) Epidemiologic evidence continues to emerge that farmers are at increased risk for specific types of cancers. The main etiologic agents hypothesized to be connected with these excessive rates are the hazardous chemicals farmers are exposed to by virtue of their occupation, namely pesticides. Many of these pesticides have been shown to be carcinogenic in laboratory studies. Additional evidence suggests that applicators do not routinely use the precautions necessary to protect themselves from exposure. Further, farmers and their families are an underserved population for health services due to their geographic and occupational status. This study proposes to translate prior epidemiologic, laboratory, clinical, and behavioral information on cancer risks into a primary prevention program to reduce cancer among farmers and their families. The preventive interventions will target pesticide applicators, most of whom are farmers, and their families through community-based educational programs designed to increase cancer prevention knowledge, risk perception, and self- efficacy in order to create behavior change to reduce cancer risks. Pesticide applicators will be randomly assigned to a control or intervention condition. The intervention group will receive an educational program designed to decrease personal pesticide exposure and increase safe pesticide handling behaviors. Pesticide handling behaviors and pesticide exposure among intervention and control groups will be compared 6 and 18 months post intervention using self-report and biological measures. Because the majority of applicators are male, and because other family members are likely to be exposed to pesticides by virtue of living in the farm setting, wives and adult daughters of the applicators will also receive an educational intervention. This intervention will be designed to increase knowledge of pesticides risks and increase cancer preventive behaviors including breast self exam and mammography screening among women of recommended age. Farm women will receive a 6 and 12 month follow-up to determine cancer prevention behavior change and maintenance. This study will take place in the state of Vermont, a predominantly rural state that has experienced excessive cancer mortality rates in the previous decade.
