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Social marketing for injury prevention: changing risk perceptions and safety-related behaviors among New York farmers
Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In the U.S., work-related death is an all too familiar occurrence on farms. Tractor overturns continue to be the most frequent cause of these fatalities. Efforts to alter farming’s ranking as one of the most deadly occupations in the country must provide proven strategies for the elimination of these preventable deaths.

In the past, efforts to decrease the rate of overturn fatalities and injuries have largely focused onincreasing the proportion of tractors with a rollover protective structure (ROPS). These devices, in combination with seatbelts, are 99% effective in protecting the tractor operator from death or injury. Unfortunately, only 59% of U.S. tractors are currently equipped with ROPS. Due to the relative lack of political willpower to legislate ROPS installation and the less than encouraging response to education and awareness programs to date, it appeared necessary to explore alternative intervention strategies.

The over-arching purpose of this thesis project has been to assess the utility of social marketing as a framework for developing effective health and safety interventions in the farm community. However, our specific objectives included; a more thorough understanding of the perceived barriers and motivators that influence farmer’s safety decisions, the design and evaluation of social marketing incentives developed to encourage safe behaviors and the evaluation of a social marketing campaign designed to positively impact farmer’s intentions and readiness to retrofit unsafe tractors.

The research was by and large conducted in New York State and supported by grants from the National Institutes of Occupational Safety and Health (NIOSH). Previous research conducted in the New York farm community had indicated that small crop and livestock farmers would be an ideal intervention target for a social marketing tractor overturn intervention as their farms accounted for close to 85% of New York farms which lack or have only one ROPS protected tractor.

A qualitative assessment of perceived barriers and motivators regarding retrofitting behaviors was performed with representatives of the small crop and livestock community. Grounded theory analysis of these in-depth interviews revealed several key categories which include: 1) risk becomes “normal”, 2) risk becomes part of a “farming identity”, and 3) risk becomes “cost-effective”. This information was used to design potential intervention incentives, such as toll-free assistance finding and purchasing ROPS, financial rebates, and campaign messages designed to address farmer’s stated concerns. Subsequent research included testing and revising messages and evaluating the effect of the different campaign incentives in a prospective quasirandomized controlled trial conducted in different regions of New York and Pennsylvania.

The results indicate that social marketing offers a promising framework for the development of injury or fatality prevention programs in farm communities. Farmers in the social marketing region demonstrated the most significant changes in both behavioral intention and readiness to retrofit compared to farmers from other regions. Data also indicated that social norms strongly influence farmer’s decisions to work safely, as demonstrated by the strong correlations between behavioral intention measures and measures of social norms.

As well as providing an assessment of the utility of social marketing as an intervention framework, the thesis provides a cogent example of how behavioral theories can be used in the design and evaluation of intervention programs. Both stages of change theory and the theory of planned behavior proved to be valuable for measuring dispositional and behavioral changes and for finetuning future interventions.

Place, publisher, year, edition, pages
Umeå: Umeå universitet , 2009. , 63 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1238
Keyword [en]
social marketing, behavior models, roll-over protective structures, tractor overturns, farm safety, occupational health, safety intervention, retrofitting incentives, health campaigns, intervention evaluation
Research subject
Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-18261ISBN: 978-91-7264-713-8 (print)OAI: oai:DiVA.org:umu-18261DiVA: diva2:158038
Public defence
2009-02-20, Sal 135, byggnad 9A, Nus, Norrlands universitetssjukhus, Umeå, 09:00 (English)
Opponent
Supervisors
Available from: 2009-02-05 Created: 2009-01-29 Last updated: 2010-01-18Bibliographically approved
List of papers
1. Encouraging farmers to retrofit tractors: a qualitative analysis of risk perceptions among a group of high-risk farmers in New York.
Open this publication in new window or tab >>Encouraging farmers to retrofit tractors: a qualitative analysis of risk perceptions among a group of high-risk farmers in New York.
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2008 (English)In: Journal of agricultural safety and health, ISSN 1074-7583, Vol. 14, no 1, 105-17 p.Article in journal (Refereed) Published
Abstract [en]

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.

Identifiers
urn:nbn:se:umu:diva-18254 (URN)18376539 (PubMedID)
Available from: 2009-01-29 Created: 2009-01-29 Last updated: 2009-08-12
2. The social marketing of safety behaviors: a quasi-randomized controlled trial of tractor retrofitting incentives
Open this publication in new window or tab >>The social marketing of safety behaviors: a quasi-randomized controlled trial of tractor retrofitting incentives
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2011 (English)In: American Journal of Public Health, ISSN 0090-0036, E-ISSN 1541-0048, Vol. 101, no 4, 678-684 p.Article in journal (Refereed) Published
Abstract [en]

Objectives. We assessed the effect of social marketing incentives on dispositions toward retrofitting and retrofitting behavior among farmers whose tractors lacked rollover protective structures.

Methods. From 2006 to 2007, we conducted a quasi-randomized controlled trial with 391 farm owners in New York and Pennsylvania surveyed before and after exposure to 1 of 3 tractor retrofitting incentive combinations. These combinations were offered in 3 trial regions; region 1 received rebates; region 2 received rebates, messages, and promotion and was considered the social marketing region; and region 3 received messages and promotion. A fourth region served as a control.

Results. The social marketing region generated the greatest increases in readiness to retrofit, intentions to retrofit, and message recall. In addition, postintervention stage of change, intentions, attitudes, subjective norms, and perceived behavioral control levels were higher among farmers who had retrofitted tractors.

Conclusions. Our results showed that a social marketing approach (financial incentives, tailored messages, and promotion) had the greatest influence on message recall, readiness to retrofit tractors, and intentions to retrofit tractors and that behavioral measures were fairly good predictors of tractor retrofitting behaviors.

Keyword
planned behavior; rollover; perceptions; fatalities; smoking; norms
National Category
Environmental Health and Occupational Health
Identifiers
urn:nbn:se:umu:diva-18259 (URN)10.2105/AJPH.2010.200162 (DOI)
Available from: 2009-01-29 Created: 2009-01-29 Last updated: 2015-04-29Bibliographically approved
3. Evaluating tractor safety messages: A concept develpment project.
Open this publication in new window or tab >>Evaluating tractor safety messages: A concept develpment project.
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2008 (English)In: Social Marketing Quarterly, ISSN 1524-5004, Vol. 14, no 4Article in journal (Refereed) Published
Identifiers
urn:nbn:se:umu:diva-18258 (URN)
Available from: 2009-01-29 Created: 2009-01-29 Last updated: 2009-08-12
4. Encouraging the installation of rollover protective structures in New York State: the design of a social marketing intervention.
Open this publication in new window or tab >>Encouraging the installation of rollover protective structures in New York State: the design of a social marketing intervention.
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2008 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, Vol. 36, no 8, 859-69 p.Article in journal (Refereed) Published
Abstract [en]

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.

Identifiers
urn:nbn:se:umu:diva-18253 (URN)10.1177/1403494808089655 (DOI)19004904 (PubMedID)
Available from: 2009-01-29 Created: 2009-01-29 Last updated: 2015-04-29

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