Virtual reality for public health: a study on a VR intervention to enhance occupational injury prevention.

BACKGROUND: Agriculture is one of the most hazardous occupations in the USA. Especially, tractor rollover incidents are the leading cause of farming-related injuries or deaths. This study examines the effect of a VR intervention (Virtual Reality Intervention for Safety Education; VRISE) on behavioral intentions for occupational safety and identifies a psychological mechanism that shows how the immersive technology works. METHODS: VRISE was developed by a multidisciplinary team of agricultural educators, computer scientists and communication specialists. It was designed to provide a virtual environment where users practice tractor operation and try to avoid several rollover hazards. The participants (291 high school students) were recruited at the 2019 National Future Farmers Association Convention & Expo and randomly assigned to one of three conditions: two different types of control groups (Control1: No treatment group and Control2: 2D Screen group) and the treatment group. RESULTS: Findings show that, through the immersive VR experience, the VR intervention enhanced perceived threat of tractor-related accidents which in turn, led to improved behavioral intentions for tractor safety. CONCLUSIONS: Findings shed light on the effectiveness of a VR intervention to improve public health outcomes, especially in occupational safety education, where unsafe practices often result in injury and fatality.

Development of an Educational YouTube Channel: A Collaboration between U.S. Agricultural Safety and Health Centers.

Objectives: The National Institute for Occupational Safety and Health (NIOSH) Agriculture, Forestry, and Fishing Centers (AFF Centers) collaborated to initiate a joint YouTube channel in order to raise awareness of agricultural, forestry, and fishing occupational hazards; provide information to prevent AFF injuries and illnesses; increase the visibility and influence of the AFF Centers; and establish a collaborative model that can be replicated by other organizations.Methods: The collaborators sought to produce a structured channel with high scientific standards. Policies, procedures, and a standard review process were established. Representatives from the AFF Centers coordinated the review process and the procedures by which videos were uploaded to the site. A marketing plan was created including a press release and ideas to promote new videos. Promotions are targeted to agricultural cooperative extension agents, educators, producers, owners, operators, first responders, families and community organizations. Viewership was tracked using YouTube metrics.Results: The site was launched in November 2013. Over a 6-year period, the channel grew from 48 videos to 125 videos with over 10,500 cumulative watch time hours. The channel is promoted by the AFF Centers through email, social media, conference presentations and outreach exhibits. The channel is also publicized during coordinated national outreach events.Conclusion: Each AFF Center benefitted from increased exposure of their content and the collaboration provided an opportunity to achieve labor efficiencies. YouTube metrics demonstrated that coordinated marketing increases views, watch time and subscriptions. In addition, the success of the channel communicates the benefits to collaboration among organizations with common missions.

Competing Roles and Expectations: Preliminary Data from an Agricultural Extension Survey on COVID-19 Impacts.

Agricultural Extension professionals play a critical role in outreach and translation of research to practice. Extension has not only been an audience for Agricultural Safety and Health Center work, but also an essential partner in promoting evidence-based farm health and safety in communities. This commentary stems from a collaborative effort among Center leaders across the nation who developed a set of surveys to explore the ways COVID-19 has affected Extension professionals. Preliminary data gathered from across the nation suggest that while many Extension professionals feel prepared to address challenges from the pandemic and are well supported by their State and Center's resources, over half also reported moderate to great difficulty in balancing personal and professional needs and, to a lesser extent, balancing remote work and family needs. Because Extension professionals act as connectors between Agricultural Safety and Health Centers and farmers and their families, they serve in a role similar to first-responders. COVID-19 has exacerbated the potential for anxiety, stress, and other mental health concerns among this group. With COVID-19 numbers rising at an especially fast rate among agricultural workers, it is important to attend to the wellbeing of the professionals who work with them.

Editorial: Response to "ROPS Are Not Homemade".

We are writing in response to the editorial "ROPS Are Not Homemade" by W. E. Field, R. Tormoehlen, S. Ehlers, C. Cheng, A. Talbert, G. Deboy, D. Haberlin, and C. V. Schwab, which was published in the July 2019 issue of the Journal of Agricultural Safety and Health (Field et al., 2019). The editorial warns secondary school teachers and FFA advisors about the potential liability of fabricating and installing low-cost rollover protective structures (ROPS) as service learning projects for agricultural education students. The apparent intent of the editorial is to discourage teachers and advisors from carrying out such projects. We wish to present arguments as to why these are actually highly beneficial projects to undertake, and perhaps one of our best hopes for significantly reducing the number of tractor overturn injuries and fatalities by directly involving our nation's youth.

Occupational Exposure Risk for Swine Workers in Confined Housing Facilities.

In an effort to change unsafe tractor operating behaviors among Appalachian youth resulting from practices and habits learned through a socialization process (termed an "apprenticeship of observation"), this study implemented a four-part intervention in high school agricultural education classes that included implementation of a cost-effective rollover protective structure (CROPS) curriculum. The curriculum included farm safety information, specific NIOSH plans for CROPS construction, and procedures for CROPS installation on unprotected tractors. In this exploratory study, pre- and post-assessments were conducted using theory of planned behavior (TPB) constructs to measure changes in four factors that influence changes in learner behavior: learner attitude, perceived social norms, behavioral control, and perceived behavioral intention. Students' perceived knowledge and skills gained through the intervention were also measured because they are integral components in assessing the effectiveness of a curriculum intervention. Participants (N = 83) were high school students from seven schools in three states in the Appalachian region. Findings revealed statistically significant differences in student attitudes toward the use of life-saving CROPS and in perceived knowledge and skills gained through the curriculum implementation. The CROPS curriculum can be an effective intervention effort for addressing the social and behavioral effects of farm youths' apprenticeships of observation by creating more positive attitudes and learning outcomes among youth at risk for tractor rollover fatalities. Recommendations are provided for expanding the applications of the curriculum intervention and the TPB constructs.

A socio-cognitive strategy to address farmers' tolerance of high risk work: Disrupting the effects of apprenticeship of observation.

INTRODUCTION: Why do generations of farmers tolerate the high-risk work of agricultural work and resist safe farm practices? This study presents an analysis inspired by empirical data from studies conducted from 1993 to 2012 on the differing effects of farm safety interventions between participants who live or work on farms and those who don't, when both were learning to be farm safety advocates. Both groups show statistically significant gains in knowledge and behavioral change proxy measures. However, non-farm participants' gains consistently outstripped their live/work farm counterparts. METHOD: Drawing on socio-cultural perspectives, a grounded theory qualitative analysis focused on identifying useful constructs to understand the farmers' resistance to adopt safety practices. FINDINGS: Understanding apprenticeships of observation and its relation to experiential learning over time can expose sources of deeply anchored beliefs and how they operate insidiously to promote familiar, albeit unsafe farming practices. The challenge for intervention-prevention programs becomes how to disrupt what has been learned during these apprenticeships of observation and to address what has been obscured during this powerful socialization process. PRACTICAL APPLICATIONS: Implications focus on the design and implementation of farm safety prevention and education programs. First, farm safety advocates and prevention researchers need to attend to demographics and explicitly explore the prior experiences and background of safety program participants. Second, farm youth in particular need to explore, explicitly, their own apprenticeships of observations, preferably through the use of new social media and or digital forms of expression, resulting in a story repair process. Third, careful study of the organization of work and farm experiences and practices need to provide the foundations for intervention programs. Finally, it is crucial that farm safety programs understand apprenticeships of observation are generational and ongoing over time, and interventions prevention programs need to be 'in it' for the long haul.

Rural Kentucky High School Students' Exposure to All-Terrain Vehicle Riding and Injuries.

From 1982 to 2007, Kentucky had 459 deaths related to all-terrain vehicles (ATVs), fifth highest among US states. By 2012, Kentucky ranked fourth highest, with 578 ATV-related deaths. Following the sentinel event of an ATV-related traumatic brain injury to an unhelmeted high school student, the authors developed a 19-item survey that collected data regarding rural Kentucky high school students' years of ATV driving, second-rider frequency, typical duration of riding events, estimated weekly number of riding events, and frequency of helmet use. Of the 159 students involved, males scored significantly higher on each of these items, except frequency of any ATV driving and frequency of helmet use, which showed no gender differences. Overall, 9.3% of students reported always wearing a helmet when driving and/or riding; 61.2% reported never wearing a helmet; 132 (83.0%) reported that they either drove ATVs or rode as a second rider, and 72 of these (57.1%) reported having had an ATV incident, 33 (45.8%) of which resulted in an injury. Twenty-one of these were serious injuries, including concussions; unconsciousness; fractures to skull, nose, collarbones, arms, ribs, and legs; elbow and hip dislocations; lacerations to head, eyes, arms, legs, and back; and multiple contusions and sprains. Findings have implications for the design of responsibility to protect (R2P) interventions that will reduce exposure and prevent ATV injury and fatality. A method that leverages the relevance of a sentinel event as a community public-health surveillance opportunity is described. Study surveillance data showed higher exposure to ATV hazards than previously reported.

Integrating Cost-effective Rollover Protective Structure Installation in High School Agricultural Mechanics: A Feasibility Study.

This study with three Appalachian county agricultural education programs examined the feasibility, effectiveness, and impact of integrating a cost-effective rollover protective structure (CROPS) project into high school agricultural mechanics classes. The project aimed to (1) reduce the exposure to tractor overturn hazards in three rural counties through the installation of CROPS on seven tractors within the Cumberland Plateau in the east region; (2) increase awareness in the targeted rural communities of cost-effective ROPS designs developed by the National Institution for Occupational Safety and Health (NIOSH) to encourage ROPS installations that decrease the costs of a retrofit; (3) test the feasibility of integration of CROPS construction and installations procedures into the required agricultural mechanics classes in these agricultural education programs; and (4) explore barriers to the implementation of this project in high school agricultural education programs. Eighty-two rural students and three agricultural educators participated in assembly and installation instruction. Data included hazard exposure demographic data, knowledge and awareness of CROPS plans, and pre-post knowledge of construction and assessment of final CROPS installation. Findings demonstrated the feasibility and utility of a CROPS education program in a professionally supervised secondary educational setting. The project promoted farm safety and awareness of availability and interest in the NIOSH Cost-effective ROPS plans. Seven CROPS were constructed and installed. New curriculum and knowledge measures also resulted from the work. Lessons learned and recommendations for a phase 2 implementation and further research are included.

Cost effectiveness of wearing head protection on all-terrain vehicles.

The use of all-terrain vehicles (ATVs) has increased in the United States and elsewhere over the last three decades, along with an increased frequency of incidents resulting in serious injuries, among which have been head injuries. ATVs are designed for motorized off-highway work and recreation, can weigh up to 600 lbs (272 kg), and may reach speeds as high as 75 mph (120 km/h). ATV crashes, including collisions and overturns, were responsible for 8104 fatalities from 1982 to 2006. One third of those killed were youth under 16 years of age. Helmets may reduce risk of death by 42% and nonfatal injury by 64%. In this study, a decision analysis was applied to determine the potential reduction in the rate of fatal and nonfatal head injuries associated with crashes, based upon the universal wearing of head protection while riding on ATVs. In addition, based upon this reduction in injury rate, a cost-effectiveness analysis was conducted to determine the savings per injury averted among ATV riders with head protection. The authors found that 238 head injuries, including 2 fatalities per 100,000 ATV drivers with an average of 145 hours of annual operation, could be averted by the universal wearing of head protection while riding on ATVs. Taking into account the social direct and indirect costs of fatal and nonfatal head injuries at a 5% discount rate, US$364,306 could be saved per injury averted over a 50-year period if there were universal wearing of head protection by ATV drivers. If the exposure is adjusted to 2000 hours per year for an equivalent work year, 3276 head injuries could be averted including 23 fatalities per 100,000 at a social cost savings of US$509,172.