Developing and Evaluating New Approaches to Youth Agricultural Injury Prevention

描述(由申请人提供)：认识到儿童农业伤害是一个严重的公共卫生问题，在1980年的《S》和1990年的《S》，导致1999年《北美儿童农业任务指南》的出版。尽管在过去15年中为减少计算机辅助教学的影响进行了一些尝试，但对这一领域的预防干预措施在方法上缺乏严格的评估。这项拟议研究的总体目标是开发和评估旨在显著降低脑梗塞风险的基于家庭的干预措施。为实现这一目标，将在项目期的前半部分编写、试行和适当修订扩大NAGCAT范围的教材。第二，将制定和评估两项加强遵守扩大后的准则的战略；一项战略将只针对父母(如NAGCAT的情况)，另一项战略将以家庭为基础，这一方法在这一领域尚未尝试过。这里的基本理由是，以家庭为基础的预防人工授精方法可以激发家庭的协同动力，使所有成人和青年户主最大限度地遵守扩大的指导方针。这些策略将通过进行随机对照试验(RCT)进行评估。这项随机对照试验的结果将为以下问题提供循证答案：通过基于理论的干预策略，可以在多大程度上最大限度地遵守扩大的指南？一种策略在多大程度上比另一种策略更有效？遵守扩大后的指南实际上能在多大程度上降低脑梗塞的风险？我们的假设是，在暴露于危险中的年轻人中，以家庭为基础的方法将比其他方法更有效地降低风险。拟议研究的具体目标是：1.制定超出《大西洋金枪鱼养护法》范围并涉及与农业有关的非工伤的初级预防致病的书面准则。2.制定和试行两项以理论为基础的战略，以加强对扩大的准则的遵守。3.通过随机对照试验(RCT)评价干预策略的有效性。4.依靠PEM数据，根据扩展的指南，定量评估每天存在的脑梗塞的风险和保护因素的程度。5.以PEM数据为依据，量化参与青年发生脑梗塞的风险。

DESCRIPTION (provided by applicant): 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.