A systematic review of farm safety interventions

Objective: The main objective of this study was to systematically review th e existing evidence for the effectiveness of farm injury prevention interve ntions. Search Strategy: We used a systematic approach to search the following elec tronic databases: MEDLINE, EMBASE, EPIC, PsycInfo, Sociofile, NTIS, Agricol a, Expanded Academic Index, Dissertation Abstracts, and Occupational Safety and Health (NIOSHTIC). Proceedings and technical papers of the National In stitute for Farm Safety were reviewed. We also checked the references of po tentially eligible studies and consulted with experts in the field to ident ify other relevant information sources. Selection Criteria: Papers had to involve a farm safety intervention to be included in the review. To best characterize the current state of farm safe ty research, all study designs were accepted, including those without compa rison groups and those with absent or inadequate evaluation methods. Results: We identified 25 studies for the review. Eleven of the studies inv olved farm safety education programs, five consisted of multifaceted interv entions that included environmental revisions, a farm visit, or both; nine papers described farm safety interventions but did not report results from an evaluation. Farm safety education interventions included safety fairs, d ay camps; certification programs; workshops; and courses for farm families, youth, and agricultural workers. Multifaceted interventions were targeted to farm operators and generally involved farm safety audits, followed by en vironmental or equipment changes and/or safety education. Program evaluatio ns assessed changes in safety attitudes, knowledge, and/or behaviors and ge nerally involved pre- and post-test methodology. Only three studies examine d changes in the incidence of farm injuries. Of the studies evaluated, most reported positive changes following the interventions. However, limitation s in the design of evaluations make the results of many of the studies diff icult to interpret. Conclusions: There is a need for more rigorous evaluations of farm safety i ntervention programs. Suggested study design improvements include randomiza tion of study subjects when appropriate, use of control groups and the obje ctive measurement of outcomes such as behavior change and injury incidence.