Background Addressing overweight and obesity among men at-risk for obesity-related diseases and disability in rural communities is a public health issue. Commercial smartphone applications (apps) that promote self-monitoring for weight loss are widely available. Evidence is lacking regarding what support is required to enhance user engagement with and effectiveness of those technologies. Pragmatically comparing these apps effectiveness, including rural men’s desired forms of support when using them, can lead to greater weight loss intervention impact and reach. This study assessed the feasibility and acceptability of a mobile technology application applied differently across two groups for weight loss. Methods In a two-armed, pragmatic pilot feasibility study, 80 overweight and obese men aged 40–69 were randomized using a 1:1 ratio to either an enhanced Mobile Technology Plus (MT+) intervention or a basic Mobile Technology (MT) intervention. The MT+ group had an enhanced smartphone app for self-monitoring (text messaging, discussion group, Wi-Fi scale) whereas the MT group received a basic app that allowed self-monitoring logging only. Assessments were collected at baseline, 3 and 6 months. App logs were analyzed to track engagement and adherence to self-monitoring. Acceptability was assessed via focus groups. Analysis included descriptive statistics and qualitative content analysis. Results Of 80 men recruited, forty were allocated to each arm. All were included in the primary analysis. Recruitment ended after 10 months with a 97.5 and 92.5% (3 month, 6 month) retention rate. Over 90% of men reported via survey and focus groups that Lose-It app and smart scale (MT+) was an acceptable way to self-monitor weight, dietary intake and physical activity. Adherence to daily app self-monitoring of at least 800 dietary calories or more (reported respectively as MT+, MT) was positive with 73.4, 51.6% tracking at least 5 days a week. Adherence to tracking activity via recorded steps four or more days weekly was positive, 87.8, 64.6%. Men also adhered to self-weighing at least once weekly, 64, 46.3%. At 6 months, an observed mean weight loss was 7.03 kg (95% CI: 3.67, 10.39) for MT+ group and 4.14 kg (95% CI: 2.22, 6.06) for MT group, with 42.9 and 34.2% meeting ≥5% weight loss, respectively. No adverse events were reported. Conclusions This National Institutes of Health-funded pilot study using mobile technologies to support behavior change for weight loss was found to be feasible and acceptable among midlife and older rural men. The interventions demonstrated successful reductions in weight, noting differing adherence to lifestyle behaviors of eating, monitoring and activity between groups, with men in the MT+ having more favorable results. These findings will be used to inform the design of a larger scale, clinical trial. Trial registration The trial was prospectively registered with ClinicalTrials NCT03329079. 11/1/2017.
Purpose The purpose of this scoping review is to summarize the current knowledge base in order to make recommendations for prevention and treatment of substance use disorders among the farming populations. Methods We conducted a scoping review of peer‐reviewed articles published between January 1989 and September 2019. The search yielded 3,426 citations and the final review was conducted on 42 articles. The full review was conducted by 4 authors to extract information about the target population, data collection methods, and main results. Findings There were 21 articles on farmers and 21 articles on farmworkers. The majority of the articles were about alcohol. Overall, farmers had higher prevalence of risky alcohol consumption patterns than nonfarmers. The prevalence of risky alcohol consumption was also high among farmworkers compared to the general population. Risk factors for risky alcohol consumption included male gender, lower socioeconomic status, and psychological problems (eg, depression). Recommendations for prevention and intervention of alcohol disorders included policy development and implementation to curb alcohol access by taxation, screening of alcohol‐related problems, and alternative means of recreation instead of alcohol consumption. Conclusions This review confirmed that alcohol‐related problems are prevalent among farmers and farmworkers. More population‐based research is called for to understand the additional risk factors of alcohol disorders and the prevalence of other substance‐related disorders. Also, interventions should be tailored to the unique culture of farmers and farmworkers.
Social marketing is an intervention development strategy that pays considerable attention to barriers to and motivators for behavioral change or adoption of recommended behaviors. Barriers are obstacles that prevent individuals from changing or adopting behaviors and are often referred to as the "cons" or "costs" of doing something. Motivators, on the other hand, are factors that encourage individuals to change or adopt behaviors and are often referred to as the "pros," "benefits," or "influencing factors" of doing something. Importantly, social marketing does not target education or knowledge change as an end point; rather, it targets behavior change. Studies across several types of desired behaviors (e.g., smoking cessation, weight control, more exercise, sunscreen use, radon testing) using the Stages of Change model have found systematic relationships between stages of change and pros and cons of changing behavior. A review of literature identifies numerous research and intervention studies that directly reference social marketing in agricultural safety and health, studies that identify reasons why parents allow their children to be exposed to hazardous situations on the farm, and reasons why youth engage in risky behaviors, but only two studies were found that show evidence of systematically researching specific behavioral change motivating factors. The authors offer several suggestions to help address issues relating to social marketing and agricultural safety and health.
IntroductionMen who are overweight or obese in the rural Midwestern USA are an unrepresented, at-risk group exhibiting rising rates of cardiovascular disease, poor access to preventive care and poor lifestyle behaviours that contribute to sedentary lifestyle and unhealthy diet. Self-monitoring of eating and activity has demonstrated efficacy for weight loss. Use of mobile technologies for self-monitoring eating and activity may address rural men’s access disparities to preventive health resources and support weight loss. Our pilot trial will assess the feasibility and acceptability of two mobile applications for weight loss in rural men to inform a future, full-scale trial.Methods and analysisA 6-month randomised controlled trial with contextual evaluation will randomise 80 men using a 1:1 ratio to either a Mobile Technology Plus (MT+) intervention or a basic Mobile Technology (MT) intervention in rural, midlife men (aged 40–69 years). The MT+ intervention consists of a smartphone self-monitoring application enhanced with discussion group (Lose-It premium), short message service text-based support and Wi-Fi scale. The MT group will receive only a self-monitoring application (Lose-It basic). Feasibility and acceptability will be evaluated using number of men recruited and retained, and evaluative focus group feedback. We seek to determine point estimates and variability of outcome measures of weight loss (kg and % body weight) and improved dietary and physical activity behaviours (Behavioral Risk Factor Surveillance System (BRFSS) physical activity and fruit and vegetable consumption surveys, data from Lose-It! application (kcal/day, steps/day)). Community capacity will be assessed using standard best practice methods. Descriptive content analysis will evaluate intervention acceptability and contextual sensitivity.Ethics and disseminationThis protocol was approved by the University of Nebraska Medical Center Institutional Review Board (IRB# 594–17-EP). Dissemination of findings will occur through ClinicalTrials.gov and publish pilot data to inform the design of a larger clinical trial.Trial registration numberNCT03329079; preresults. Protocol V.10, study completion date 31 August 2020. Roles and responsibilities funder: NIH/NINR Health Disparities Section 1R15NR017522-01.
Fire departments have right-of-entry to most commercial industrial sites and preemptively map them to identify the onsite resources and hazards they need to promptly and safely respond to an emergency event. This is not the case for private farms. Emergency responders are blind to resources and hazards prior to arrival and must spend critical minutes locating them during an emergency response at a farm location. The original 2013 Farm Mapping to Assist, Protect and Prepare Emergency Responders (Farm MAPPER) project was undertaken to develop a method to give emergency responders an up-to-date view of on-farm hazard information to safely and efficiently conduct emergency response activities on private agricultural operations. In 2017, an augmented reality version of Farm MAPPER was developed to combine the technological advantages of geographic information system-based data points with a heads-up display and graphical overlay of superimposed hazard imagery and informative icons. The development and testing of this iOS- and Android-ready prototype uncovered lessons learned applicable to other mobile-based apps targeting farmers, ranchers, and rural populations faced with limited or inconsistent mobile internet connectivity.
This collaborative research study contributes to a better understanding of hazards faced by tribal bison workers. Findings from this research influenced the ITBC in their decision to add worker safety and health training to the agenda of their yearly conference and promote tailgate trainings for their workers. UNL veterinarians have taken the lessons learned from this research and provided safety and health information to mangers of other non-tribal bison herds. This research partnership will continue with a 5-year research study focusing on best management practices and establishing training to improve the health and safety bison workers.
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