Agriculture Reference
In-Depth Information
and as a way of providing continuing education to a variety of health practitioners
on AFF topics.
The committee is impressed by efforts in the U.S. Public Health Service to
explore factors that affect health outcomes. Much of the endeavor involves urban
and suburban populations, and the committee encourages NIOSH to investigate
with sister agencies on opportunities to conduct, endorse, or fund health outcomes
research in rural AFF populations. Those populations have been only lightly stud-
ied despite the fact that their occupational pursuits and rural residence and work
locations predispose them to some kinds of exposure and affect their access to
healthcare. Such work might build on successful activities in urban settings.
NIOSH can explore ways to enhance attention to AFF issues in university-based
clinical research training. Because NIOSH has excellent linkage through its ERCs,
the potential to affect clinical curricula is enormous. Such linkage might capture
nontrivial issues of rural geography, spatial isolation, lack of access to high-speed
Internet infrastructures, cultural features, indigenous languages, and rural work
patterns that are markedly different from those with which most urban-based
clinical researchers have contact.
A continuing supply of physicians knowledgeable in the AFF arena and in other
areas of occupational and environmental health is needed, as are incentives that
would include occupational and environment health training and continuing edu-
cation in medical school curricula. NIOSH can develop standardized assessment
tools for extramural occupational health training activity so that there will be a
mechanism to corral data on program relevance, quality, and execution. Recogniz-
ing that academic communities, volunteer organizations, and workers often have
strong desires to implement interventions to prevent occupational injuries and
illnesses and that they may lack resources to evaluate programs to guide the best
use of their resources, the committee believes that a coordinated approach to train-
ing program evaluation has merit. Development of such tools would contribute
information on knowledge and skill gaps, clinical and other professional relevance,
needs for training and other professional experience, the ability of instructors and
others to convey key messages, and incentives that might propel future collabora-
tive activity in occupational training venues.
Intervention Research
The AFF Program needs a more systematic and unified approach to evaluating
and disseminating intervention research. It has taken a unified approach with the
National Agricultural Tractor Safety Initiative, albeit a decade or so late, and needs
to take a similar approach to intervention research in general. Although there are
regional differences among the activities undertaken by AFF workers, the many
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