What is the role of occupational therapy in Ohio's AgrAbility Program in helping farmers continue to farm?

The purpose of this study was to; 1) identify the issues faced by AgrAbility clients who have a disabling condition or who have experienced an injury, and 2) determine the potential role that occupational therapy can have in the Ohio AgrAbility program in supporting these farmers as they transition back to and/or continue to farm. Individual interviews and property tours were conducted with each participant (n=15). Methods of data collection included completion of a participant questionnaire, individual interviews and a property tour. Interviews were audio recorded, transcribed, and analyzed by three researchers. Photographs of each participant’s property were also collected at the time of the interview session. Three researchers analyzed the data both independently and collectively to establish thematic similarities with further independent study being conducted by the student researcher. Based on the experiences shared with the researcher during this study, twenty common themes were identified as those best suited to describe the experience of farming with a disability as depicted by study participants. These themes included: tradition; meaning/purpose; independence; assistance needed; role change; home grown modifications; finances; different outlook; frustrations; coping; mental health; family/community support; guilt; attitude towards health; disconnect; occupational therapy recommendations; concurrent health problems; assistive devices; AgrAbility services, and consult services. The results of this study found a need for occupational therapy services within the Ohio AgrAbility program. Additionally, it was found that these services would be most beneficial to clients if they were individualized specific to the needs of each client as well as based on and rooted in the ideals of farm culture. The current study aimed to identify the need for occupational therapy services within the Ohio AgrAbility program and to provide input into how therapy services can be effectively integrated into the program. Providing farmers with FARMING WITH A DISABILITY 3 individualized occupational therapy services may be key in helping them to continue to farm and to be active participants in a lifestyle that holds deep meaning and purpose to them. FARMING WITH A DISABILITY 4 What is the Role of Occupational Therapy in Ohio’s AgrAbility Program in Helping Farmers Continue to Farm? The purpose of this study was to determine the role of occupational therapy within the Ohio AgrAbility program. Occupational therapists play a pivotal role in helping their clients return to the occupations they find meaningful and purposeful after sustaining an injury that results in a limitation. Providing farmers with individualized occupational therapy services may be key in helping them to successfully return to farming. Before describing the current study, relevant information is provided describing the incidence of disability among farmers, features of the AgrAbility program, and how occupational therapists have been involved in helping farmers thus far. The current study will then be introduced. Prevalence of Disabled Farmers Thirteen million rural Americans are affected by chronic or temporary disabilities (Willkomm, 2004). Specifically, it is estimated that between 1.04 million to 2.23 million rural agricultural workers in the U.S. have a disability that impacts their ability to successfully perform their daily occupations (Deboy, Jones, Field, Metcalf, & Tormoehlen, 2008). The high incidence of injury among agricultural workers comes as no surprise as The National Safety Council lists agriculture as one of the three most hazardous professions (Field & Jones, 2006). The National Institute for Occupational Safety and Health estimates that injury to agricultural workers is at a rate of 500 per day with 5% of such injuries resulting in a permanent disability (Field & Jones, 2006). Employing 1 in 6 workers in Ohio, agriculture is the states’ largest industry (AgrAbility, 2010). With 77,000 farms, of which 91% are family-owned and operated, Ohio is a national leader in the production of corn, soybeans, hogs, chickens, eggs, and pumpkins (AgrAbility, FARMING WITH A DISABILITY 5 2010). With so many farms, the number of farmers affected by disability within the state is high as 1 out of every 14 Ohio families experience an injury related to farming each year (McGuire, 2011). Of these injuries, it is estimated that 69% are farming operations related (McGuire, 2011). With such high rates of injury, the United States Department of Agriculture (USDA) recognized the need for a program aimed at helping prevent farm-related injuries and assisting those farmers who had already sustained an injury; thus, the AgrAbility program was created in 1990. History of AgrAbility AgrAbility was created as a component of the 1990 Farm Bill as a means of providing much needed assistance to agricultural workers who were disabled and their families (Willkomm, 2004). The National AgrAbility Project currently operates in 22 states as a partnership between the United States Department of Agriculture (USDA) Cooperative Extension System and privately funded nonprofit service organizations (Willkomm, 2004). According to Willkomm (2004) AgrAbility has provided services to more than 11,000 farmers nationally since its creation. Services provided by AgrAbility include farm-site assessments, home modifications, secondary injury prevention, education, peer support groups, and training for rural professionals. The populations served vary widely from those with orthopedic related disabilities to those with neuromuscular disorders such as cerebral palsy and muscular dystrophy. In 2009, Ohio was awarded its second four-year grant to assist farmers throughout the state with special interests in peer support and universal design (AgrAbility, 2010). The Ohio AgrAbility program exists as a partnership between The Ohio State University Extension and the Easter Seals organization. The clients AgrAbility serve in Ohio are diverse with the majority of family farms being multigenerational and multicultural with large communities of Amish and migrant workers (McGuire, 2011). With the average Ohio farmer being 57 years old, most FARMING WITH A DISABILITY 6 farmers within the state face the challenges of being an aging farmer as he or she experiences a decrease in reaction time, decreased balance, hearing impairment, and vision deficits (McGuire, 2011). The farming environment in Ohio is also unique as ownership of acreage is large, workdays are long, and the weather is a constant concern (McGuire, 2011). Similarly to the national project, the Ohio program serves clients with a wide range of disabilities from amputation to respiratory impairment (McGuire, 2011). No cost services provided by the Ohio AgrAbility program include on-site assessments and technical assistance, peer-to-peer support, referral information, training, and public awareness. Ohio AgrAbility’s knowledge of the unique challenges faced by disabled farmers within the state and their ability to provide a wide variety of assistance make the program a lifeline for farmers who are facing a disability and want to continue their agricultural lifestyle.