavior items. A knowledge score indicated the number of 8 knowledge items answered correctly, a behavior risk score indicated the amount of risk exposure for the child based on 8 behavior items, and an ATV safety gear risk score indicated, for those who rode ATVs, the level of risk due to lack of proper safety gear (4 items). From pre-test to post-test, there was an increase in knowledge scores and a decrease in behavior risk scores and ATV safety gear risk scores. These changes were consistent both for males and females, for farm residents and non-farm residents, and across all ages in the sample. These results support claims for the effectiveness of farm safety day camps for increasing knowledge and improving safe practices among camp participants.     

A study of the impact and efficacy of health fairs for farmers

The purpose of this study was to evaluate the effectiveness of two regional multi-disciplinary farm health fairs, pairing cardiovascular and agricultural health and safety risk factor assessments and education, in agricultural regions in southern Minnesota in 1999 and 2001. This study explores the rationales and motives cited as having an influence on: (1) work practice and lifestyle adaptations, (2) resistance to such changes, and (3) compliance with health fair recommendations. Evaluation took the form of standardized telephone surveys and callbacks with an open-ended component administered by a parish nurse interviewer and conducted six months following each of the fairs. Participants had received individualized work practice and lifestyle recommendations based upon their medical results and questionnaire responses. Of the 378 total attendees at the two farm health fairs, 272 (72%) participated by filling out on-site questionnaires, and 284 (75%) completed a post-fair interview. Participants who were actively farming totaled 237 (63%) of all participants. A majority of those interviewed on callback (78%) reported either work safety or lifestyle changes, while 47% of those actively farming claimed varying work safety changes as a result of the fair. The conclusions drawn from the follow-up interviews include: (1) the two farm health fairs resulted in a substantial number of participants positively modifying lifestyle and work practices, (2) the stand-alone farm health fairs were effective in attracting farmers, and (3) low-level stressors identified in the participants could be effectively addressed by knowledgeable rural health care resources such as parish nursing.     

Farm safety issues in Old Order Anabaptist communities: unique aspects and innovative intervention strategies

The Amish and other Old Order Anabaptists have been inseparably linked with agriculture since coming to America. However few efforts have been identified which analyze the issues involved with Old Order Anabaptist farm injuries or present best practices for addressing these problems. As part of an effort to develop culturally appropriate and effective injury prevention strategies for use within the Old Order Anabaptist community, this article identifies important cultural issues that should be considered in understanding and attempting to reduce farm injures in this population, summarizes statistics concerning farm-related fatalities among Old Order Anabaptists, and discusses methods which have been effectively used to address farm injuries within these communities. In the statistical analysis, 92 cases were identified that were classified as being work-related or occurring in a farm work-related setting during the period 1980 to 2000. Approximately 64% of the identified cases were children 15 years and under; and approximately 77% were male. Run-over incidents were the most frequent primary cause of the fatal injuries, while animal-related behavior was the most frequent secondary cause, reflecting agricultural practices that remain highly dependent upon the use of horses and mules. The authors believe evidence suggests that certain Old Order Anabaptist choices concerning farm safety issues may be directly related to their socio-religious beliefs, and that effective intervention strategies must also be sensitive to socio-religious beliefs.     

A qualitative assessment of children's farm safety day camp programs

In order to increase farm safety awareness and teach children good safety habits, farm safety day camp programs have been initiated in many communities. For the most part, the effectiveness of the programs is unknown because few evaluations have been performed. The purpose of this project was to qualitatively assess the overall strengths and weaknesses of farm safety day camp programs and to generate recommendations for future programs. Interviews, a literature search, and observations were used to identify strengths and weaknesses of the farm safety day camp programs. Major strengths of the programs are that: 1) positive attention is given to agriculture and agricultural safety; 2) programs are hands-on, interactive, and fun; 3) children gain knowledge about farm safety; 4) programs bring a community together to work toward a common goal; and 5) children talk to parents about safety. Key weaknesses of farm safety day camp programs are that: 1) there is a lack of parental involvement in many of the programs; 2) it is hard to change patterns of behavior in one day; 3) programs are expensive and time consuming; 4) curricula may include content that is inaccurate or inappropriate for the age of participants; and 5) evaluation is difficult. When done well, farm safety day camp programs can teach children about safety and influence safety practices affecting children on the farm. Recommendations for future farm safety day camp programs are: 1) ensure that child-development principles are applied to all aspects of program activities and curricula; 2) provide session leaders with accurate and relevant content; 3) increase parental involvement; and 4) address safety issues throughout the year.     

Gender and occupational health and safety requirements among Saskatchewan farm adolescents

Children on farms perform hazardous work that exposes them to risks for injury. Hazards include operation of heavy machinery, working with limited supervision, working at heights, and performing work prohibited by law in other industries. Incidence rates and patterns of injury are known to differ between boys and girls on farms. Farm adherence to occupational health and safety practices, and whether such practices vary by gender, has received limited study in this occupational setting. The objective of this study was to evaluate associations between gender and work practices, and required occupational health and safety practices, within a sample of adolescent children age 12 to 18 years living on Saskatchewan farms. A cross-sectional study was performed. Measures were obtained by self-report. We compared requirements for boys and girls on the following: (1) use of personal protective equipment (PPE), (2) conduct of specific hazardous jobs, (3) training and supervision for equipment work, and (4) training and supervision for large animal work. A total of 434 children were identified, and 297 (68%) met the eligibility criteria. Of these, 170 were boys (57%) with a mean age of 14.5 years (SD 1.9). Occupational health and safety requirements varied by gender; girls were less likely to be required to use PPE (adjusted OR 2.39; 95% CI: 1.16, 4.94). There was no evidence of an association between gender and the conduct of hazardous work. Gender patterns in required training and supervision for work suggested disadvantages for girls, but were not significant. Adolescent girls and boys both performed hazardous jobs on the farm. Girls were as likely to conduct hazardous jobs but not to be required to use PPE. This gender disparity may indicate a need for a public health approach that recognizes gender as a determinant of work assignment and of health and safety practices on farms.     

The farm apprentice: agricultural college students recollections of learning to farm "safely"

A consistent message in the farm safety literature is the need to develop effective interventions to manage the unacceptably high rate of injury and death among farm children. To better understand the influence of childhood farm experiences on safety beliefs, attitudes, and practices, semi-structured interviews were conducted with 24 farm youth attending the Nova Scotia Agricultural College. The interviews were designed to elicit information pertaining to participants' earliest memories of involvement in farm activities, the decision-making processes that led them to assume work-related responsibilities, and the roles that their parents played in their safety training. A common theme of experiencing childhood as a "farm apprentice" emerged across all narratives whereby farm activities were learned primarily through observational learning and modeling of parents and then mastered through repetition. As "farm apprentices," the youths' involvement in dangerous activities such as tractor driving and livestock handling began at early ages, with very little formal training and supervision. Although participants clearly described themselves as being exposed to dangerous activities, they believed that they had the capacity to control the risks and farm safely. Based on our findings, the concept of the "farm apprentice" appears to be integral to the social context of the farming community and should be considered in the design of interventions to reduce child injury and death.     

Factors Affecting the Selection of Information Sources of Sustainable Agricultural Practices by Malaysian Vegetable Farmers

Information is key in reducing the uncertainties of sustainable agricultural practices (SAPs). The objective of this study was to improve the understanding of the relationship between utilized informational sources and other key identified factors affecting Malaysian vegetable producers' choices. The findings of a multivariate probit model suggest that information sources are complementary. The choices for these sources are influenced by heterogeneity in access to credit, social network (member of farmers association), and farm settings (distance from farm to market, resource depletion issues, and geographical regions). Future promotion of SAPs should be delivered through the provision of quality content disseminated through the preferred information sources, which target potential users.     

Understanding the public health impacts of farm vehicle public road crashes in North Carolina

Discussions with groups of North Carolina farmers identified farm vehicle public road safety as their primary occupational health and safety concern. Findings of a mail survey of North Carolina growers participating in a North Carolina Department of Labor migrant housing inspection program indicated that over 97% of them felt less safe on North Carolina public roads now (1999) than five years prior (1995), and over 79% currently (1999) felt unsafe transporting farm vehicles on North Carolina public roads. Using both primary and secondary data, we explore the context of farm vehicle public road crashes, identify contributing individual and environmental risk factors, and estimate the public health cost. Recommendations and suggestions for future farm vehicle public road safety research and interventions are proposed.     

Safety and animal handling practices among women dairy operators

This article presents suggestions toward safer animal handling utilizing the results of a qualitative study of women dairy farmers in Finland. A major proportion of injuries (43%) occur in livestock-related work in Finnish agriculture. An even greater proportion of women's farm injuries (77%) is related to animals. We investigated the working conditions often women dairy farmers. Data were collected by observing farm work and performing semi-structured interviews. The study farms represented different milk production technologies with an average farm size of 106 ha (262 acres) of cultivated land, 51 ha (126 acres) of forest, and 45 dairy cows. Farm-related injuries were frequent; eight respondents out often had suffered one or several injuries during the previous two years. The women considered farm animals as the greatest hazard, and unexpected animal behavior was viewed as the most significant work-related injury risk. Dangerous situations often resulted from stress in cows caused by unpleasant circumstances or making animals fearful of people. Experiences from some farms suggested that dairy farm work can be relatively safe and that improving the trust between the cows and their handlers plays a key role in safety. We synthesized our findings into four animal handling strategies that can potentially reduce the risk of injury among stockpersons. We developed practical guidelines on how to gradually build a good cow-handler relationship based on our findings and the literature on cattle handling strategies and animal welfare science.     

Farmers' perceptions and concerns: the risks of driving farm vehicles on rural roadways in North Carolina

This study focuses on farmers' perceptions of roadway safety and reviews specific and pertinent North Carolina rural road crash data to evaluate their perceptions and concerns. A survey was mailed to 1,357 prospective participants throughout North Carolina. Of these, 656 (48.3%) North Carolina farmers completed and returned the survey. The study revealed that while the majority of respondents took a number of specific safety measures to ensure their safety while driving their tractor on rural roads, most believed that driving their tractor on rural roads was more dangerous than it was five years ago. Few respondents believed that laws governing tractors on rural roads are well known by urban residents. While a majority of the respondents would support a law to mandate the use of a slow-moving vehicle (SMV) emblem on the back of slow-moving farm equipment, a majority also believed that a more effective way to mitigate potential crashes would be to ensure that all farm vehicles had blinking or flashing lights, that diamond-shaped caution signs depicting a tractor were posted on roadways with frequent tractor traffic, and that roadway shoulders were created or widened on roads with heavy farm traffic so that tractors could move off the roadway. Only 22% of respondents felt safe driving their tractor on rural roadways in North Carolina. Most respondents felt that the biggest problem with roadway safety was the lack of respect and increased speed of other drivers. Recent data indicate that in crashes involving farm vehicles, citations were issued to 34% of the non-farm vehicle operators and 24% to farm vehicle operators. For those driving non-farm vehicle who were deemed at fault, 66% were cited for failure to reduce speed. For those driving farm vehicles, the most frequent citation involved the lack of safe movement.     

National AgrAbility Project impact on farmers and ranchers with disabilities

The impact of AgrAbility was evaluated through a survey of farmers and ranchers with disabilities who have been served by AgrAbility. The general demographics of the client population and assistance received were evaluated. Other information gathered included client ability pre- and post-onset of a disability and implications of self-reported outlook for the future. Eight states with AgrAbility programs participated in this cooperative survey with the National AgrAbility Project, with a 58.7% response rate (N = 618). The client population was mostly male (85.2%) with an average age of 53.3 with many working full-time (42.4%), part-time (27.6%), only off-farm (3%), or both off and on the farm (27%) in predominately row-crop (58.2%), cattle (not dairy) (46.6%), and hay or forage (41.4%) operations. Nearly half (48.2%) of the clients reported that the origin of the disability was due to a chronic health condition, as opposed to an injury. The majority of clients reported receiving information referring them to a funding source (42.0%) and receiving technical assistance with modifications around the farm or ranch (41.3%). Only two areas of farm operation were reported to have increased after the onset of disability (farm office from 43.8% to 61.2% and household chores from 30.9% to 36.0%). Field machinery operation continues to be the most common activity on the farm, with 73.3% reporting operating field machinery after the onset of disability. The present sample was more optimistic than expected. From a simultaneous multiple linear regression analysis, the factors contributing to positive future outlook include: ability to manage one's chores, machinery, and farm, F (5, 387) = 34.91, p < 0.001). Implications for safety professionals are included.     

Barriers and enabling factors for safety improvements on farms in Finland

Systematic reviews of agricultural safety and health interventions have shown little evidence of effectiveness. In this study, we used a self-documentation and collaborative interpretation method (cultural probes, n = 9) as well as farm interviews (n = 11) to identify factors affecting the adoption and implementation of safety information. The three main barrier groups found were (1) personal characteristics of the farmer, (2) limited resources to make safety improvements, and (3) the slow incremental evolution of the physical farm environment where old, hazardous environments remain along with new, safer improvements. The enabling factors included good examples or alarming (and thus activating) examples from peers, ease of implementation of the promoted safety measures, and enforcement of regulations. The findings suggest that a user-centered approach could facilitate the development of more effective safety and health interventions. A conceptual model of the safety intervention context created in this study can be used as a framework to examine specific barriers and enabling factors in planning and implementing safety and health interventions.     

Tractor overturn concerns in Iowa: perspectives from the Keokuk county rural health study

Agriculture remains one of the most hazardous industries in the U.S., with tractor overturns producing the greatest number of agricultural machinery-related fatalities. Rollover protective structures (ROPS) and seatbelts effectively reduce tractor overturn deaths. However, a large proportion of tractors in use in American agriculture are older tractors without ROPS and seatbelts. This article describes the tractor-related responses from participants in a population-based study conducted in Keokuk County, Iowa. This study was designed to measure rural and agricultural adverse health and injury outcomes and their respective risk factors. Questionnaires were partially developed from well-documented national surveys. Questions about agricultural machinery use, presence of safety equipment on the machinery, work practices, and attitudes about farm safety were included. Study participants on farms who owned tractors had an average of 3.1 tractors with an average age of 27 years. Only 39% of the 665 tractors had ROPS. Tractor age was associated with the presence of ROPS; 84% of tractors manufactured after 1984 were ROPS-equipped, whereas only 3% of tractors manufactured before 1960 were ROPS-equipped. ROPS-equipped tractors were significantly more common on larger farms and households with higher income. Only 4% of the farmers reported that their tractors had seatbelts and they wore them when operating their tractors. The results of this study support the findings of other studies, which indicate that many older tractors without ROPS and seatbelts remain in use in American agriculture. Until a dramatic reduction in the number of tractors in the U.S. operated without ROPS and seatbelts is achieved, the annual incidence of 120 to 130 deaths associated with tractor overturns will persist.     

Kids and communities count: reaching migrant children and families with the North American Guidelines for Children's Agricultural Tasks (NAGCAT)

The Kids and Communities Count Farm Safety Lesson is a follow-up to our Kids Count Lesson that used the North American Guidelines for Children's Agricultural Tasks (NAGCAT) and was previously delivered to nearly 2,000 fifth-grade students in Hillsborough County, Florida. This year, the lesson was administered in two migrant schools and included a parent survey and a presentation of the lesson in a community setting. The lesson covers animal, machinery, water, and general safety topics applicable to farming in Florida. A staggered pretest-posttest study design was followed whereby school 1 (N = 66) received a multiple-choice pretest and posttest and school 2 (N = 91) received the posttest only, for a total sample size of 157 participants. Results of the study showed a significant increase in the mean number of correct answers on the posttest compared to the pretest, such that the mean score improved from 5.0 on the pretest to 6.6 on the posttest (paired t-test, p = 0.000). The results of the parent survey and the administration of the lesson in the community showed that over 50% of the 106 parent participants reported that their children were practicing safe farm behaviors since the lesson; however, there was a particular need to address pesticide safety in the community. This study shows the efficacy of the Kids Count lesson in improving farm safety knowledge among migrant school children, and the applicability and acceptance of the lesson by parents and community members.     

The perception of farm safety and prevention issues among the Old Order Amish in Lancaster County, Pennsylvania

The purpose of this study was to explore farm safety and prevention issues within an Old Order Amish community. A qualitative ethnographic approach was used to explore perceptions of Amish adults as to the issues related to farm safety and prevention for their children. Access to this community was facilitated through two contact people who were well known in the community. Data were collected using semistructured interviews and recorded as field notes. Data analysis was done by looking for themes based on the questions asked about safety and prevention. From this analysis, four themes were found related to safety and prevention. They included education of the parents, education of the children, home and farm preventive measures, and enforcement of established rules. In addition, childhood readiness was found to be another important issue related to farm safety. Childhood readiness was found to have three themes, developmental appropriateness, parental control and supervision, and birth order of the child. Data from this study suggested that farm safety is a concern of the Old Order Amish in Lancaster County. Their perceptions of safety and prevention issues centered on the incidents that have occurred and are considered dangerous. It is important to look at the identified safety and prevention and childhood readiness themes to identify the most beneficial approaches for the Amish to promote safety on their farms.     

Instructional practices at Farm Safety 4 Just Kids (FS4JK) safety day camps

The instructional methods used with 1,347 youth in seven Farm Safety 4 Just Kids (FS4JK) day camp sessions conducted in five states during the summer and fall of 2002 were videotaped. The videotapes, instructor questionnaires, and day camp materials were analyzed using an observation protocol that focused on instructional practices and an interaction analysis of instructor-student talk during the sessions. Results showed that instruction focused on hazard recognition, a high level of participant attention during all the sessions observed, and safety day camp content relevant to rural participants regardless of whether they live or work on a farm. Recommendations for improving instructional practice include better use of print materials, more interactive, participatory activities for students, and reduction of instructor-centered, didactic approaches. Given the high level of students' attention, increased involvement of students in active, participatory approaches might enhance the effectiveness of the instruction by: (1) further engaging students through personalizing hazard recognition, (2) contextualizing reports of injuries, (3) examining the complexities of choosing safe behaviors, and (4) paying more attention to the consequences of injury events. Role-playing, narrative simulations, and other types of interactive and collaborative exercises are instructional approaches that support the inclusion of the pre-event contingencies and post-event consequences that are part of all injury events.