Farm Dinner Theater: Testing an innovative health and safety intervention among older farmers and their families.

PURPOSE: The effectiveness of a novel intervention for increasing health and safety behaviors of older farmers was tested. Blending didactic and readers' theater techniques, Farm Dinner Theater (FDT) engages farmers in discussions of health and safety in a nonthreatening social atmosphere supportive of potential changes. METHODS: Through community collaborations, farmers 45 years and older were recruited in 8 communities for the FDT. For each site, 3 scripts were prepared highlighting health and safety issues especially relevant for older farmers. The brief plays were performed in a dinner theater format, with group discussion following each play. Printed educational packets (EPs) addressing the same topics were mailed to comparison groups of participants in 9 communities. In telephone interviews conducted 2 weeks and 2 months later, 870 participants (553 FDT and 317 EP) reported health and safety-related changes they had made in their farm operations. FINDINGS: FDT participants were more likely than EP participants to report having made any changes and reported making more changes on both the 2-week and 2-month follow-up assessments. This outcome occurred when analyzing all farms and when considering only farms with at least 1 participant who spent 10 or more hours per week farming. CONCLUSIONS: FDT is a fun, relaxing intervention; it is acceptable to farming communities; and it is more effective in producing health and safety-related changes than the common approach of providing printed materials. FDT not only had a greater impact than EP, but it has the potential to reach larger audiences due to its greater appeal.

Changing Health Practices Through Research to Practice Collaboration: The Farm Dinner Theater Experience.

Production agriculture ranks as one of the most hazardous occupations in the United States, with older producers suffering 3.5 times the fatalities compared with their younger counterparts. Previous interventions have not significantly improved the health or work behaviors of farmers. Through careful collaboration among academics and Cooperative Extension agents, we developed, tested, and expanded a unique educational experience, Farm Dinner Theater (FDT), for farmers aged 45 years and more and their families across three states (n = 8 communities, 573 participants). More than 50% of the participants made health or safety changes following the theater. Communities requested more theater events, noting the realism and applicability of the content and the engaging atmosphere for discussion. Participants remarked that the theater should be used across all age-groups. The FDT project created a community of "champions" that synergized the initial research project and fostered expansion and sustainability of the intervention. Process evaluation guided refinement of the theater intervention and built trust, respect, and further cooperative work among all collaborators. Members of the FDT partnership have received national recognition and funding to upscale the concept. The number of FDTs has expanded under local leadership. A toolkit that resulted from the project is available to the public and is constantly updated as more adopters contribute insight and scripts. This article describes the collaborative theater concept and demonstrates how sustained translation from research to practice can be accomplished through continued community engagement, collaboration, and outreach.

Risk for Depressive Symptoms and Suicide Among U.S. Primary Farmers and Family Members: A Systematic Literature Review.

Background: About 84% of the agriculture, fishing, and forestry occupational sector is comprised of farmers. This sector is at high risk for suicide in the United States. Recent disasters and trade upheavals may make farmers and their families more vulnerable to depression and suicide. This review focused on the risk for depression and suicide among United States' primary farm operators and their families. Methods: A systematic search of the literature published between January 2000 and June 2019, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was conducted. Results: A total of 30 articles met full inclusion criteria. Seventeen reports emanated from the midwest. Twenty studies used a cross-sectional design, primarily assessing a convenience sample or random stratified sample from a limited geographic area. We discovered only one intervention evaluation study. Depressive symptoms were assessed as part of the studies, but it was not the major focus. A variety of instruments measured depressive symptoms, with the Centers for Disease Control Epidemiologic Studies-Depression (CES-D) Scale used more frequently than other scales. Thirteen studies focused on the relationship between pesticide/chemical exposure and depression or suicide risk. Increased stress, poor physical health, compromised financial position, and previous injury were among the leading indicators of depression. Conclusion/Application to Practice: The limited number of studies that was discovered identified the need for more robust science where the risk for depression and suicide is the primary focus of the study and for intervention studies grounded in science. Occupational health providers should be vigilant about farm exposure and be aware of factors that may influence depressive symptoms of workers who operate farm establishments.

Moving social work norms via theater for senior farmers.

PROBLEM: Senior farmers have a 2.6-fold risk of fatal injury compared to their younger counterparts. Usual educational interventions have resulted in limited success in reducing injury. METHOD: An innovative strategy, didactic readers theater, was piloted. Farmers' stories provided the foundation for the scripts. The approach incorporated adult learning strategies based on Ajzen's Theory of Planned Behavior. The intervention was marketed as a "dinner theater" to farm couples. Three short socio-novels (plays) were presented by local farmers who served as actors. Following each play participants completed a reaction form and participated in a short discussion about the play's content. One week later a phone survey was completed that tapped further reaction to the content and behavior changes. RESULTS: Thirty-three farm household individuals (including 16 couples) participated. Participants expressed favorable reaction to the intervention. Within one week post intervention, 42% had made safety changes and 67% were "thinking about/intending" to make changes. DISCUSSION: The use of real stories contributed to the success of this intervention. Farmers identified with the stories and began to think and talk about the impact that aging exerts on their health and safety. Interaction among the group identified work modifications which empowered the farmers to make positive changes in their own work behavior. SUMMARY: Educational interventions with farmers have met with limited success in reducing farm-related injuries. Moreover, few interventions have utilized the family unit. This novel program, incorporating local organizations and using limited financial resources, resulted in swift behavior changes. PRACTICAL APPLICATIONS: Total Worker Health includes not only the worker, but also the family. Interventions that include family units should be considered when possible. This format is effective, easily adapted to local issues, can be delivered using existing infrastructure, and is acceptable to the farm community. It is currently being tested on a larger scale.

What we know about the effectiveness of farm safety day programs and what we need to know.

BACKGROUND: Farm safety day camps are grassroots educational interventions organized and conducted by members of a local community. These events are held in an effort to promote safety knowledge and behavior in children who live on family farms or are exposed to the hazards of the agricultural industry. Since the dramatic increase in farm safety day camps beginning in the 1990s, researchers have been called upon to evaluate their effectiveness. PURPOSE: The current paper reviews more than a decade of research, describing what is currently known about the effectiveness of farm safety days and suggesting potential methods for addressing questions regarding gaps in what we know about their effectiveness. CONCLUSIONS: The results of these evaluations indicate that farm safety days have a positive impact on children's safety behavior and knowledge; however, much remains to be investigated regarding the effectiveness and impact of these interventions.

Behind the scenes: spousal coping following permanently disabling injury of farmers.

Hidden within the pastoral setting of rural America are the struggles of farm families who must cope with a decreasing economy, increasing technology, and one of the highest injury rates of any industry. Wives of farmers often juggle household responsibilities, hold an off-farm job, and work on the farm. Too often, wives are first on the scene of a serious injury to their spouses. All attention is focused on the farmer but the wife must cope with caregiving, her usual work, and the added full responsibility of the farm. This grounded theory study examined the process of spousal coping after a permanently disabling injury occurred to their farmer husbands. Interviews conducted with 12 farm wives elicited four themes in the coping process. These findings may help identify critical points of mental stress and form interventions to assist spouses of injured farmers in their adjustment to changing roles and responsibilities.