College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand.
Risk Manag Healthc Policy. 2013 Sep 20;6:33-41. doi: 10.2147/RMHP.S50409. eCollection 2013.
An intervention to reduce insecticide exposure in Shogun orange farmers was implemented in Krabi Province, Thailand. Intervention effects on insecticide-related knowledge and attitude were evaluated in a quasi-experimental study in two farms about 20 kilometers (km) apart. The intervention was conducted at one farm; the other served as control. The study included 42 and 50 farmers at the intervention and control farms, respectively. The intervention included several components, including didactic instruction, practical demonstrations, use of a fluorescent tracer, and continuing guidance on insecticide use via a small, specially trained group within the overall intervention group. To the best of our knowledge, this was the first such intervention in Thailand. Knowledge and attitude were measured at baseline (pre-intervention), and at 2 and 5 months after the intervention (follow-up 1 and follow-up 2, respectively). Intervention effects were assessed with linear mixed models, specified to enable testing of effects at each follow-up time. The intervention was associated with substantial and statistically significant improvements in both knowledge score and attitude score (P < 0.001 for each score at each follow-up time). Intervention-related improvements in knowledge score and attitude score were equivalent to about 27% and 14% of baseline mean knowledge and attitude scores, respectively. Intervention-related benefits were similar at both follow-up times. Findings were similar before and after adjustment for covariates. These findings increase confidence that well-designed interventions can reduce farmers' insecticide exposure in Thailand and elsewhere. In future research, it would be desirable to address long-term intervention effects on farmers' health and quality of life.
在泰国甲米府实施了一项减少沙果橙种植户接触杀虫剂的干预措施。在一项距离约 20 公里的两个农场进行的准实验研究中，评估了干预措施对与杀虫剂相关的知识和态度的影响。干预措施在一个农场进行，另一个农场作为对照。该研究包括 42 名和 50 名分别来自干预和对照农场的农民。干预措施包括几个组成部分，包括教学指导、实际演示、使用荧光示踪剂以及通过一个小的、专门训练的小组在整个干预组内持续提供有关杀虫剂使用的指导。据我们所知，这是泰国首例此类干预措施。在基线（干预前）以及干预后 2 个月和 5 个月（随访 1 和随访 2）时测量了知识和态度。使用线性混合模型评估干预效果，该模型指定了在每个随访时间进行效果测试。干预措施与知识评分和态度评分均有显著和统计学意义的提高有关（每个随访时间的每个评分均 P<0.001）。知识评分和态度评分的干预相关改善相当于基线平均知识和态度评分的约 27%和 14%。干预相关的益处在两个随访时间相似。在调整协变量前后，结果均相似。这些发现增加了信心，即精心设计的干预措施可以减少泰国和其他地方农民接触杀虫剂的情况。在未来的研究中，最好解决长期干预对农民健康和生活质量的影响。
