Farm Dinner Theatre
Background & Goal
The health of farmers in the United States is in crisis. The responsibility of producing much of the world’s food rests with the approximately 12 million farm workers whose average age is 58. Many of the current farm operators are lifelong farmers who grew up working on their family farms and who will continue to work until their failing health forces them from their labor. The physical intensity of farming has left this population with a myriad of chronic health issues in excess of that experienced by the general population which include arthritis, hearing loss, hypertension, skin cancer, cataracts, and musculoskeletal disorders. Farmers are also at excessive risk for nonfatal and fatal injuries compared to other occupations, with senior farmers age 50 and over having a fourfold risk of dying from their injuries. As they age, farmers are also at higher risk for suicide. Over 97% of America’s farms are still family owned and operated and are exempt from OSHA regulations; therefore, all attempts to implement health and safety precautions are dependent upon the farm families themselves. The goal of Farm Dinner Theatre is to take real life farm experiences and turn them into plays to raise senior farmers’ awareness of the many health challenges they confront and changes they can make to improve their health and safety.
Dr. Deborah Reed, PhD, MSPH, RN, FAAOHN, FAAN designed Farm Dinner Theatre as a novel and effective method of moving the social norms of farm communities to adopt and embrace behavior changes which improve the health and well-being of older farmers and their families. Farm Dinner Theatre is a partnership between the University of Kentucky’s College of Nursing, the University of Alabama Institute for Social Science, Cooperative Extension programs in Kentucky, Tennessee, and Virginia, and local agricultural communities. Since Dr. Reed understood that senior farmers often resist approaching health care systems, she created Farm Dinner Theatre to be a safe environment where, over a meal and through truthful, humorous stories, members of a local farm community may share conversations about sensitive topics. Each dinner theatre is personalized for the location, with an extension agent enlisting local farmers as the planning group. The planning group supplies the real life stories and topics to be discussed, recruits the farmers to be the readers on stage, and manages the local financial and logistical support. The stories and topics are given to a nurse facilitator who turns them into scripts for three short plays which portray the cultural, physical, and spiritual struggles of farming. The focus of each play is the meaning behind the story, not the acting or choreography. Between each play, the nurse facilitator leads a focused discussion so the audience can reflect on and personalize the story and its consequences. This discussion supports the farmers and their families in verbalizing possible solutions for the challenges identified in the play.
Evidence of Success
At both two weeks and two months after the theatre intervention, telephone interviews are conducted to assess the extent to which participants have thought about, talked about, or done something about the safety and health issues addressed in the plays. An analysis conducted with eight theatre and nine comparison sites (with comparison sites receiving a standard packet of 12 educational materials on the main topic included in the theatre) revealed that the theatre group increased their actions on health and safety more than the comparison group at both the two week period (Theatre- 57%; Comparison -40%) and the two month period (Theatre -60%; Comparison-52%). Moreover, at the two week and two month 24% and 38% of Farm Dinner Theatre attendees, respectively, shared their new knowledge with non-attendees. Ninety-six percent of the participants completed all aspects of the study. Dr. Reed was appointed to serve as Kentucky’s Agriculture Nurse and now works across disciplines to develop and deliver health and safety programs for Kentucky’s 85,000 plus farmers. She administers a Facebook page, AgNURSE (www.facebook.com/Agriculture.nurse) that reaches not only farmers, but health care providers who often do not understand or know about farmers’ health issues.