A Proportionate Mortality Study of Mississippi's Agricultural Industry, 2017-2021.

OBJECTIVES: Individuals employed in the agricultural industry encounter hazards in their work that could lead to injury or illness. Furthermore, the mental stress of being involved in the agricultural industry could lead to negative health-related outcomes for workers. This study evaluates the causes of deaths among employees in Mississippi's agricultural industry from 2017 to 2021. METHODS: Data are provided by the Mississippi Department of Health. Proportionate mortality ratios (PMRs) are calculated to determine if agricultural industry employees show an elevated mortality in comparison to the general population for any cause of death. RESULTS: Agricultural industry employees show a statistically significant elevated mortality for circulatory disease (PMR 107, 95% confidence interval [CI] 103-110) and coronavirus disease 2019 (PMR 122, 95% CI 111-134). They also show a significant excess mortality for deaths caused by transport accidents (PMR 117, 95% CI 101-136) and exposure to inanimate mechanical forces (PMR 274, 95% CI 183-396). CONCLUSIONS: The causes of death for which agricultural employees show an excess mortality can be explained by the hazards associated with working in the agricultural industry. These findings can be used to create targeted future public health programs for individuals who are employed in agriculture.

Development and Pretesting of Prescription Opioid Misuse Prevention Messages: Results and Implications for Practice.

Well-designed health communication campaigns can contribute to the uptake of preventive behaviors, but there has been a lack of attention on using communication research to develop opioid misuse prevention messages. We report the results of two studies designed to inform the development of prescription opioid misuse prevention messages for adults ages 30-59. In Study 1, 16 adults across 4 counties participated in semi-structured interviews to provide input on message concepts addressing six key prescription opioid misuse prevention behaviors. In Study 2, 1,335 adults completed an online, survey-based between-subjects experiment in which participants were randomized to a no message control condition or a message condition that aligned with a prevention behavior. The survey examined Reasoned Action Approach (RAA) predictors of intention in no message control participants and examined differences in intention to perform prevention behaviors among experimental conditions. The qualitative interviews yielded insights about message preferences and perceived facilitators and barriers related to the prevention behaviors. The online survey demonstrated that attitude and descriptive norms are important determinants of preventive behaviors and potential targets for communication interventions. Message testing results demonstrated that the draft messages were effective in changing intentions to safely store, securely dispose of, and monitor the use of prescription opioids, but they were not effective in increasing intentions to talk to healthcare providers, older adults, or children about proper opioid use. A communication campaign addressing attitudes and perceived descriptive norms may be successful in increasing intentions to engage in opioid misuse prevention behaviors.

Increasing Uptake of Prescription Drug Take-Back Boxes: Eliciting Preferences and Applying the Theory of Planned Behavior to Predict Use.

This study assesses adults' perceptions of and predictors of intention to use prescription drug take-back boxes. This mixed methods study utilized focus groups and an online survey to examine factors related to intention to use a prescription drug take-back box. This study was conducted in [State] during the spring and summer of 2018. Themes identified in focus group data included the importance of take-back box location, benefits of take-back box use (such as reducing opportunities for medication misuse), and barriers to take-back box use (such as lack of awareness, stigma associated with law enforcement). Survey results indicate that pharmacies are the most preferred take-back box location and that attitudes, subjective norms, and perceived behavioral control are statistically significant predictors of intention to use a take-back box. Results suggest that individuals are open to using take-back boxes in secure, convenient locations, but many are unaware of take-back boxes as an option for safe disposal. These findings have implications for health communication and policy efforts designed to increase the use of take-back boxes for prescription drug disposal.

Rural adults' perceived role of family members in prescription opioid misuse prevention: Implications for family-based approaches.

PURPOSE: This study explored and documented rural adults' perceptions of family roles in prescription opioid misuse prevention and the predisposing, reinforcing, and enabling factors that influence family members from taking those roles. METHODS: Nine focus groups with rural adults (n = 55) were conducted to evoke discussion about family roles in prescription opioid misuse prevention. Transcripts were coded based on common ideas that arose during the focus groups, previous literature, and the PRECEDE-PROCEED program planning model. FINDINGS: Findings suggest that rural adults perceive the opioid epidemic as partially a family problem. Additionally, rural adults perceive themselves as having a critical role in preventing prescription opioid misuse among family members. Participants identified specific predisposing, reinforcing, and enabling factors that influence whether or not family members take responsibility in preventing prescription opioid misuse within their families. Rural adults also perceive that family-based education is important in preventing prescription opioid misuse. CONCLUSIONS: These results suggest that there is an interest in family-based approaches that enable or foster the skills and resources necessary to engage in prescription opioid misuse prevention behaviors. Specifically, family-based prevention programming should include efforts to shape knowledge and attitudes about prescription opioid misuse, increase resources to facilitate prevention behaviors, and build skills related to prevention.

Mental health first aid training for Extension agents in rural communities.

OBJECTIVE: The goal of the current study is to evaluate the effectiveness of Mental Health First Aid (MHFA) in broadening the network of gatekeepers in rural communities. METHOD: Extension agents in Mississippi who completed MHFA training were recruited via email to participate in a 22-item, web-based, quantitative and qualitative, six-month follow-up survey that measured demographic characteristics, which MHFA skills agents used post-training, barriers to skill use, and confidence in ability to use those skills (n = 80). RESULTS: Over 60% of the agents reported using the skills learned from the MHFA training, and nearly 15% of agents reported having an encounter with someone in crisis since completing the MHFA training. Agent participants reported using the skills learned from the training with farmers, 4-H youth, volunteers, and parents, family members, colleagues, and friends. One agent commented that the training, "has been very helpful in speaking with various people and has increased confidence when encountering someone with mental health challenges." CONCLUSION: MHFA trainings appear to increase the confidence and competence of Extension agents as community gatekeepers and may greatly enhance the reach of the mental health network of rural areas by increasing identification and referral of those requiring mental health services.