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.