Protecting Young Agricultural Workers: The Development of an Online Supervisor Training.

Adolescents and young adults working in agriculture are at greater risk of injury. We describe the development of an online safety and health training for people who hire, teach, or supervise young agricultural workers. The online training targeted specific skills supervisors can use to effectively supervise, train, and communicate with young workers about health and safety hazards that impact injury risk. Consistent with NIOSH's evidence-based Total Worker Health® approach, the training integrated safety and health promotion and was also informed by behavioral change theories. An iterative approach was used to develop and evaluate the training. A content review provided feedback on topics and organization of material. Safety and health experts assessed the revised training content and rated the training topics on clarity, accuracy, and completeness. Finally, a pilot study with employers and health and safety professionals was used to evaluate the training materials. The content review suggested ways to reorganize the material to improve flow and reduce redundancy. Ratings of clarity, accuracy, and completeness were high, ranging from 5 to 7 (mean ratings from 5.8 to 7.0) on a scale of 1 ("does not do this at all") to 7 ("does this very well"). The pilot study led to changes in wording and items used to assess knowledge. A theoretically-informed approach was used to develop an online supervisor training to increase awareness and build skills. An iterative process that included expert review, evaluation of learning competencies, and a pilot study with the end-users is described.

Dissemination and Implementation Science Approaches for Occupational Safety and Health Research: Implications for Advancing Total Worker Health.

Total Worker Health® (TWH), an initiative of the U.S. National Institute for Occupational Safety and Health, is defined as policies, programs, and practices that integrate protection from work-related health and safety hazards by promoting efforts that advance worker well-being. Interventions that apply the TWH paradigm improve workplace health more rapidly than wellness programs alone. Evidence of the barriers and facilitators to the adoption, implementation, and long-term maintenance of TWH programs is limited. Dissemination and implementation (D&I) science, the study of methods and strategies for bridging the gap between public health research and practice, can help address these system-, setting-, and worker-level factors to increase the uptake, impact, and sustainment of TWH activities. The purpose of this paper is to draw upon a synthesis of existing D&I science literature to provide TWH researchers and practitioners with: (1) an overview of D&I science; (2) a plain language explanation of key concepts in D&I science; (3) a case study example of moving a TWH intervention down the research-to-practice pipeline; and (4) a discussion of future opportunities for conducting D&I science in complex and dynamic workplace settings to increase worker safety, health, and well-being.

Evaluation of an Online Training for Supervisors of Young Agricultural Workers.

Adolescents and young adults (<25 years) working in agriculture are at greater risk of injury than youth working in other industries. Supervisors play an important role in protecting these young workers who lack workplace experience and whose bodies and brains are still developing. A theoretically based approach was used to develop an online training for supervisors of young agricultural workers. The training addresses an expanded view of occupational safety that not only addresses injury prevention, but also focuses on health promotion and worker well-being using a Total Worker Health approach. A pre-post/post study design was used to evaluate the training. Questionnaires included demographics, workplace characteristics, knowledge, beliefs about protecting young workers, and supervisors' communication behaviors. One-hundred-eighty-two participants completed all parts of the efficacy trial. A post-test administered immediately after completing the training, indicated that supervisors had greater understanding of the risks to young workers and at 3-month follow-up were more likely to engage in communication behaviors to protect the safety and health of young workers. Positive changes in when, how, and under what circumstances supervisors talk about safety and health occurred. Establishing patterns of protective behaviors in the workplace can have lifelong impact, particularly among young workers.

Help-Seeking Behaviors of Abused Women in an Abortion Clinic Population.

Women who seek induced abortion procedures experience high rates of intimate partner violence, yet little is known about their help-seeking behaviors. Using data collected from patients attending a large Midwestern clinic who screened positive for intimate partner violence, we analyzed how help-seeking women differed from women not seeking help and those not disclosing their help-seeking behavior. We measured current and planned resource use and evaluated self-perceived helpfulness of resources. Severe battering, physical and/or sexual abuse, frequent sexual abuse, increased relationship length, and employment were positively associated with help-seeking. Nearly half of women who screened positive for abuse in the past year had already sought or planned to seek help, indicating this population is receptive to intervention.

The Impact of Work Demand and Gender on Occupational and Psychosocial Stress in Hispanic Farmworkers.

Hispanic farmworkers experience hazardous work conditions, language barriers, poverty, and limited healthcare access that increase their risk for health problems. We sought to characterize occupational and lifestyle stressors in farmworker couples and to examine the impact of seasonal work demand and gender on health outcomes. We administered surveys to 31 couples (N = 62) in May (low work demand) and September (high work demand) of 2012. Measures included acculturation, perceived stress, depressive symptoms, quality of life, decision latitude, support (supervisor, co-worker), and work-family conflict. This population did not report significant differences in stress in low and high work demand times. Women reported more work-family conflict (F = 19.06, p 0.0001; F = 11.28, p = 0.0015) and less supervisor support (F = 6.56, p = 0.0135). Women experienced more conflict between work and family and less support at work. This group reported low depressive symptomology and moderate levels of stress; a subset reported elevated levels.

Injuries associated with bottles, pacifiers, and sippy cups in the United States, 1991-2010.

OBJECTIVE: To describe the epidemiology of injuries related to bottles, pacifiers, and sippy cups among young children in the United States. METHODS: A retrospective analysis was conducted by using data from the National Electronic Injury Surveillance System for children <3 years of age treated in emergency departments (1991-2010) for an injury associated with a bottle, pacifier, or sippy cup. RESULTS: An estimated 45398 (95% confidence interval: 38 770-52 026) children aged <3 years were treated in emergency departments for injuries related to these products during the study period, an average of 2270 cases per year. Most injuries involved bottles (65.8%), followed by pacifiers (19.9%) and sippy cups (14.3%). The most common mechanism was a fall while using the product (86.1% of injuries). Lacerations comprised the most common diagnosis (70.4%), and the most frequently injured body region was the mouth (71.0%). One-year-old children were injured most often. Children who were aged 1 or 2 years were nearly 2.99 times (95% confidence interval: 2.07-4.33) more likely to sustain a laceration compared with any other diagnosis. Product malfunctions were relatively uncommon (4.4% of cases). CONCLUSIONS: This study is the first to use a nationally representative sample to examine injuries associated with these products. Given the number of injuries, particularly those associated with falls while using the product, greater efforts are needed to promote proper usage, ensure safety in product design, and increase awareness of American Academy of Pediatrics' recommendations for transitioning to a cup and discontinuing pacifier use.

Association of seasonality with hypertension in pregnancy: a systematic review.

A systematic literature review was conducted to examine all academic, peer-reviewed studies of seasonal or monthly variation in the prevalence of gestational hypertension, preeclampsia, or eclampsia. The objective was to test the hypothesis that prevalence rates are highest during the winter months in non-tropical regions and during wet or humid periods in tropical climates. The authors searched the epidemiological literature indexed in PubMed, cross-referenced bibliographic materials, and reviewed personal archives. Of 60 abstracts and articles screened, 20 met the final inclusion criteria. Studies included were published between 1938 and 2010. Despite differences in setting, data sources, study design, outcome definitions, and control of known risk factors, 16 separate studies (11 non-tropical and 5 tropical) concurred that prevalence rates were higher for winter delivery in non-tropical regions or delivery during wet or humid periods in tropical climates. Although the reasons for these patterns are unknown, seasonal variation in infectious diseases, environmental triggers of asthma, vitamin D levels, physiological responses to cold temperatures, healthcare access, and nutritional intake may all play a role.