Recognition of childhood agricultural injury (CAI) as a serious public health problem grew in the 1980's and 1990's, leading to the 1999 publication of the North American Guidelines for Children's Agricultural Tasks (NAGCAT). Despite a number of attempts to reduce the impact of CAI over the past 15 years, methodologically rigorous evaluations of prevention interventions in this area are sorely lacking. The overarching goal of the proposed research is to develop and evaluate a family-based intervention designed to significantly reduce the risk of CAI. To achieve this goal, educational materials that expand the scope of the NAGCAT will be developed, pilot-tested, and appropriately revised during the first half of the project period. Second, two strategies for enhancing compliance with the expanded guidelines will be developed and evaluated; one strategy will target only parents (as is the case with the NAGCAT), and the other will be family-based, an approach not yet attempted in this area. The underlying rational here is that a family-based approach to CAI prevention can stimulate a synergistic family dynamic resulting in maximal compliance with the expanded guidelines on the part of all adult and youth householders. The strategies will be evaluated by conducting a randomized controlled trial (RCT). Results from this RCT will provide evidence-based answers to the following questions: To what extent can compliance with the expanded guidelines be maximized through theory-based intervention strategies? To what extent is one strategy more effective than another? To what extent can compliance with the expanded guidelines actually reduce the risk of CAI? Our hypothesis is that a family-based approach to primary prevention of CAI among hazard- exposed youth will be more effective than other approaches in reducing risk.
Specific Aims of the proposed research are: 1. Develop written guidelines for the primary prevention of CAI that extend beyond the scope of the NAGCAT and address non-working agriculture-related injuries. 2. Develop and pilot test two theory-based strategies for enhancing compliance with the expanded guidelines. 3. Evaluate the effectiveness of the intervention strategies by conducting a randomized controlled trial (RCT). 4. Relying on the PEM data, quantitatively assess the extent to which risk and protective factors for CAI are present on a daily basis with respect to the expanded guidelines. 5. Relying on the PEM data, quantify the risk of CAI among participating youth. ? ? ?
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