The Teaching Kids Safety on the Farm: What Works Study will determine the impact of the active dissemination of the North American Guidelines for Children's Agricultural Tasks (NAGCAT) to farm families on the rates of childhood agricultural injury. These guidelines were developed to assist parents in selecting age- appropriate farm tasks for their children as well as promoting farm safety for children through increased awareness, simple behavioral changes and increased adult supervision. Using a population-based design made possible by the Bassett Research Institute's Health Census '99, 900 farm households with child residents or employing children will be randomized to a NAGCAT intervention group or to a control group. New York Center for Agricultural Medicine and Health (NYCAMH) outreach educators will visit each intervention farm household to explain, review and leave a copy of the NAGCAT guidelines with the parent or adult employer. Two months later, parents or adult employers will receive a NAGCAT knowledge, attitudes and behavioral intention survey (NAGCAT KAB) and will begin a two year period of injury surveillance. Telephone surveillance will be conducted every two months for both intervention and control farms. Seven counties in the northern Appalachia region of New York State will be included in this study. The Training Intervention Effectiveness Model (TIER) will be used to organize the large number of modifying, intervening or confounding variables that may affect the dependent variables, i.e. change in NAGCAT KAB and incidence of childhood agricultural injury potentially attributable to the independent variables, receipt of NAGCAT training at home. Health Census '99 will provide information on a large number of modifying variables, but an enrollment survey will be conducted to collect more farm specific information. Analytic techniques will include comparison of the injury rates between the intervention and control groups using ANOVA and Poisson regression models. An exploratory nested case control study will compare the NAGCAT KAB score of the parent or adult employer between injured children (cases) and non-injured children (controls) in the intervention group to ascertain if NAGCAT KAB is associated with injury status.
