Transcript Safety and Health Education to Aging Farmers and Scarce Resources

Safety and Health Education to
Aging Farmers and Scarce
Resources,
What are the Implications?
Chike Anyaegbunam, Ph.D.
SE Center for Agric. Health
and Injury Prevention
University of Kentucky
Who’s Chike?
Chike Anyaegbunam, National Director,
Community-based Social Marketing Programs for Tractor Safety in the U.S.
The Social Marketing Project:
A Description
 A 24-month national research
project funded by CDC/NIOSH to
initiate the incremental
development of a communitybased social marketing program
for the promotion of selected
aspects of the National
Agricultural Tractor Safety
Initiative.
 Based on community trials
carried out by Dr. Cole et al in
four Kentucky counties.
Social Marketing Project: Goals
Engage grassroots farm community
members in …
 the refinement of the Initiative and its
recommendations,
 identifying the most influential local media
and communication channels for
promoting the Initiative, and
 developing and pretesting a prototype
social marketing toolkit for promoting
selected aspects of the Initiative.
Social Marketing Project:
Participating Universities/Centers
 University of Kentucky
 University of Texas
 East Carolina University
 Colorado State University
 University of Washington
 University of California, Davis
 Northeast Agric. Center, NY
 National Farm Medicine Center, WI
 CDC/NIOSH Health Communication Unit
Project Design and Method
 Thirty-two focus groups totaling 288 participants in
eight geographically diverse states used to interact with
farm communities during the project.
 Focus group participants were selected from principal
farm operators, farm managers, farm women, and
those who provide business, social, and professional
services to farmers (Cooperative Extension, equipment
dealers, insurance, health care, financial, farm supply.
etc.).
 8-10 participants in each focus group.
 Project approved by participating universities’ IRBs
Phase I:Year I ACTIVITIES
Formative Research:
 Secondary information gathering and
analysis
 Communication audit
 Design/pretest discussion guide
 Development of prototype campaign
toolkit
 Workshop #1
 Conduct focus groups
 Transcription
Phase I: Year II ACTIVITIES
 Transcription
 Data analysis - constant comparative
analysis +
NVivo 7
 Focus group report and
recommendations
 Campaign toolkit revision
 Workshop #2
 Community meetings
 Project report
 Disseminate report
Phase II:
National Tractor Safety Campaign Design
and Implementation
 Campaign strategy design
 Development of themes, messages,
materials, partnerships, special events
and activities
 Pilot testing and revision
 Implementation and monitoring
 Evaluation
COLLABORATION
Great Lakes (1)
+
KNOWLEDGE DEVELOPMENT
Tractor
Overturn &
Roadway
Crashes (2)
+
Cost of
Injuries &
Fatalities
(2, 3 & 7)
CAPACITY BUILDING
=
CAMPAIGN PLATFORM
Stakeholder Support:
Regional
National
Great Plains (2)
Surveillance Data
High Plains (3)
National Children’s
Center (4)
Northeast (5)
Model
Vehicle
Code for
Tractors (1)
Recommendations:
Programs
Policies
Resources
Changes in
ROPS
Standards
(3)
Recommendations:
Marketing
Publicity
Current Standards Review
NATIONAL
TRACTOR
SAFETY
CAMPAIGN
Pacific Northwest (6)
Southeast (7)
Southern Coastal (8)
Southwest (9)
Incentives
for ROPS
Retrofitting
(2&4)
Recommendations:
Interventions
Standards
ROPS
Intervention
Effectiveness
(2, 4 & 5)
Prevention/Intervention Options
Social Marketing
Programs
(1, 3 ,5, 6, 7, 8,
9 & 10)
Theoretical Support:
Human
Behavior
Engineering
Community/P
artners (1&6)
Western (10)
Social Marketing/Community
NIOSH & AG CENTER PARTNERSHIPS
PROJECTS
PROCESS
OUTCOMES
LONG TERM GOAL
COLLABORATION
Great Lakes (1)
+
KNOWLEDGE DEVELOPMENT
Tractor
Overturn &
Roadway
Crashes (2)
+
Cost of
Injuries &
Fatalities
(2, 3 & 7)
CAPACITY BUILDING
=
CAMPAIGN PLATFORM
Stakeholder Support:
Regional
National
Great Plains (2)
Surveillance Data
High Plains (3)
National Children’s
Center (4)
Northeast (5)
Model
Vehicle
Code for
Tractors (1)
Recommendations:
Programs
Policies
Resources
Changes in
ROPS
Standards
(3)
Recommendations:
Marketing
Publicity
Current Standards Review
NATIONAL
TRACTOR
SAFETY
CAMPAIGN
Pacific Northwest (6)
Southeast (7)
Southern Coastal (8)
Southwest (9)
Incentives
for ROPS
Retrofitting
(2&4)
Recommendations:
Interventions
Standards
ROPS
Intervention
Effectiveness
(2, 4 & 5)
Prevention/Intervention Options
Social Marketing
Programs
(1, 3 ,5, 6, 7, 8,
9 & 10)
Theoretical Support:
Human
Behavior
Engineering
Community/P
artners (1&6)
Western (10)
Social Marketing/Community
NIOSH & AG CENTER PARTNERSHIPS
PROJECTS
PROCESS
OUTCOMES
LONG TERM GOAL
Local and International Projects
1979 - preset
Focus Group Session in Kentucky
Focus group with Ovahimba women, Northern Namibia
Overview
 Aging American farmers: a “special
population” with unique health and safety
education needs
 Health education and communication
approaches for promoting agricultural safety
and injury prevention
 Engaging older farmers in community-based
participatory research and health marketing
programs - What are the implications?
Aging American farmers as a
“special population”
Older farmers are a
“special needs
population that needs
recognition and
attention.” However, they
have been
underrepresented within
the research literature
dealing with Farm Health
and Safety.
Hernandez-Peck (2001)
NORA News (2003)
Aging American farmers as a
“special population at risk”
Unlike the rest of the population,
farmers tend to remain in farming
beyond the normal retirement
age. It is not surprising to see
farmers in their 70s still farming
full-time.
Hernandez-Peck (2001)
Nora News (2003)
Age-related Risks
Aged, or “senior” farmers, like most
agricultural workers, are at risk of
sustaining serious injuries. Senior
farmers, however, may be at additional
risk due to normal physical and sensory
deficits associated with aging.
Whitman & Field (1995)
Physical Conditions
Conditions frequently associated with age
(i.e., arthritis, limited vision and hearing, and
depression) potentially make the demands of
daily farming extremely dangerous for the
older farmer
Hernandez-Peck (2001)
Use of prescription drugs.
Risks that increase older farmers’
susceptibility to injury
 Sensory loss
 Loss in muscle and skeletal strength
 Slower reaction time
 More rapid fatigue
 Reduced ability to handle such tasks as
operating agricultural machinery under time
stress
 Automatic, rather than attentive, behaviors
(due to the farmer having performed the task
so many times in the past)
Dan Lago
(1999)
Psychographics
 Older farmers enjoy their work. It gives them a sense





of accomplishment and cannot be extricated from
their heritage and culture.
Older farmers have been described as unwilling to
recognize or accept their physical limitations.
Older farmers may be willing to acknowledge, for
instance, that a risk of tractor-related injury exists, but
believe the likelihood of an injury occurring to them
personally is small.
Older farmers tend to have a high level of confidence
in their own abilities and often believe that they
possess the ability to prevent serious tractor and
machinery-related injuries, for instance.
Older farmers may not think there's anything new to
learn, and habits are hard to break.
Fatalistic beliefs
Aging and limited-resource
farmers
Limited-resource farmers often belong to socially
disadvantaged groups whose members have been
subjected to racial or ethnic prejudice because of
their identity as members of a group without regard to
their individual qualities.
Those groups include African Americans, American
Indians or Alaskan natives, Hispanics, and Asians or
Pacific Islanders. Women have also been added to
theRisks
list of sociallyResearch
disadvantaged farm operators.
USDA (1997)
?
Studies?
Fatal occupational injury rates in the agriculture, forestry, and fishing industry
and the private sector by age, 1992–2001
(Sources: BLS [2002a]; Myers [2003].)
Need for Targeted
Interventions
A need exists for intervention efforts geared toward enhancing
awareness of agricultural related hazards, fostering positive
attitudes concerning injury prevention strategies, and
encouraging safer work practices among older farmers and
resource-poor farmers.
Whitman & Field (1995)
Excellent tactical efforts/suggestions exist:
 John Myers et al (1999)
 Dan Lago (1999)
 Kansas: Measuring reaction time of older farmers at
displays; older people were amazed at how many seconds
it took them to react, often a major cause of accidents
among senior farmers (1997).
Integrated Strategic Efforts
 NYCAM Social Marketing Campaign
 Canadian Agric. Safety assoc.
Selling Safety to Farmers
 Safety advocacy bore fruits because of
2nd World War
 Research by farm safety specialists into the
nature of the farm accident problem
 Dissemination of their solutions through an
organizational network of governmental and
private institutions
 Education increased farmer’s dependence
on the expert for safety information
Oden (2005)
Health Education/Communication:
Definitions
 Health education: A continuing process of
informing people how to achieve and
maintain good health; of motivating them to
do so; and of promoting environmental and
lifestyle changes to facilitate their objective.
 Health communication: The study and use of
communication strategies to inform and
influence individual and community decisions
that enhance health. It links the domains of
communication and health and is increasingly
recognized as a necessary element of efforts
to improve personal and public health.
Social Marketing:
Definition
Social marketing involves “the application of
commercial
marketing technologies to the analysis,
planning, execution
and evaluation of programs designed to
influence the voluntary
behavior of target audiences in order to improve
their personal
welfare and that of their society.”
Strategic communication and
community engagement
Beltran, 1979
The 3-D Communication Approach
 Emergence of an unprecedented sense of
empowerment among organizations’ internal
and external stakeholders
 Adding the horizontal axis of communication
to the traditional one-way top-down or centerout and bottom-up models
2007
From Selling to Marketing
Agric. Health and Safety
 Typically, top-down safety and
health education/communication
programs have had little effect
on lowering farm injury rates
 Farmers and farm community
members do not buy into the
safety practices for a variety of
reasons.
 A more effective way to develop
attitudes that support the
adoption of safety practices is
for researchers and members of
the farming community to
What is Dialogue?
 Jürgen Habermas: System and Lifeworld Spheres
 James Carey: Transmission vs. Ritual Models
 Hans-Georg Gadamer: Co-creation of meaning in
conversation
 James Grunig: From press agentry/publicity to
two-way symmetrical models of public relations
 Everett Rogers: The Passing of the Dominant
Paradigm - From top-down to participatory
communication
What is Dialogue? (2)
 Bruner and Cole: Construction of Reality through
Narratives and Storytelling
 Freire: Dialogue and conscientization through problem
posing and use of picture and audio codes as triggers
 Green, Israel, and Anyaegbunam et al: Community
Based Participatory Research/ Participatory
Communication Research
 Kotler, Zaltman, Andreasen and CDC: Social
Marketing and Prevention/Health Marketing
From Selling to Marketing
Agric. Health and Safety(2)
Approaches in the field of health
education and communication have
evolved over the years from dictating
the way that information is to be
conveyed from the top-down, to
strategies that favor learning from and
listening to the needs and desires of the
target audience themselves, and
building the program from there.
From Selling to Marketing
Agric. Health and Safety(3)
Innovative health promotion practice includes
community partnerships that focus on both
individuals and communities at risk.
Interventions directed at individual behaviors
alone, without also influencing the social,
cultural, economic, and political levels that
shape behavior, do not have as great an
impact on health status.
Marketing Agric. Safety and
Health to Farmers
Understanding the demographics and
psychographics, including beliefs,
perceptions, values, norms, lifestyles and
concerns of an agricultural population is one
of the first and most important steps in
assessing its health and safety needs.
It is also a fundamental precursor to planning
effective programs to prevent occupational
injury and improve health among the
Health Marketing
Health Marketing
involves creating,
communicating, and
delivering health
information and
interventions using
customer-centered
and science-based
strategies to protect
and promote the
health of diverse
populations.
(CDC,
2005)
What is
Health Marketing?
 A transdisciplinary practice that integrates
traditional marketing field with public health research,
social marketing, health education and
communication theories and practice
 It promotes the use of marketing research to educate,
motivate and inform the public on health messages
 It is a complex framework that provides guidance for
designing health interventions, campaigns,
communications, and research projects
 A broad range of strategies and techniques that can
be used to create synergy among public health
research, communication messages and health
behaviors.
Why a transdisciplinary
approach?
Injury prevention needs to be conceptualized broadly
enough that it can subsume a wide variety of specific
scientific theories and the insights derived from research in
a variety of disciplines. Moreover, a broad conception of
injury prevention enables several programming difficulties
to be overcome. Many programs provide services
potentially relevant to prevention but with no demonstrated
connection to injury prevention. Thinking contextually
allows these undertakings to be considered as resources to
the prevention effort.
Preventing Neurotrauma: A Casebook of Evidence Based Practices
Richard Volpe and John Lewko 2004
Health Marketing Basics
 The offer, its competitive cost and benefits
induce prospective consumers to purchase or
adopt product, idea or service
 Self-interest: The invisible guiding hand that
ensures the efficiency of the marketplace
 Consumer research: Used by marketers to
identify the ways in which prospective
consumers define their self-interest
 4Ps of Marketing: Product, price, place,
promotion + partnership = the marketing mix
Uses of the health
marketing approach
 Consumer Research + needs
assessment
 Building sustainable distribution
channels
 Improving products and product
selection and reducing product price
 Developing and testing products that
specifically respond to consumer and
distributor preferences
Community-based Participatory
Research (CBPR)
Collaborative partnership approaches to actively
involve participants in all phases of the research
process from problem identification through adoption
and dissemination of results.
Recognizes the community as an integral partner in
the research endeavor; the knowledge and
experiences of community members are incorporated
into the research process to ensure acceptance and
improve community health.
Recognizes that behavior and health are influenced
by individual attributes as well as the conditions
under which they live - the ecological models of
CBPR and Health Marketing:
A Basic Process
 Research
 Action Planning
 Communication/Implementation
 Evaluation
*All phases carried out by
transdisciplinary team + the
community
Conclusion
 Commercial marketing gave us the
consumption of tobacco, alcohol and excess
calories.
 Health marketing can help us improve the
occupational health and safety of farmers,
especially, resource-poor and older farmers.
 What are the implications of taking this road
to agric. health and safety promotion among
resource-poor and older farmers?
Thank you