The Use of eLearning to Enhance Access to Preventative - - PowerPoint PPT Presentation

The Use of eLearning to Enhance Access to Preventative Musculoskeletal Health Education for Individuals Involved in Agricultural Work

Emily Bogen, SPT, ATC, Jackson Faught, SPT, Santiago Patiño, SPT, Grace Pulsifer, SPT, and Maggie Stewart, SPT Faculty Advisor: John Carzoli, PT, DPT, OCS

Project Funding

• agricultural-health-and-injury-prevention-scahip.html

Funding for much of this project was provided by a grant made possible by:

• Southeast Center for Agricultural

Health and Injury Prevention (SCAHIP) at University of Kentucky

• National Institute for Occupational

Safety and Health (NIOSH)

• Centers for Disease Control and

Prevention (CDC)

Background

• Migrant and seasonal agricultural workers (MSAW) are

individuals who either move from place to place to work as seasons change or temporarily work during a specific season but have a permanent residence ○ MSAW ofuen leave their families behind or travel with their families from site to site for work and financial opportunities

• Farm work is consistently ranked among the most dangerous
• ccupations in the United States1

○ They are at increased risk for developing musculoskeletal (MSK) symptoms and injuries due to repetitive, physically demanding tasks2-4

MSAW Demographics5 Barriers to Access6

• More than 3 million live in the U.S.
• 72% of all farm workers are foreign

born

• 70% cannot speak English well
• Average level of completed

education is 8th grade

• 23% have total family incomes

below the U.S. poverty level (family of 4 - $24,600)

• 5-8% covered by

employer-provided health insurance

• Limited financial resources

and health insurance

• Limited English language

proficiency

• Low general literacy and

health literacy levels

• Limited transportation
• Extensive work hours

MCN Migrant Clinicians Network NCFHP North Carolina Farmworker Health Program

Levels of Agricultural Healthcare and Health Education

Vecinos CHW Community Health Workers

MSAW

Only 29% of MSAW in western NC receive occupational training for MSK injury risk reduction!7

Identification of MSAW MSK conditions; incidence and prevalence based

• n MSK survey and

screen Face-to-Face (FtF) education for CHWs on MSK conditions and prevention in agriculture Evidence-based video series developed for CHWs delivered by NCFHP website Hybrid learning of video-based education for MSAW FtF Reassessment of dissemination strategies to increase access to educational materials

2012- 2014 2017

Efficacy of FtF education among MSAW regarding MSK conditions

2018 2019 2015 2016

Educational Materials

• English video for CHW: 2016-20178

○ Piloted evidence-based video series with 30 participants ○ Results: positive knowledge retention and perceptions of learning with video-based format

• Spanish video for MSAW: 2017-20189

○ Development of evidence-based video (per NCFHP request) using hybrid delivery method among 28 participants ○ Results: positive knowledge retention and perceptions of learning and mode of delivery

Community-engaged assessment with multiple stakeholders involved in MSAW health Research question: Can eLearning be used to effectively disseminate health education resources? Literature review on eLearning in various populations Grant application resulted in funding for use of Learning Management Systems (LMS) LMS research → Moodle; website & course instructional design development Dissemination of materials via various local, state, and national partnerships

2018- 2019

Aims of Current Project

1. To improve access to educational materials related to MSK injury risk reduction associated with agricultural work via electronic learning (eLearning) series 2. Assess the eLearning series on the following factors: ○ Learning outcomes ○ Perceptions of content and delivery mode

eLearning

• eLearning is the integration of electronic technology, including media

and devices, in the delivery of education10 ○ May include both synchronous (FtF or remote) and asynchronous strategies

• May be an effective method for wide dissemination of education to

individuals involved in agricultural work10-12 ○ Easily accessible ○ High value (outcomes/cost of delivery)10

Literature Review

• Majority of research on eLearning has been conducted in higher

education settings ○ Evidence of eLearning being at least as effective as traditional FtF education10-12 ○ May be a convenient and cost-effective strategy for delivering health education11

Literature Review

• Limited research available regarding efficacy of health

education via eLearning in lay populations ○ Video-based vs pamphlet-based delivery resulted in:13 ■ Higher improvements in knowledge retention ■ Greater adherence to positive health habits ○ eLearning used with in both average and lower literacy populations resulted in positive perceptions of learning and mode of delivery13,14

Targeted Populations

English Series Topics

1. Introduction to Musculoskeletal Health in Agricultural Workers 2. Physical Risk Factors in Agricultural Work 3. Protective Factors: Strategies to Reduce Risk 4. Screening and Basic First Aid 5. Review

Spanish Series Topics

• Topics

○ Physical risk factors for musculoskeletal conditions ○ Optimal movement and work task performance ○ Personal preventative measures and self-care

• Culturally and linguistically appropriate and relevant

○ Narrated by native Spanish speaker ○ Emphasis on importance of peer-to-peer learning ○ Addition of humor to enhance learner engagement

Learning Management System (LMS)

• Medium for delivering our resources while simultaneously tracking

access, usage, and other learning analytics

• Extensive process for choosing an LMS for dissemination and

sustainability

• Receival of grant → Moodle (an open-source LMS)
• Contracted eLearning Experts (Moodle partner) to assist with

webpage and courses design in LMS

• Videos hosted in Panopto to track participant usage data

https://farmworker.expertlearning.net/

Plan for Dissemination

• Compilation of local, state, and national partners
• Networking for assistance with distribution of materials

○ Migrant Clinicians Network (national), North Carolina Farmworker Health Program, NC Agromedicine Institute, Vecinos

• Participant recruitment via above networking, email list, marketing

○ Partnership with WCU Marketing team ■ Facebook targeting ■ Email with attached flyer

Data Collection Plans

• Primary analyses:

○ Learning Outcomes ■ Knowledge retention ■ Changes in confidence & self-efficacy ○ Access ■ # of course participants ■ Completion rate ○ Participant Perceptions ■ Course content ■ Mode of delivery

Future Research

• Optimal combinations of

synchronous and asynchronous delivery for learning and participation outcomes

• Iterations afuer improvements to

content/delivery based on outcome data & stakeholder feedback

https://i.pinimg.com/originals/92/9b/27/929b27200bc926a0e6c7728a865f855a.jpg

Acknowledgments

Previous WCU DPT Classes and Project Advisors Vecinos HHS IT Services WCU Marketing & Creative Writing Department The Migrant Clinicians Network North Carolina Farmworker Health Program North Carolina Agromedicine Institute

• Dr. John Carzoli, PT, DPT, OCS

References

1. About us. North Carolina Farmworker Health Program. https://www.ncfhp.org/about-us/. Accessed March 28, 2019. 2. Da Costa BR, Vieira ER. Risk factors for work-related musculoskeletal disorders: A systematic review of recent longitudinal

• studies. Am J Ind Med. 2010;53(3):285-323. doi:10.1002/ajim.20750.

3. Garg A, Hegmann KT, Moore JS, Kapellusch J, Thiese MS, Boda S, et al. Study protocol title: a prospective cohort study of low back pain. BMC Musculoskeletal Disord. 2013;14(84). doi:10.1186/1471-2472-14-84. 4. Plamondon A, Delisle A, Bellefeuille S, Denis D, Gagnon D, Larivière C. Lifuing strategies of expert and novice workers during a repetitive palletizing task. Appl Ergon. 2014;45(3):471-81. doi: 10.1016/j.apergo.2013.06.008. 5. Farmworker health fact sheet. National Center for Farmworker Health. http://www.ncfh.org/uploads/3/8/6/8/38685499/fs-migrant_demographics.pdf. Published September 2012. Accessed March 28, 2019. 6. Facts About North Carolina Farmworkers. https://www.ncchurches.org/2012/10/facts-about-north-carolina-farmworkers-2/. Accessed August 22, 2016. 7. Carzoli, J.A., Lunnen, K., George, M., Goforth, M., Marion, J., Trott, C. (2015). Incidence and Prevalence of Musculoskeletal Symptoms Related to Specific Functional Movements and Work Tasks in Migrant Farmworkers Involved in Strawberry Production in Western North Carolina. APTA 2015 NEXT conference. 8. Carzoli J, Assad Z, Hardin L, Hyatt D, Mulzer K, Setzer L, Spencer S, Won A. A Training Program for Health Outreach Workers to Enhance Musculoskeletal Health in Migrant and Seasonal Agricultural Workers in North Carolina. 2017 WCU Gradute Research Symposium. 9. Carzoli, J, Bryan T, Icenhour S, Lippard, L, Parmenter, B, Sivley, K, Zaruba, M. Cultivating Musculoskeletal Health in Farmworkers through Video-Based Teaching and Learning. 2018 WCU Graduate Research Symposium.

References

10. Al-Shorbaji, N, Atun, R, Car, J, Majeed, A, Wheeler, E. eLearning for undergraduate health professional education: A systematic review informing a radical transformation of health workforce development. World Health Organization. 2015. Accessed at: http://www.who.int/hrh/documents/14126-eLearningReport.pdf 11. Nyugen, T. The Effectiveness of Online Learning: Beyond No Significant Difference and Future Horizons. MERLOT Journal of Online Learning and Teaching. 2015;11(2), 309-319. 12. Stack, S. Learning Outcomes in an online vs traditional course. International Journal for the Scholarship of Teaching and

• Learning. 2015; 9(1), 1-18.

13. Armstrong A, Idriss N, Kim R. Effects of video-based, online education on behavioral and knowledge outcomes in sunscreen use: A randomized controlled trial. Patient Educ Couns. 2011; 83(2): 273-277. doi: 10.1016/j.pec.2010.04.033. 14. Bello-Bravo J, Dannon E, Agunbiade T, Tamo M, Pittendrigh BR. The Prospect of Animated Videos in Agriculture and Health: A Case Study in Benin. IJEDICT. 2013;9(3):4-16.

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