Agriculture for Life: A Guide for Health Promotion and Participation for Farmers with Health Challenges

Cindy L. Chavez, MOTSCelicia Perez, MOTS

Research AdvisorCarla S. Wilhite, OTD, OTR/L

BackgroundA growing number of people are using the Internet to access health information, including rural and agricultural community members. Reliable health information content promotes self-management of health and self-advocacy. Occupational therapists have the skills, knowledge, and expertise to design and encourage the use of online health information to support positive health outcomes and occupational performance.

Many farmers in the United States now have computers and Internet access, with those having online access expanding annually. Agricultural producers and their families are more likely to experience occupational injury and fatality, compared to most other work sectors in the country, as well as being susceptible to the same major health issues as their non-rural counterparts including skin cancer, arthritis, diabetes, and depression. Farming families also need health information content tailored to their unique work and living contexts. Agriculture for Life is a conceptualized product of online health promotion for agricultural producers to be designed and delivered by an occupational therapist.

Purpose The authors engaged in a comprehensive literature review on developing health promotion content for the internet in order to ground the health promotion content in the growing evidence base and best practices in eHealth promotion. Specific topics of the literature searched for included: web design elements, adult learning theory used for online health promotion, and effectiveness of eHealth delivery in improving health, quality of life, making behavior changes, or increasing participation level in valued activities.

Methods• Databases for the literature review included Pub Med,

CINAHL, ERIC, and Psych Info.

• Some of the terms used interchangeably for electronic or online intervention were: eHealth, EHealth, e-Health, electronic health, online health promotion, and Internet health promotion.

• Additional search terms were used to further limit the number of articles to those using a learning theory.

• Thirty articles and one book were identified to contribute to the literature review.

• Due to the limited number of articles on eHealth research, most articles were included. Exclusion criteria were articles dealing with eHealth informatics.

ResultsCurrent evidence supports eHealth as means for improving health outcomes by users. Several kinds of eHealth content seem effective, including individualized feedback, tailored feedback, prompting or reminders, sequential versus simultaneous delivery, and video versus visual based content. Adult learning theories in use include the trans-theoretical model and integrative models like I-Change. The Integrated Change Model (I-Change) was selected as the learning theory to guide Agriculture for Life because it addresses human motivation, determination, self-efficacy, intention, ability factors, and barriers to change. Limitations includes the limited number of research articles available on the topic of eHealth/online health promotion using best practices and adult learning theory.

DiscussionAgriculture for Life is a proposed online program with content targeted to promote participation in farm roles across the life span. The content will cover topics such as: acquiring a disability, coping with a disability, farming with major health conditions, adapting farm work, and planning farm transitions. Agriculture for Life strives to provide targeted information which enables individuals to make informed choices about remaining in agricultural occupations across the lifespan.

Implications for OTeHealth is a way for occupational therapists to deliver content that promotes health through living, learning, working, and playing

• OTs can provide health information that is accessible to people in rural communities

• OTs can emphasize health outcomes in terms of desired and necessary occupations

• Agriculture for Life is an example of OT created eHealth that promotes living and working on farms for people with health issues, across the lifespan

ReferencesChristiansen, C. H. (1999). 1999 Eleanor Clarke Slagle Lecture: Defining lives, occupation as identity: An essay on competence, coherence, and the creation of meaning. American Journal of Occupational Therapy, 53, 547-558. Retrieved from https: www.aota.org

Eysenbach, G. (2001). What is eHealth? Journal of Medical Internet Research. 3(2): e20. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1761894/

Fox, S. (August 26, 2008). The engaged e-patient population. Pew Research Internet Retrieved from http://www.pewinternet.org/2008/08/26/the-engaged-e-patient-population/

Kreuter, M.W. & Skinner C.S. (2000, February). Tailoring: what's in a name? Health Education Research. 15(1):1-4. Retrieved from http://her.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=10788196.Dorough