Julie A. Sorensen

The role of primary care professionals in lifestyle counseling for smoking, alcohol consumption, physical activity, and diet is receiving attention at the national level in many countries. The U. S. and Sweden are two countries currently establishing priorities in these areas. A previously existing international research collaboration provides a unique opportunity to study this issue.

Tractor rollovers are the most frequent cause of death in the farm community. Rollover protection structures (ROPS) can prevent the injuries and fatalities associated with these events; however, almost half of U.S. farms lack these essential devices. One promising strategy for increasing ROPS use is social marketing. The purpose of this study was to assess the costs associated with the New York ROPS Social Marketing Campaign in relation to the cost of fatalities and injuries averted as a result of the campaign to determine whether cost savings could be demonstrated in the initial years of program implementation. A total of 524 farmers who had retrofitted a tractor through the program were mailed a survey to assess the number of rollovers or close calls that occurred since ROPS installation. Responses were obtained from 382 farmers, two of whom indicated that they had a potential fatality/injury scenario since retrofitting their tractor through the program. The cost savings associated with the intervention was estimated using a decision-tree analysis adapted from Myers and Pana-Cryan with appropriate consumer price index adjustments. The data were compared to the cost of the New York ROPS Social Marketing Campaign to arrive at an associated cost-savings estimate relative to the intervention. This study indicates that a net savings will likely be demonstrated within the third year of the New York ROPS Social Marketing initiative. These data may provide evidence for researchers hoping to generate support from state and private agencies for similar initiatives.

Aims: Increasing the percentage of rollover protective structure (ROPS) equipped tractors has been the focus of many agricultural safety campaigns. Traditionally efforts have attempted to persuade farmers through education or community awareness interventions. These efforts have lead to marginal change. In response, a social marketing approach was tested as a means for increasing interest in ROPS retrofitting in New York. Methods: An initial phone survey was conducted with a random sample of New York farmers to identify a potential target population. Following target selection, in-depth interviews were conducted to isolate barriers and motivators to retrofitting. This information was used to develop message prototypes which were tested in small focus group discussions. Selected and revised messages, as well as various other incentives developed in response to feedback from interviews, were then tested in a prospective, quasi-randomized controlled trial. Results: Small crop and livestock farms were selected as the intervention target since they represent 86% of New York farms with none or only one ROPS protected tractor. Barriers to retrofitting which were identified in interviews were: 1) constant exposures normalize risk, 2) risk is modeled by significant others and 3) safety in general and retrofitting in particular requires too much time and money. The piloting of ROPS incentives led to a marked increase in ROPS sales in New York. Conclusions: Social Marketing provides a promising framework for the design of agricultural injury prevention programs. The potential implications for other health initiatives seeking to promote behaviour change are also discussed.

Tractor rollovers continue to be one of the most frequent causes of agricultural fatalities. Despite knowledge of rollovers and the efficacy of rollover protective structures (ROPS), few New York farmers have considered installing ROPS on their unprotected tractors. Qualitative interviews conducted with an "at-risk" segment of the New York farming community indicate that there are a number of barriers to safety in general and to retrofitting, in particular. The following themes and categories emerged in relation to safety and risk taking: constant exposures to risk with positive outcomes normalizes risk; the modeling of risk by significant others positions risk as part of a farming identity; and the pressure to reduce costs, save time, and accept risk frames risk-taking as the cost-effective option (especially in regard to retrofitting, which farmers believe is both expensive and time-consuming). Recommendations for researchers planning retrofitting interventions would be to focus safety messages on the risk to significant others or on the financial impact of rollovers, and to provide financial incentives and assistance to farmers considering retrofitting.

The prevalence of tractor rollovers among agricultural workers has made theretrofitting of tractors with rollover protective structures (ROPS) and seat belts a publichealth priority for agricultural health and safety specialists. To address this concern, the NewYork Center for Agricultural Medicine and Health (NYCAMH) developed a seven-questionsurvey, designed to assess perceptions of risk as well as potential motivators and barriers toretrofitting. Data from 465 phone surveys were gathered from New York State farmersrepresenting various commodities and farm sizes. Analysis of responses to three qualitativequestions contained in the survey indicated that most farmers in New York understand theimportance of ROPS but lack the proper motivation to consider retrofitting. It appears thatmore convenient safety strategies, cost, and age of the tractor compete with a farmer’sinitiative to retrofit. In addition, survey responses illustrate that although many farmersbelieve ROPS are important in a general sense, many believe that this safety measure is notnecessary for them in particular. Frequent motivators to retrofitting are concerns about safety,although the authors conclude that a more thorough analysis of these “general safetyconcerns” in qualitative interviews is important.