The effectiveness of educational interventions aimed at agricultural workers' knowledge, behaviour, and risk perception for reducing the risk of pesticide exposure: a systematic review and meta-analysis

Development and Psychometric Properties of Scale for Safe Pesticide Use Behaviors Assessment Based on the Health Belief Model

OBJECTIVES

This study aimed to develop and validate a measurement tool that provides a model-based assessment of health beliefs affecting individuals' safe pesticide use behaviors.

METHODS

This study employed a methodological design. The study sample consisted of 701 agricultural workers engaged in pesticide-related work in a district in southern Türkiye. Data were collected using a sociodemographic form and the 42-item draft version of the Health Belief Model Scale for Safe Pesticide Use Behaviors (HeBSaPUB). Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to determine construct validity. Cronbach's alpha internal consistency and test-retest correlation coefficients were calculated for reliability.

RESULTS

The 39-item HeBSaPUB scale showed good psychometric properties in terms of reliability, content validity, and construct validity. In the EFA, a six-factor structure emerged, explaining 61.36% of the total variance in the measured variables: perceived susceptibility, perceived barriers, perceived severity, perceived benefits, cues to action, and self-efficacy. This structure was confirmed by CFA using a cross-validation approach. Cronbach's alpha coefficient was 0.90 for the whole scale and ranged from 0.81 to 0.92 for the sub-dimensions. The test-retest reliability coefficient values of the scale were between 0.763 and 0.927. The items on the scale were not additive, and each sub-dimension was evaluated independently. An increase in the scores of perceived susceptibility, perceived benefit, perceived severity, cues to action, and self-efficacy, along with a decrease in the scores of perceived barriers, indicated positive health beliefs.

CONCLUSION

The results of the study demonstrated that the HeBSaPUB scale is a valid and reliable instrument for measuring attitudes and beliefs toward safe behaviors in preventing the risk of pesticide exposure. The HeBSaPUB scale can contribute to identifying needs for health professionals.

Effectiveness of educational interventions to promote safe handling of pesticides: protocol for a systematic review and meta-analysis

INTRODUCTION

Appropriate use of pesticides minimises harm to human health and the environment. Despite regulations and restrictions on use, however, many farmers still use highly toxic pesticides in ways that endanger their health and the environment. Many pesticide users know little about the health effects of these chemicals or how to handle them safely. A systematic review will collate evidence of the effectiveness of educational interventions among farmers regarding health hazards and the safe handling of pesticides. The review aims to summarise the impact of educational interventions on knowledge and reported behaviour of pesticide users and to identify characteristics of more effective interventions.

METHODS AND ANALYSIS

We will search MEDLINE, LILACS, AGRICOLA, IMBIOMED, SciELO, Web of Science, Scopus, Embase databases and from the grey literature, Open Grey and WHO to identify potentially eligible studies. We will consider randomised and non-randomised controlled trials that evaluated the impact of educational interventions among farmers about the safe use of pesticides. We will include studies published between 2000 and 2024 in English, Spanish and Portuguese and consider outcomes of knowledge about pesticide health effects, knowledge about safe handling of pesticides and reported behaviour when handling pesticides. A meta-analysis of eligible studies, using a random-effects model, will estimate the impact of educational interventions on the outcomes as the difference between the intervention group and the control group at the last point of measurement. We will assess heterogeneity using the χ2 test and I2 statistic, conduct a sensitivity analysis by removing each study from the meta-analysis and evaluate publication bias with a funnel plot and Begg and Egger tests. Subgroup analyses will examine the impact of different kinds of educational interventions.

ETHICS AND DISSEMINATION

Ethics approval is not required as no information from individuals are collected. The results will be published in a peer-reviewed journal or disseminated at relevant conferences.

PROSPERO REGISTRATION NUMBER

CRD42023413028.

Impact of Pesticide Training on Safety Climate Perception Among French Cereal Farmers

Background: The training of farmers in pesticide safety is of prime importance for reducing pesticide use and exposure through the implementation of sustainable management practices. This study aimed to assess the impact of compulsory training on the knowledge and perceptions of cereal farmers, with the help of a safety climate scale. Method: We approached cereal farmers throughout France during compulsory training and certification procedures for pesticide-related activities. Trainees were asked to complete a safety climate questionnaire at the start and end of the course. In total, 733 cereal farm managers or workers completed the questionnaire at the start of the study, 131 of whom declined to complete the questionnaire at the end of the training session, leaving 602 subjects available for pre-training/post-training comparisons. Statistical analyses were based on paired t-tests and mixed models for repeated measures. Findings: The mean safety climate score increased from 82.37 to 88.22 after the training course (7.1 %, p < .001) in both univariate and multivariate analyses. Mean increases were also found for each of its seven dimensions (p < .001), ranging from 2.8% for "rules and best practices" to 12.4% for "communication and feedback." Few covariate-by-time interactions were found to be significant. Conclusion/Application to Practice: This study demonstrates that pesticide training is highly effective in increasing safety climate perception among cereal farmers and provides hints for improving the design of educational programs. Promoting the development and facilitation of lifelong learning with continuously updated training programs should be a top priority for minimizing pesticide exposure.

The effectiveness of a theory -based health education program on waterpipe smoking cessation in Iran: one year follow-up of a quasi-experimental research

BACKGROUND

The present research aimed to determine the effect of an educational intervention based on the extended theory of planned behavior (ETPB) on waterpipe (WT) smoking cessation in women.

METHODS

The present quasi-experimental had a pre-test, post-test design with 3, 6 and 12 months follow-ups was conducted in Bandar Abbas city, south of Iran in December 2021-March 2023. A total of 448 women over the age of 15 (224 in the intervention group (IG), 224 in the control group (CG)), using a two-stage cluster sampling method participated. The educational intervention focused on WT smoking cessation implemented in 14 sessions. The educational methods in the training sessions were lectures, collaborative discussions, Q&As, brainstorming, role plays, and peer education. The main outcome was WT cessation behavior. Repeated measures ANOVA tests and post hoc were run to compare the IG and CG at baseline in terms of demographic variables, t-test and chi square test, and in the four points of time of data collection. The data were analyzed in Stata14. A p-value < 0.05 was considered as statistically significant.

RESULTS

The mean and standard deviation of WT cessation behavior and all ETPB constructs in the IG was significantly higher than the CG. After the educational intervention, in the IG, the perceived behavioral control, attitude, subjective norm, intention and knowledge increased, and the weekly smoking and WT smoking habit decreased (P < 0.001). The CG did not have any significant change in other variables except for the increased knowledge score. During the 12-month follow-up, the cessation rate was 43.81% (P = 0.645) in the IG and 7.45% in the CG (P = 0.081).

CONCLUSIONS

The educational intervention positively affected WT smoking reduction and cessation in women through influencing the ETPB constructs. It is strongly recommended to design theory-based interventions beyond the individual level with an emphasis on interpersonal relationships to facilitate WT cessation as far as possible.