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Scholars have noted persistent high rates of agricultural health and safety incidents and the need to develop more effective interventions. Participatory research provides an avenue to broaden the prevailing research paradigms and approaches by allowing those most impacted to illuminate and work to solve those aspects of their lives. One such approach is photovoice, an emancipatory visual narrative approach. Yet, despite its broad appeal, photovoice can be hard to implement. In this article, we leverage our experience using photovoice for a farm children safety project to describe and reflect on the ethical and methodological aspects broadly relevant to agricultural health and safety topics. We first contextualize the tensions of navigating between photovoice, the research ethics committees (RECs) regulatory frameworks, and competing views on visual representations in agriculture. We then discuss the sources of risks to participants and researchers, how we addressed these risks, and how these risks unfolded during the research phase of the photovoice activity. We conclude with three lessons we (re)learned: the importance of collaborating with RECs, the need to increase preparation to limit psychological risks to participants and researchers, and avenues to augment the emancipatory power of photovoice in a virtual environment. [ABSTRACT FROM AUTHOR]

Increased attention to suicide in agriculture has led to an increase in interventions informed in part by research on who is most likely to die from suicide, using what means, and for what reason(s). However, the limited understanding of how suicide is studied and the limited engagement in previous studies with theories raises questions about the body of knowledge underpinning these interventions. To assess prevailing methodological approaches and the implications of gaps in our understanding of suicide, we conducted a scoping review of 108 English-language articles. The use of the prevailing health science model to conduct literature reviews also provides a space to reflect on the knowledge that is missed or obscured when using overly positivistic approaches to identify and summarize bodies of literature. We find that the prevailing approaches to studying suicide are methodologically narrow, overplay a limited set of individual-level factors, and underplay key structural-level factors. In line with previous critics, our review hints at the inadequacy of existing interventions given that the existing body of knowledge has not adequately incorporated theoretically important drivers of suicide. Our reflections on current approaches to conducting literature reviews and gaps in the suicide literature provide a roadmap to bridge disciplinary traditions while helping address the knowledge gaps we have identified. [ABSTRACT FROM AUTHOR]

Over the last 20 years, earth's increasing surface temperature has dramatically altered local climates and risks associated with agricultural work. In parallel, increasing automation has continued to be a hallmark of innovation in agriculture, promising to lower the economic and health externalities of labor in food production by reducing worker demand and hazardous exposure. However, many of these automations neither eliminate labor nor ameliorate climate change pressures on farms. As a result of the confluence between automation and environmental change, empirical studies into the social determinants of agricultural health and safety in rapidly automating industries impacted by local effects of climate change are essential for a responsive agricultural health and safety science. In this commentary, I suggest that looking outside of our disciplinary boundaries to the lessons learned from rural studies (RS), environmental social science (ESS), and science and technology studies (STS) can lend useful theoretical framing for the development of new research trajectories in the areas of automation and climate change as they impact agricultural health and safety. [ABSTRACT FROM AUTHOR]

Objectives: Measures to curb the spread of COVID-19 in the Spring of 2020 immediately raised concerns among farm safety experts about the increase in children's risk exposure due to changes in childcare and schooling arrangements. The goal of this study is to understand how farm parents were taking care of their children in the early months of COVID-19. Methods: I conducted univariate and inductive content analysis on survey data from 134 farm parents from 38 U.S. states to understand. Results: My findings overall confirm experts' predictions. The move to distance learning for about three-quarter of respondents with school-age children and changes in childcare arrangements for over half of those with pre-school-age children led respondents to contend with fewer options and added responsibilities. Most frequently used adaptation strategies reflected lower reliance on the traditionally important social networks, a desire to preserve household income, and greater involvement of children on the farm. As a result, taking care of their children became harder for more than half of respondents with likely repercussions on children's exposure to risk, parents' well-being, and on the farm business. Conclusion: The empirical insights of this study provide descriptive baseline and contextual data for future research on the impact of COVID-19. The conceptual insights expand the farm safety literature by illustrating the need to study underappreciated structural factors shaping how farm parents juggle children with their professional obligations. Finally, findings around the complexity of raising children and connections to farm productivity and farm safety highlight the importance of considering farm women's well-being alongside the safety of their children. [ABSTRACT FROM AUTHOR]

Rural studies scholars have highlighted the important role farm households play in propping up the farm business along the life course. Yet, little is known about how challenges facing farm households impact the farm business and how social safety nets may interact with household and business development trajectories. We use the example of US farm households' access to health insurance and health care to develop empirical insights into these research gaps. We draw on a life course conceptual framework integrating the European and US literature and conduct bivariate analysis using age categories as the dependent variable on a primary dataset of 1,114 surveyed farm families. Difficulties meeting health care needs affected respondents at any age. Variations in trade‐offs between consumption, savings and investments as farm households make health‐related decisions hint at compounding effects over the life course on farm structure and transition timing. With biggest differences between households under and over 65 years of age (the threshold for universal public coverage), our findings highlight the importance of considering how social policies shape farm families' (in) ability to meet their social needs and the connections to farm persistence. [ABSTRACT FROM AUTHOR]

In the midst of the COVID-19 pandemic, farmers and farm workers have been deemed essential workers across the world. Yet, despite working in one of the most dangerous occupations, and despite being especially vulnerable to the virus (due to existing health risk factors and risk of infection stemming from difficulties adopting control measures), many farmers and farm workers in the United States have long lacked essential resources to ensure they can meet their health needs: affordable and accessible health insurance and health care. In this commentary, we draw on our own research focused on farm families and collective experiences to discuss three main challenges farm families have faced meeting their health needs: reliance on off-farm work for health insurance coverage, the need to forecast income when purchasing a plan on the health insurance marketplace, and barriers to health care in rural areas. As we discuss these challenges, we highlight the ways in which the COVID-19 pandemic is likely exacerbating these pressures. Recognizing that major crises in the past have led to major shifts in economic, social, and political systems, the disruptions brought on by COVID-19 could be leveraged to work toward increasing access to affordable and adequate health insurance and health care. As such, we conclude our commentary by outlining policy reforms and research efforts that are needed to ensure that those working in the farm sector have access to essential resources to preserve their health and safety. [ABSTRACT FROM AUTHOR]

Amid concerns of inadequate medical supplies and staffing anticipated from a surge in COVID-19 cases, many health care systems across the United States (U.S.) began shutting down non-essential patient services in March 2020. These sudden shifts bring up questions about the long-term effects of COVID-19 on already fragile rural health care systems and the ability of rural populations, including farmers and farm workers, to meet their health care needs. To provide alternative and safe access to health care, the Federal government relaxed telehealth regulations, which effectively removed some of the largest regulatory barriers that had limited the adoption of telehealth in the U.S. In this commentary, we draw on the example of the Marshfield Clinic Health System (MCHS), a large rural health care system in Wisconsin and provide an early assessment of how it adjusted its telehealth services during the early months of COVID-19. While the long-term effects of the pandemic on rural health care systems will not be known for some time, the example of MCHS points to the importance of on-going and sustained investments to support the resilience of health care systems and their ability to weather crises. With early evidence that MCHS patients and practitioners are interested in continuing to use telehealth post-COVID-19, we conclude our commentary by offering three recommendations to remove hurdles and improve quality of telehealth care. [ABSTRACT FROM AUTHOR]

The article explores the economic impacts of local food procurement, which is a central component of farm-to-school (FTS) programs in the U.S. The economic impact of FTS beyond food procurement is tackled. The potential of FTS programs to leverage food procurement and educational programming to increase nutritional knowledge and skills among students is also discussed.

The 2011 Food Safety Modernization Act (FSMA) exempts most small- and medium-scale growers in the U.S. from the new produce safety rule that creates a set of minimum safety standards for producing and processing fresh fruits and vegetables. While the exemption may limit the financial burden of growers in the short term, growers not willing or unable to meet food safety standards could lose out on market opportunities. In this article, we draw on a primary dataset of 301 survey responses from small- and medium-scale produce growers in New England (NE) and develop a conceptual framework for analyzing both objective and subjective factors associated with the on-farm adoption of food safety practices. We begin our analysis by exploring the extent to which growers report being financially able and willing to invest in food safety practices, and continue with an assessment of factors associated with the financial ability and willingness to adopt these practices. Regarding ability, we find that 24% of growers were able to adopt practices regardless of cost, while 64% were able to invest if not cost prohibitive. The odds of being able to invest increased 4% for every one-unit increase in the food safety knowledge test score and increased 20% for every one-unit increase in the number of practices implemented. In addition, the odds were 84% lower for those who reported financial barriers to adoption compared to those who did not. With respect to willingness, 46% of growers were willing to adopt practices regardless of cost, while 49% were willing if not cost prohibitive. The odds of being willing to invest increased 4% for every one-unit increase in food safety knowledge test score, were 4.9 times more likely for those who perceived no barriers to the implementation of practices, and were 2.7 times more likely for those who perceive that growers have a role to play in food safety. We conclude with a discussion of the practical implications for technical assistance providers, policy makers, and government agencies, as well as avenues for future research. These are centered around three points: (1) the high potential for adoption of food safety practices where cost remains a limiting factor, (2) a potential disconnect between the commonly used knowledge deficit approach to food safety training and what growers want and need to know, and (3) the importance of adopting a systemic approach to understand the realities of growers and the diversity of factors that shape the adoption of food safety practices. • Small- and medium-scale growers are willing to adopt food safety practices, but cost is a concern. • Importance of financial support such as grants and government-backed loans. • Disconnect between food safety training and what growers want and/or need. • Guidelines and trainings need to account for growers' realities, needs and finances. • Increased adoption of food safety practices requires a systemic approach. [ABSTRACT FROM AUTHOR]

In this study, we seek to illuminate: (1) the ways farm service providers and mental health professionals understand the drivers of farm stress, (2) the strategies, challenges, and opportunities farm service providers and mental health professionals identify for supporting the mental health needs of farm families, and; (3) opportunities for future research and outreach to improve the mental health of farmers in the U.S. Midwest region. We obtained qualitative data from a series of semi-structured key informant interviews with 19 subject matter experts, using content analysis to identify themes across four domains: main challenges, unique impacts by subpopulation, coping strategies, and interventions and recommendations. The key informants we interviewed identified a variety of acute and chronic stressors, including several that are structural, rather than individual and interpersonal, and which lie outside of the control of farmers themselves. They also highlighted diversity within farm populations by socio-demographic and farm characteristics as well as positive and negative coping strategies, with negative being more common. For interventions and recommendations, they stressed the importance of education on mental health, improving access to care, and addressing root causes of stress. While farmer stress is well-documented, less is known about the perspectives of farm service professionals and mental health providers who care for them. The insights from this study add important information on how to best support the immediate and long-term mental health needs of farmers and farm families in the U.S. Midwest and beyond. [ABSTRACT FROM AUTHOR]

Background: Childhood obesity persists in the United States and is associated with serious health problems. Higher rates of obesity among children from disadvantaged households may be, in part, attributable to disparities in access to healthy foods such as fruits and vegetables. Community supported agriculture can improve access to and consumption of fresh produce, but the upfront payment structure, logistical barriers, and unfamiliarity with produce items may inhibit participation by low-income families. The aim of this project is to assess the impact of subsidized, or "cost-offset," community supported agriculture participation coupled with tailored nutrition education for low-income families with children.Methods/design: The Farm Fresh Foods for Healthy Kids community-based, randomized intervention trial will build on formative and longitudinal research to examine the impact of cost-offset community supported agriculture on diet and other health behaviors as well as the economic impacts on local economies. The intervention will involve reduced-price community supported agriculture shares which can be paid for on a weekly basis, nine skill-based and seasonally-tailored healthy eating classes, and the provision of basic kitchen tools. Low income families with at least one child aged 2-12 years will be recruited to join existing community supported agriculture programs in New York, North Carolina, Vermont, and Washington. In each program, families will be randomized 1:1 to intervention or delayed intervention groups. Data will be collected at baseline, and in the fall and spring for 3 years. The primary outcomes are children's intake of fruits and vegetables and foods high in sugar and/or (solid) fat, as well as diet quality; secondary outcomes include physical, behavioral, psychosocial, and environmental variables. Cost-effectiveness and economic impact at the farm and community levels also will be assessed.Discussion: This integrated project will provide important information and contribute to the evidence base regarding the use of local agricultural interventions to improve children's dietary behaviors and weight maintenance. Findings also will inform the development of a toolkit for farmers and education modules related to local food system innovations for undergraduate and graduate students.Trial Registration: ClinicalTrials.gov NCT02770196 . Registered 5 April 2016. [ABSTRACT FROM AUTHOR]

The article focuses on the Community Supported Agriculture Cost-offset Intervention to Prevent Childhood Obesity and Strengthen Local Agricultural Economies project which is funded by the U.S. Department of Agriculture (USDA) Agriculture and Food Research Initiative (AFRI) project. It involves community supported agriculture (CO-CSA) participation as a strategy for improving dietary quality among low-income families. It also draws on research related to obesity, fruit and vegetable consumption.