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Journal of Agromedicine
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Agricultural Hazards Reduction Through Stress Management

Pamela Dee Elkind PhD , John E. Carlson PhD & Barbara Schnabel MA
a b a b

Center for Farm Health and Safety , Eastern Washington University , Cheney, WA, 99004, USA
b

Social Survey Research Unit, College of Agriculture , University of Idaho , Moscow, ID, 83843, USA Published online: 11 Oct 2008.

To cite this article: Pamela Dee Elkind PhD , John E. Carlson PhD & Barbara Schnabel MA (1998) Agricultural Hazards Reduction Through Stress Management, Journal of Agromedicine, 5:2, 23-32, DOI: 10.1300/J096v05n02_05 To link to this article: http://dx.doi.org/10.1300/J096v05n02_05

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Agricultural Hazards Reduction Through Stress Management

Pamela Dee Elkind, PhD John E. Carlson, PhD Barbara Schnabel, MA

ABSTRACT. This paper describes a community based program to reduce farm hazards through recognition and training about the role of stress in farm health and safety. Through data from focus groups and a questionnaire administered at the 1993 Agricultural Exposition in Spokane, Washington it was hypothesized that occupational stressors are perceived by farmers to be significantly related to farm injuries. Farm-related stressors include economic pressures such as debt burden, weather, undependable farm labor, government regulation, and market variability and costs. A workshop to aid farmers was developed and conducted in Eastern Washington state to provide farmers with information about how stressors may be affecting them and to introduce and encourage interventions that alleviate stress as a potential source of farm injury. A summary of the workshop presentations and a brief analysis of the effectiveness of this intervention program follow. Evaluation data from workshop participants and from random samples of Eastern Washington farmers are analyzed. The reported results demonstrate stress reduction in workshop participants.
[Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: getinfo@haworthpressinc.com]

KEYWORDS. Farm stress, farm safety, stress management, occupational stress

Pamela Dee Elkind is Sociologist and Director, Center for Farm Health and Safety, Eastern Washington University, Cheney, WA 99004. John E. Carlson is Rural Sociologist and Director, and Barbara Schnabel is Survey Manager, Social Survey Research Unit, College of Agriculture, University of Idaho, Moscow, ID 83843. Journal of Agromedicine, Vol. 5(2) 1998 E 1998 by The Haworth Press, Inc. All rights reserved. 23

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BACKGROUND The Center for Farm Health and Safety is in the Department of Sociology at Eastern Washington University (EWU), Cheney, Washington, and was founded in 1989. Its principal purposes are to conduct research and design interventions relevant to rural health issues. During the past four years the Center has managed a W. K. Kellogg funded Community-based program to reduce farm hazards through recognition and training about the role of stress in farm safety and health. The activities of the program have centered on developing a videotape and workbook for use in stress management workshops, and delivering workshops in rural areas. Local sponsoring organizations designated facilitators who were trained to reach Eastern Washington farmers with this workshop. The project has an advisory board consisting of local/regional individuals involved in agribusiness and farming operations. The program was a natural consequence of the Centers work. Several years prior to the establishment of the Center at EWU, we were invited by the University of Iowa to conduct the eastern Washington state portion of research that was to become the National Coalition for Agricultural Safety and Health (N-CASH) survey.1 The N-CASH study was the basis for a Bush administration briefing and the EWU Center director was a keynote speaker at the Surgeon Generals conference on Farm Health and Safety. The results of the Eastern Washington survey showed that farmers appear to be knowledgeable concerning the dangers of their occupation but still tend to engage in unsafe practices.2 The question which emerged and has not yet been adequately answered is; Why do they continue to engage in unsafe practices? Seeking additional insight into the factors related to high farm injury rates, the Center has conducted several research activities, each addressing the question: If a farmer knows that a practice is unsafe or unhealthy, why does he or she still perform these unsafe practices? In 1992 a series of focus groups were conducted with local individuals engaged in agribusinesses. Participants in these groups concluded that occupational stress prevents farmers from taking appropriate safety precautions even when they are aware of the dangers of their practices.3 To further understand the impact of occupational stress via specific stressors, a stress survey was conducted at the Spokane Agricultural Exposition in 1993. The survey, completed by 215 Exposition attendees, ranked the perceived impact of stressors on Washington farmers.4 A number of earlier studies had reported that several variables, mostly economic were the major form of stressors.5,6 Given the consistency with which stress had been related to farm safety

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by area farmers, a project proposal was submitted to the W. K. Kellogg Foundation to address the following goals: a. introduce to the agricultural community in three eastern Washington counties user-friendly techniques to help reduce stress, and thus promote health and safety; b. encourage networking and coalition-building as a means of reducing stress in order to promote health and safety; c. involve the agricultural community in health and safety promotion through stress management techniques; and d. train community members to present stress reduction workshops, and to have these community members train other local citizens to do the same. Specific strategies designed to accomplish these goals were incorporated into the development of a multi-focused, interactive farm stress workshop. The Centers proposal became one of 11, 3-year national demonstration projects funded in 1993 by the W. K. Kellogg Foundation. The initial year of the project was devoted to the development of the stress reduction program. A professionally-produced videotape was developed including live testimony from individuals who had experienced serious injury or personal loss due to a farm accident which had occurred while stressed. A Farm Stress Workbook was also developed including exercises for recognizing and coping with stress, with the expectation that these exercises would serve as the basis for group discussions. At the end of the workbook, a contract was presented for the individual to outline the steps he or she would take to reduce the impact of stressors in his/her life. An in-depth survey was designed by the external evaluator from the University of Idaho in conjunction with the advisory board. The purpose of the survey was to measure the impact of the workshop on participants and to evaluate the success of the project. During 1993-94, the primary focus of the project was the implementation of the stress workshops. The program was initially tested at the 1994 Ag Expo in Spokane and 25 workshops were subsequently held at local agribusiness and agricultural organization meetings. Community trainers were selected and trained by Center staff members to administer the workshop. PARTICIPANT PROCEDURES The adult Farm Stress Workshop took approximately one hour to complete. After the purpose of the workshop was explained to the participants,

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they were asked to complete the demographic portion of an evaluation questionnaire. The questionnaire included questions about their farm operations, education level, age, family income, experiences with farm-related injury, personal and significant others attitudes and perceptions of control over safety practices. The participants then watched a video. Following the introductory portion of the video, participants completed a farm stress inventory. After the video presentation concerning stressor identification, participants completed activity sheets about coping strategies. Workbook discussion followed describing strategies for establishing support networks, learning problem solving skills, and engaging in thought stopping techniques to reduce stress. The three stress reduction techniques are defined as follows: Networking is a way to take action and a way to connect with people or resources that can be of assistance. Networking is also knowing the right person to contact so you can obtain the information you need. Problem solving is a process of breaking down a large problem into more manageable tasks. The four steps to problem solving are (1) define the problem, (2) find alternatives, (3) choose an alternative, (4) implement a solution. Thought stopping involves concentrating on the unwanted thoughts and, after a short time, suddenly stopping and emptying your mind. Thought stopping clears your mind of the unwanted thoughts and worries that distract you from work, sleep, and leisure. A brief video introduced networking, problem solving, and thought stopping, the three coping strategies. Participants completed a questionnaire which assessed the degree to which they intend to use coping strategies following their workshop presentation. The signing of a self-contract to try coping mechanisms completed their participation. Workshops were conducted in 1994 with farmers in Spokane, Lincoln, and Whitman counties (see Table 1 for additional information about the samples). Farmers who had participated in the 1994 workshops and had completed the questionnaire were contacted again in 1995. The follow-up questionnaire contained many questions identical to the questions in the 1994 questionnaire. In 1994 a questionnaire similar to the one handed out at the 1994 workshops was mailed to a random sample of 982 farmers in Spokane, Lincoln and Whitman counties. The random samples were drawn from lists of farmers obtained from the Agricultural Stabilization and Conservation Service in each county. In 1996, questionnaires were mailed to the farmers who had responded to the 1994 survey. The random sample provided a basis for comparing workshop participants with the general population of farmers in the area. Additional workshops were conducted in 1995 with farmers in Spo-

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TABLE 1. Sample Characteristics.

1994 Workshops Workshop Total in Sample Non-farmers, ineligible* Farmer responses Response rate** 325 90 235 1995 Workshops Random Sample Follow-up 546 206 340 67%

Follow-up Workshop 270 122 148 63% 237 63 174

Follow-up Initial mailing 174 78 96 65% 982 436 546 64%

*Ineligible included those retired, no longer farming, deceased or moved from the area. **Response rate was calculated using the following formula: Response Rate =
Valid Responses 100 Total Sample Ineligibles

kane, Adams, Lincoln, Whitman and Yakima counties. In 1996, a followup questionnaire was mailed to the farmers who participated in the 1995 workshops. The following section presents selected characteristics of the workshop participants and random sample of farmers. BACKGROUND CHARACTERISTICS The 1994 and 1995 workshop participants average age was a little younger (49.9) than the average for respondents from the random sample (52.1). Educational levels for respondents and their spouses were roughly equivalent for the three groups (Table 2). Seventy-two percent of the 1994 workshop participants and 57% of the 1995 workshop participants were a part of a family farm corporation, whereas 51% of the random sample were part of a family farm corporation. Respondents from the random sample were more likely to farm alone than 1994 workshop participants (49% compared with 29%). The percentage of workshop participants who farmed with relatives was higher (73% of the 1994 participants and 74% of the 1995 participants) than for respondents from the random sample (44%). It is possible that persons farming with others have more time to belong to organizations where workshops were held. The majority of respondents from all three groups were male yet there was a higher percentage (15% and 17%) of female respondents in the 1994 and 1995 workshops than in the random sample (6%). The majority (53%) of respondents from the random sample had a gross

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household income in 1992 of more than $100,000 (Table 3). The gross household income for almost half the respondents from the 1994 workshop (48%) was $30,000 to $99,999 and for the 1995 workshop (51%) was $30,000 to $74,999. The following analysis evaluates the influence of the workshops on the reduction of stress from factors related to the farm operation. FARM STRESS ANALYSIS Farmers were given a list of 28 items that potentially could cause stress in managing farm operations and were asked to indicate the level to which
TABLE 2. Characteristics of Workshop Participants and Random Sample of Farmers: Level of Education.
Workshop 1994 (n = 224) Respondent Elementary school Some high school High school graduate Vocational training Some college College graduate Advanced college degree
*Reported as percents

Education

Random Sample (n = 507) Respondent 0 2 23 10 29 30 6 Spouse 1 3 23 9 28 27 9

Workshop 1995 (n = 166) Respondent 4 5 13 13 27 32 6 Spouse 0 2 20 9 26 36 7

Spouse 0 1 20 13 28 29 9

0* 2 15 11 26 37 9

TABLE 3. Characteristics of Workshop Participants and Random Sample of Farmers: Gross Household Income Before Taxes and Expenses in 1992.
Income LESS THAN $19,999 $20,000 TO $29,999 $30,000 TO $49,999 $50,000 TO $74,999 $75,000 TO $99,999 $100,000 TO $249,999 $250,000 TO $499,999 $500,000 OR MORE
*Reported as percents

Workshop 1994 (n = 228) 10* 14 28 10 10 19 7 2

Random Sample (n = 518) 4 7 11 12 13 37 13 3

Workshop 1995 (n = 174) 7 12 34 17 9 17 3 1

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each item was stressful to them in their farm operation. These items have been previously developed with farmer input and have been used in earlier farm research.4 All survey instruments were pre-tested prior to their being finalized. The response categories were No Stress, Slight Stress, Moderate Stress, Serious Stress, or Not Applicable. By subjecting the list of stressors to factor analysis six groups emerged. They were: stressors related to farm management, health stressors, stress factors not controlled by the farmer, financial stressors, stressors associated with government policies or programs, and stressors specific to the farm (Appendix). The means for each scale are presented for the three sample groups in Table 4. A higher scale mean for the farm management scale indicated that farmers felt more stress when determining the most profitable ranch and farm enterprises, getting enough information to make decisions, keeping records, and establishing long range farm operation goals. The 1994 and 1995 workshop respondents had higher scale means than those from the random sample or the follow-up surveys. Workshop participants felt more stress in the area of farm management than the random sample. The
TABLE 4. Farm Stress Scale Means.
Workshop 1994 2.316 2.506 2.994 2.727 2.781 2.482 Workshop 94 Follow-up 2.181 1.905*** 2.820*** 2.210*** 2.622 2.382 Workshop 1995 2.286 2.598 2.776 2.647 2.622 2.343 Workshop 95 Follow-up 2.068** 1.836*** 2.571* 1.913*** 2.426* 2.216*** Random Sample 2.022 1.952 2.743 2.114 2.517 2.254 Random Sample Follow-up 1.992 2.009 2.706 2.093 2.531 2.274

Scale Farm management Health Control Finances Government Farm problems

NOTE: Means are based on the following scores: No stress = 1; Slight stress = 2; Moderate stress = 3; and Serious stress = 4. A difference of means test for dependent samples was done on each workshop group and the random sample. The asterisks associated with the follow-up scores indicate the statistical level of significance according to the following probabilities: P < .05 P < .01 P < .001

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follow-up survey showed a reduction in stress for this scale which was significant for the 1995 workshop respondents. A higher scale mean for the health scale indicated farmers felt more stress when confronted with major illness or accident, alcohol or drug use, a death in the family, lack of health care providers, transfer of the farm to the next generation, family conflicts, and responsibility for dependent relatives. Participants of the 1994 and 1995 workshops showed the greatest reduction in health related stress on the follow-up surveys. The control scale was comprised of factors not completely within the farmers control such as weather, poor crops or machinery breakdown. The control scale means were closest for the 1995 workshop participants but the differences between the workshop and follow-up scores were still statistically significant. The control scale means were higher for each group than the farm management, health, finances, government or farm problems scales means. This would indicate that factors perceived to be outside the farmers control cause more stress than factors within the farmers control. The finances scale was made up of items concerning high interest rates on debt, off-farm employment, inability to obtain credit or farmers debt load. Respondents from the 1994 workshop had a higher finances scale mean than respondents from the other groups. Reductions in financial stress were the second largest for respondents from the 1994 and the 1995 workshops. The government scale was comprised of items related to the uncertainty of foreign or national markets, government regulations or policy shifts, transporting of crops and the cost of machinery or production. Government scale means from all samples were among the highest, indicating that government issues tend to generate relatively high levels of stress among farmers. The farm problems scale included problems that were specific to the farm operation such as soil erosion, inability to hire and keep good laborers, use of dangerous chemicals, use of dangerous machinery, or the death of a valuable animal. Respondents from both workshops had the second lowest farm problems scale means. Farm management scale means were the lowest for both groups. Differences due to the workshops was not significant in 1994. Overall, the stress scale means dropped for both the 1994 and 1995 workshop participants who responded to the follow-up questionnaire for all six scales. Stress scale means for random sample follow-up respondents were only slightly different between the two time periods. This suggests that less stress was perceived by farmers after the workshop.

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SUMMARY AND CONCLUSIONS Their were consistent findings in the six stress scales following the workshops. It is possible that the workshops had a positive influence on the farmers ability to handle the stressors of his/her farming operation. The greatest reductions in stress in the 1994 workshops were in the health, control, and finances scales. In the 1995 workshops the greatest differences were in the health, finances and farm problems scales. In 1995 differences in the farm management scale, the control scale and the government scale were also statistically significant. Workshop attendees were younger and had lower income levels than the random sample. It is possible these farmers would have higher stress levels in their farming operations than older farmers with higher incomes. Workshop attendees also were slightly higher in education level than the random sample. In general, results suggest that positive results can be achieved by presenting a workshop focusing on reducing the influence of stressful situations in a farmers life. The presentation of stress reducing techniques can play a positive role in reducing stress and increasing the health and safety of farm operations. REFERENCES
1. Elkind P. Correspondence between knowledge, attitudes and behavior in farm health and safety practices. Journal of Safety 1993; 24:171-179. 2. Meyers M, et al. Papers and Proceedings of the Surgeon Generals Conference on Agricultural Safety and Health. U.S. Department of Health and Human Services. NTIS PB 93-114890. September 1992. 3. Elkind P. Attitudes and risk behavior. In Meyers, et al. (eds) Papers and Proceedings of the Surgeon Generals Conference on Agricultural Safety and Health. U.S. Department of Health and Human Services. NTIS PB 93-114890. September 1992. 4. Elkind P. Farm stressors: The hazards of agrarian life. AAEM 1994; 1: 23-27. 5. Weigel RR. Helping farmers handle stress. Journal of Extension 1980; 18:37-40. 6. Walker LS, Walker JL. Stressors and symptoms: Predictive of distress informers. Family Relations 1987; 36:374-378.

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JOURNAL OF AGROMEDICINE APPENDIX QUESTIONS USED TO DEVELOP FARM STRESS SCALES

MANAGEMENT SCALE 1. 2. 3. 4. Determining the most profitable ranch and farm enterprises. Having enough information to make important decisions. Too much or too little time spent on record keeping. Difficulty in establishing long range farm operation goals.

HEALTH SCALE 1. 2. 3. 4. 5. 6. 7. Major illness or accident (yourself or others). Alcohol and other drug use, abuse or addiction (yourself or others). Death in family. Lack of health care providers. Transfer of farm from one generation to next. Family conflicts. Responsibility for dependent relatives (young or elderly).

CONTROL SCALE 1. Weather. 2. Poor crops. 3. Machinery breakdown. FINANCES SCALE 1. 2. 3. 4. High interest rates on debt. Off-farm employment to make ends meet. Inability to obtain credit. Debt load.

GOVERNMENT SCALE 1. 2. 3. 4. Uncertainty of foreign/national markets. Government regulations or policy shift. Transporting of crops (roads and rail). Cost of machinery or production.

FARM PROBLEMS SCALE 1. 2. 3. 4. 5. Soil erosion. Inability to hire and keep good laborers. Use of dangerous chemicals. Use of dangerous machinery. Death of a valuable animal.