A systematic review of farm safety interventions.

OBJECTIVE The main objective of this study was to systematically review the existing evidence for the effectiveness of farm injury prevention interventions. SEARCH STRATEGY We used a systematic approach to search the following electronic databases: MEDLINE, EMBASE, ERIC, PsycInfo, Sociofile, NTIS, Agricola, Expanded Academic Index, Dissertation Abstracts, and Occupational Safety and Health (NIOSHTIC). Proceedings and technical papers of the National Institute for Farm Safety were reviewed. We also checked the references of potentially eligible studies and consulted with experts in the field to identify 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 safety research, all study designs were accepted, including those without comparison groups and those with absent or inadequate evaluation methods. RESULTS We identified 25 studies for the review. Eleven of the studies involved farm safety education programs, five consisted of multifaceted interventions 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, day 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 environmental or equipment changes and/or safety education. Program evaluations assessed changes in safety attitudes, knowledge, and/or behaviors and generally involved pre- and post-test methodology. Only three studies examined changes in the incidence of farm injuries. Of the studies evaluated, most reported positive changes following the interventions. However, limitations in the design of evaluations make the results of many of the studies difficult to interpret. CONCLUSIONS There is a need for more rigorous evaluations of farm safety intervention programs. Suggested study design improvements include randomization of study subjects when appropriate, use of control groups and the objective measurement of outcomes such as behavior change and injury incidence.