A Needs Assessment of Ohio Farmers' Self-Reported Health Behaviors.

The study purpose was a needs assessment, to identify and quantify health behavior risk-factors of Ohio farmers in sleep, mental health, fruit/vegetable serving frequency, physical activity, tobacco, alcohol and illicit drug use, and weight status. Guided by the RE-AIM implementation framework, the research question was What behavioral choices pose health risk factors for Ohio farmers? This cross-sectional, quantitative, descriptive study used Qualtrics' hyperlinks, QR codes, or paper-and-pencil surveys to collect data on seven focused health behaviors. The survey combined valid and reliable public domain questionnaires. The target audience included Ohio farmers representing various commodities. Extension educators at the county, regional, and state level provided access and data collection during their existing community-based programs and annual pesticide training sessions. The survey has been opened from January 20, 2020 to December 5, 2020 with modified recruitment during COVID. A convenience sample of 505 farmers participated. The majority self-identified as male, married, white, non-Latino, and worked full-time. The most frequent commodity was field crops. Most farmers reported 7-to-8 h of sleep, but the MOS SLP6 subscale indicated 89.5% of the farmers reported a score greater than 51. The two PHQ-2 questions showed 9.6% of the farmers scored >3, indicating a likely major depression disorder. Fruit and vegetable serving frequency appeared less than dietary recommendations. Time spent in physical activity did not meet guidelines. Almost 80% of the farmers said they did not use tobacco; the most common choice was chews and snuffs. Audit-C showed 31.4% of the men and 27.7% of the women can be categorized as hazardous drinkers. Illicit drug use was reported by 3.7%. Most farmers were obese or overweight. Male respondents were 83.5% overweight or obese; females 70.8% were overweight or obese. Males ages 55-64 years were mostly likely to be obese (58%) followed by males ages 35-44 years (46%). Results were compared to Ohio's Behavioral Risk Factor Surveillance System. These data will assist county Extension educators in identifying health prevention programming important for farm populations, utilizing community resources and services. While the findings of Ohio farmers may not be generalizable to other state farming communities, this survey and lessons learned can serve as a model for other Extension assessments.

Health Behavior Resources Available to Farmers in Rural Ohio.

Poor health habits correlate with morbidity and mortality. Rural communities often have decreased access to prevention programs and health care. As a state highly dependent on agriculture, this study identifies rural health services for Ohio farmers. This cross-sectional, descriptive study surveys key informants in Ohio at rural health clinics, critical access hospitals, health departments, Ohio State University (OSU) Extension offices, migrant clinics, and Federally Qualified Health Centers about the types of services available to address eight health behaviors. Key informants were invited via email and U.S. Postal Service to complete an electronic survey. After service types were identified, additional information to describe format, barriers to delivery and perceived importance of the service was asked. Of Ohio's 75 rural counties, 51 counties are represented in the data by at least one participating organization. Nutrition/healthy eating-related health services are provided most often by organizations (95.8%) and sleep services were least often reported (49.5%). The other health behaviors services (sun/UV exposure, physical activity, mental health, tobacco cessation, alcohol/substance abuse, and opioid abuse) fell in-between. Organizations are most likely to offer health education resources in print or web-based format across all health behaviors except for sleep, where social media promotion are the most common. The largest barrier to providing any type of health service is a lack of personnel. Providing health behavior services to farmers and farm families is important for improving their overall health. Documenting available services will assist the rural health community in future collaborative wellness projects.

The Cultural Perceptions of Healthy Eating in Mexican American Children: A Focused Ethnography.

Introduction: Obesity in Mexican American children is reaching epidemic proportions. Improved understanding of children's healthy eating perceptions in culturally diverse populations is needed. The purpose was to describe the meanings and experiences associated with healthy eating from the perspective of Mexican American children. Methodology: The design was a focused ethnography. Midwestern children, aged 11 to 13 years, were interviewed in home and school settings. Leininger's four phases of qualitative data analysis was used to analyze data. Parental consent/child assent was obtained. Results: Twenty-one children were interviewed. Two themes emerged: (a) Mexican American children connect healthy eating with familiar foods in the context of their ethnic culture; and (b) foods that provide feelings of happiness and well-being are associated with healthy eating. Discussion: This study provides a clear understanding of the meaning and perceptions of healthy eating from the perspective of Mexican American children and offers data to promote culturally congruent care.

Agricultural Safety Comic Book for Latinx Migrant Families: Development and Evaluation.

INTRODUCTION: Comic books and graphic novels have been used in health education. The youth of migrant and seasonal agricultural workers are highly vulnerable to the health hazards associated with agricultural work and the migrant workers' itinerant home environment. METHOD: The purpose of the study was to create a bilingual, culturally specific educational comic book to inform families of safety issues in youth hand-harvesting agricultural work and provide anticipatory guidance safety tips for agricultural work camp residence. In a mixed-methods design, a multistate and multidisciplinary team used focus groups to obtain the voice of potential users regarding the strengths and weaknesses of the comic book prototype and scales on satisfaction, helpfulness, and usability. RESULTS: Focus group participants contributed constructive criticism to modify the prototype. Quantitative surveys found the comic book to be satisfactory, helpful, and highly usable. DISCUSSION: This report describes the steps in the creation of the comic book that can be used for health promotion education.

Senales de Peligo: Guatemalan Lay Midwives' Perceptions of Responding to Obstetrical Complications.

Introduction: The Guatemalan maternal mortality rate is among the highest in Latin Americans, and lay midwives (LMs) attend home births. The study's purpose was to explore LMs' knowledge of, attitudes toward, and practices regarding obstetrical complications and emergencies. Method: In the remote Peten region, a descriptive ethnographic study held focus group discussions before education programs to teach/boost LMs' awareness about obstetrical complications. The long-table approach of analyses developed a matrix of common themes. Results: Nearly 200 LMs participated in 11 groups. Six themes emerged: LMs attribute their knowledge to God, recognize signs of obstetrical danger, want more training and equipment, encounter resistance from a patriarchal culture, feel fear and despair in addressing obstetrical complications/emergencies, and experience arduous logistics in emergency hospital transfers. Discussion: Contrary to published literature, LMs were able to verbalize basic knowledge of obstetrical complications. Information learned can guide future, action-research studies to address the maternal mortality rate in resource-poor settings.

An evidence-based method for assessing the value of a search tool: a pilot study.

OBJECTIVE: The objective of this study was to develop an evidence-based method with a set of metrics that could be used to assess an information search tool. METHODS: This pilot study analyzed a two-group convenience sample of graduate nursing students and resident physicians. The intervention group received ten minutes of instruction on a familiar search tool (eSearcher). Each group was provided one prompt to search for clinical guidelines on a given topic within their scope of practice and asked to find the best result using only eSearcher (intervention group) or specifically excluding eSearcher (comparison group). Three measurements of search results were employed: time elapsed to complete the search, an accuracy score, and a participant-reported score of confidence in the result. RESULTS: Forty-two students participated in this study (23 graduate nursing students and 19 resident physicians). The intervention group consisted of 22 participants (12 graduate nursing students and 10 resident physicians), and the comparison group consisted of 20 participants (11 graduate nursing students and 9 resident physicians). The intervention group had lower mean ranks in both accuracy and confidence compared to the comparison (not eSearcher) group, although these differences were not significant. However, the intervention (eSearcher) group had significantly longer search times compared to the comparison (not eSearcher) group. DISCUSSION: These findings provided new insights into the performance of the search tool and how users felt about their search experience. The quantitative evidence gained from this study led directly to an informed decision to explore other options for search tools. The evidence-based methods and process developed in this pilot study will enable similar studies to test other student groups and other search tools, leading to better informed purchasing and instructional decisions.

Using Google to Survey PNPs About Agricultural Safety.

INTRODUCTION: Youth and children in agriculture are highly vulnerable to the health hazards associated with agricultural work and the rural environment. METHODS: The purpose of this study was to conduct a national needs assessment for developing a continuing education unit that increases the knowledge of pediatric nurse practitioners (PNPs) on safety in an agricultural environment using the Google family of products. This was a cross-sectional, one-group design descriptive-correlational study. RESULTS: Surveys were received from 315 participants. On Day 1, 57% of responses were received, and 91% were received within Week 1. DISCUSSION: The use of the free Google Forms and Google Sheets facilitated this researcher to obtain a sample size, saving research expense dollars, and entering data file into SPSS. In addition, a pattern of survey return rates was demonstrated. Second, clinical implications indicate that agricultural safety is missing from PNP curricula: PNPs are not knowledgeable about existing resources and would be interested in a continuing education unit.

Investigating Interrater Reliability in an Online RN-to-BSN Program: Disparate Conclusions.

BACKGROUND: Interrater reliability of student-written assignments within a nursing education program is a desirable characteristic to ensure uniform quality of academic work. As online programs that advance RNs to baccalaureate-prepared nurses (i.e., RN-to-BSN programs) grow in popularity, the challenges of quality control increase. METHOD: Grading data representing mean, median, mode, and range from 19 course sections in an online RN-to-BSN program were submitted. Data were analyzed for measures of central tendency with a query of interrater reliability. RESULTS: The data indicate that instructors assess student performance at a uniformly high level. CONCLUSION: The data lead to two disparate conclusions: student performance is high and is reliably assessed as such, or the online program suffers from grade inflation. Such disparate conclusions are uniquely endemic to any program that serves the RN-to-BSN population, typically high-performing students who have established prior mastery on licensure examinations. [J Nurs Educ. 2017;56(6):360-363.].

Influences on Healthy-Eating Decision Making in Latino Adolescent Children of Migrant and Seasonal Agricultural Workers.

INTRODUCTION: Latino children demonstrate high rates of unhealthy weight, and children of Latino migrant and seasonal agricultural workers are heavier than their Latino peers. METHOD: This one-group, cross-sectional, mixed-methods pilot study explored healthy-eating decision making with 12- to 14-year-olds recruited from a Midwest summer migrant education program. Demographics, decision-making, self-efficacy, and social support survey instruments were used, along with gender-specific focus groups. RESULT: In the convenience sample, which included 24 participants, students felt varying degrees of uncertainty when choosing healthy foods in social situations, and 67% made poor-quality decisions. Parents offered greater support for healthy eating compared with friends. Qualitative analyses identified three themes: healthy decision making includes fruits, vegetables, and physical activity; mothers have influence over health and healthy decisions; and friends encourage unhealthy food choices. DISCUSSION: Influences on healthy-eating decision making in Latino adolescent children of migrant and seasonal agricultural workers, which were previously missing from the literature, were identified. Future research includes development of interventions to assist these adolescents with healthy-eating decision making.

Making a Difference in Migrant Summer School: Testing a Healthy Weight Intervention.

OBJECTIVE: Evaluate the effectiveness of a healthy weight intervention designed for children of migrant farmworkers embedded in a 7-week summer Midwest Migrant Education Program (MEP) for changes in: weight; Body Mass Index (BMI); BMI-percentiles (BMI-p); muscle strength and muscle flexibility; nutrition knowledge; attitudes; and behaviors. DESIGN AND SAMPLE: This is a two-group pre-post quasi-experimental study. Latino children of migrant farmworkers attending summer MEP in grades one through eight were enrolled (n = 171: comparison n = 33, intervention n = 138). MEASURES: Weight, BMI, BMI-p, muscle strength and flexibility, knowledge, and healthy behaviors. INTERVENTION: Classroom content included: food variety; increasing fruits and vegetables; healthy breakfasts; more family meals; increasing family time; decreasing TV and electronic game time; increasing physical activity; limiting sugar-sweetened drinks; portion sizes; and food labels. RESULTS: Statistically significant were increase in comparison group mean weight, decrease in intervention group BMI-p, and improvements in muscle flexibility and healthy behavior attitudes. The intervention students showed trends toward healthy BMI. The number of MEP days attended was significantly correlated in four outcomes. CONCLUSION: Study findings have the potential to decrease incidence of unhealthy weight in Latino migrant children, reduce rates of premature adult diseases in these children, and a potential to decrease future health care costs.

Latino migrant farmworker student development of safety instructional videos for peer education.

The purpose of this community-based study was to test effectiveness of a peer-education safety education program that included student-produced videos and photovoice, nested in a 7-week summer Migrant Education Program. The second aim was to evaluate psychometrics of an adapted safety survey from Westaby and Lee used to evaluate changes in safety knowledge and attitudes. This was a one-group pre/post design intervention study. The convenience sample was Latino migrant students (N=117, middle school [grades 6-8, n=37], lower school [grades 3-5, n=80]), with data collected at baseline and post-intervention. Participants were male n=59, female n=58. Nine student safety videos were created by the middle schoolers who presented safety to the lower school. There were no statistically significant results comparing pre/post median subscale scores but results showed increased safety knowledge and there was a slight increase in injury experience. Wilcoxon Signed Rank Tests split for middle versus lower school showed statistical difference in middle school students over lower school students (P=.054) in safety knowledge. Kruskal Wallis analysis by gender showed statistical differences in medians in safety consciousness (χ2=5.949, df 1, P=.015); dangerous risk-taking (χ2=5.409, df 1, P=.020). There were positive significant associations between age and dangerous risk taking participation; safety consciousness and dangerous risk taking; safety knowledge with safety activity participation; and safety activities with safety consciousness. Survey showed 0.69% random missing data. Cronbach's alphas ranged .689-.863. Future research needs to review lessons learned and replication with larger samples.

Summer migrant students learn healthy choices through videography.

The purpose of this single-group pre- and posttest intervention pilot study was to teach middle school migrant farmworker children the benefits of healthy eating and activity using a multimedia and ethnic-tailored health curriculum, embedded in a 7-week summer Migrant Education Program. Conceptual frameworks were from transcultural nursing, education, and child development. Student-made video productions enhanced classroom learning and content retention. Outcomes were health infomercials, body mass index (BMI), BMI percentile, muscle strength and flexibility, and We Can! and Coordinated Approach To Child Health (CATCH) surveys. Sixty-four students were enrolled (girls n = 31, boys n = 33), 96% Latino, and 65% were overweight or obese. Students had significant improvement in 12 knowledge and attitudes measures with significant gender differences in 11 measures. Although not statistically significant, trends toward healthier weight were seen. Five student infomercials were produced. The school environment effectively delivered health promotion to migrant children and will serve as a prototype for middle school health interventions.

Effects of a healthy eating intervention on Latina migrant farmworker mothers.

This is a report of a 2-group pre-/post-quasi-experimental pilot intervention study, Dietary Intake and Nutrition Education-Phase Three. The purpose of the study was to present self-management health education on healthy eating to Latina migrant farmworker mothers. The intervention had three 1-hour classes. Surveys included household food security, general self-efficacy, acculturation, knowledge, and children's food patterns and anthropometric measurements. Positive results were seen in mothers' nutrition knowledge. Intervention children had decreased body mass index percentiles. Children whose mothers had higher acculturation had greater reduction in body mass index percentiles. Mothers living alone had higher probability to attend intervention classes. Lessons learned will guide future health promotion research.