Intervening to Improve Health Indicators Among Australian Farm Families

Abstract

The Sustainable Farm Families project (http://www.sustainablefarmfamilies.org.au/) was a 3-year demonstration and education project designed to influence farmer behavior with respect to family health and well-being among cropping and grazing farmers in Victoria, New South Wales, and South Australia, Australia. The project was conducted by the Western District Health Service, Hamilton, Australia, in partnership with farmers; Farm Management 500 (peer discussion group); the Victorian Farmers Federation; Royal Melbourne Institute of Technology; and Land Connect. During the 3 years of the project, 128 farmers-men (70) and women (58)-were enrolled. The project utilized a combination of small group workshops, individualized health action plans, and health education opportunities to encourage farm safety and health behavior changes and to elicit sustained improvements in the following health indicators: body mass index (BMI), total cholesterol, fasting blood glucose, and blood pressure. Mean changes in these health indicators were analyzed using repeated measures analysis of variance (ANOVA) and McNemar's test compared the proportion of individuals with elevated indicators. Among participants with elevated values at baseline, the following average reductions were observed: BMI 0.44 kg/m(2) (p = .0034), total cholesterol 48.7 mg/dl (p < .0001), blood glucose 10.1 mg/dl (p = .0016), systolic blood pressure 12.5 mm Hg (p < .0001), and diastolic blood pressure 5.0 mm Hg (p = .0007). The proportion of participants with elevated total cholesterol at baseline decreased after 24 months (p < .001). Such findings suggest that proactive intervention by farmer associations, rural health services, and government agencies may be an effective vehicle for promoting voluntary farm safety and health behavior change while empowering farm families to achieve measurable reductions in important health risk factors.

Educational Interventions to Improve Safety and Health Literacy Among Agricultural Workers: A Systematic Review

“…Of these 36 studies, a number of 12 studies focused on farm-induced diseases such as prevention of zoonosis [36][37][38][39][40], asthma [41][42][43], skin cancer [44], hearing loss [45], and good manufacturing practices for prevention of antimicrobial resistance [46] and microbiological contamination [47]. A number of two studies focused on agricultural health promotion [48,49] and 23 studies focused on accident and injury prevention concerning pesticide safety [50][51][52][53][54][55][56][57][58][59][60][61][62][63][64] and injury prevention among farmers [65][66][67][68][69][70][71]. The years of publication varied from 1996 [44] to 2018 [63].…”

“…The years of publication varied from 1996 [44] to 2018 [63]. Eighteen articles presented research performed in North America (16 in USA) [42][43][44][45]51,53,54,59,61,[64][65][66][67][68][69][70], one in Canada [38], and one in Nicaragua [60]); eight articles presented research performed in Asia (three in Thailand [62,63,71], two in India [52,57], one in Laos [37], one in Cambodia [39], and one in Vietnam [40]); four articles presented research from South America (two from Ecuador [55,58], one from Bolivia [56], and one from Brazil [47]); three articles presented research from Africa (two from Tanzania [36,46] and one from Egypt [50]); two articles were from Australia [48,49], and one from Europe [41]. Of the studies considered for the review, six had used an RCT as a study design [36,39,61,63,64,69], 20 used a pre-post with control group…”

“…From the studies included in this review, four had a weak methodological quality [47,53,57,65], 19 had a moderate methodological quality [38,[40][41][42][44][45][46][50][51][52][54][55][56]58,61,63,64,69,71], and 13 had a strong methodological quality [36,39,43,48,49,59,60,62,[66][67][68]70]. None of the studies received a score indicating a very strong methodological quality, since none of them produced results that were generalizable.…”

“…The two articles that focused on the general health and well-being of farmers discussed improving nutrition for a better health [48,49]. Both studies had been conducted in Australia, used a pre-post design without a control group, and involved a convenience sample, one consisting of 99 participants [48] and the other of 321 participants [49], both using families as agents of change. Both interventions lasted for three years and involved repeated exposure (meetings once per year).…”

“…Both interventions lasted for three years and involved repeated exposure (meetings once per year). The methods and instruments used for the interventions consisted of workshops on agricultural health and safety topics, newsletters, a supermarket tour, health assessments by means of an individual manual for each participant [48], and workshops on health issues that are prevalent in farming and among rural populations, using written and visual materials and physical assessments [49]. Both interventions were based on the Theory of Planned Behavior and Kolb's experiential learning model.…”