***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The objective of this study was to determine the effects of an Injury and Illness Prevention ( IIP ) program intervention on occupational safety behavior  among rice farmers in Nakhon Nayok Province , Thail and . This was a quasi-experimental study in an intervention group and a control group . It was carried out in two rice farming communities , in which most people are rice farmers with similar socio-demographic characteristics . Multistage sampling was employed , selecting one person per rice farming household . The intervention group was 62 r and omly selected rice farmers living in a rural area ; another 55 rice farmers served as the control group . A structured face-to-face interview question naire was administered to participants to evaluate their safety behaviors in four areas : equipment use , pesticide use , ergonomics , and working conditions . The 2-week intervention program consisted of four elements : 1 ) health education , 2 ) safety inspection , 3 ) safety communication , and 4 ) health surveillance . Data were collected at baseline and 4 months after the intervention ( follow-up ) . We used a general linear model repeated- measures analysis of variance to assess the mean difference between baseline and follow-up occupational safety behavior points between the intervention and control groups . Pesticide safety behaviors significantly increased in the intervention group compared with the control group . Ergonomics and working conditions points also increased in the intervention group , but not significantly so . The equipment use score decreased in the intervention group . It is necessary to identify and develop further measures to improve occupational safety behaviors . Some methods , such as effective risk communication , could be added to increase risk perception BACKGROUND Health literacy is an emerging focus of interest in public health and is evolving as an important component of national health policy . Low health literacy ( LHL ) is associated with poor outcomes . We aim ed to identify factors associated with LHL and its relationship with health outcomes in trauma patients . METHODS We prospect ively enrolled all adult trauma patients ( age , > 18 years ) in our analysis . Patients were surveyed at discharge and followed up at 4 weeks postdischarge . At discharge , patient ’s health literacy was assessed using the  Short- Assessment of Health Literacy score  . Low health literacy was defined as Short- Assessment of Health Literacy score less than 14 . Patients were surveyed regarding their underst and ing of their injuries , treatment received , discharge instructions , and interaction with the physician . Four weeks postdischarge , all patients were inquired about clinic follow-up details and recovery . RESULTS We enrolled 140 patients , of which 70 % were white . Mean age was 45 ± 20 years , and median Injury Severity Score was 10 ( 6–12 ) . Overall , 24 % ( 34 ) patients had LHL . There was no difference in the Injury Severity Score between LHL and health literate ( HL ) patients ( p = 0.41 ) . The LHL patients were more likely to be Hispanic-white ( 78 % vs. 41 % , p = 0.02 ) , had lower socioeconomic status ( 91 % vs. 51 % , p = 0.01 ) , uninsured ( 45 % vs. 18 % , p = 0.01 ) , and were less likely to have graduated ( 0 % vs. 49 % , p = 0.01 ) compared with the HL patients . At discharge , both groups were satisfied with the time spent by a physician to explain the condition , however , the LHL patients were less likely to recall their injuries ( p = 0.03 ) or how they were treated ( p = 0.01 ) . Patients with LHL had lower follow-up rates ( p = 0.01 ) with no difference in the readmission rate ( p = 0.71 ) compared with HL . CONCLUSION Every 1 in 4 trauma patients have LHL . Low health literacy is associated with poor underst and ing of injuries and treatment provided to them , leading to a decrease in compliance with discharge instructions and longer time to recovery . Identifying LHL in high-risk patients and developing appropriate intervention before discharge may help improve outcomes . LEVEL OF EVIDENCE Prognostic study , level The emergence and spread of Highly Pathogenic Avian Influenza H5N1 has caused substantial poultry-related economic losses and public health concerns in relation to a potential p and emic . While biosecurity measures for commercial poultry industry are of the highest st and ards , these measures are difficult to implement and often unaffordable for backyard poultry farming , particularly in tropical and low-income setting s. We design ed a feasible biosecurity intervention to improve flock hygiene in Cambodia , - based on community hygiene , cleaning of poultry flock areas and human and poultry movement control . We conducted a cluster r and omized and controlled intervention trial in 18 villages in Takeo province to evaluate improvements in biosecurity-related knowledge and practice s. The intervention relied on community involvement and community education using special information dissemination tools . We trained village teams ( VT ) to assist villagers in implementing the intervention using a cascade training approach , in which a few individuals were trained , who in turn trained a larger group of people . During the 14 month follow up , we conducted observational and interview-based surveys ( baseline vs. final surveys , VT supervision visits , monitoring surveys ) to assess VTs ' motivation , intervention messages dissemination and the implementation of recommended measures . Most of villagers ( 95 % , confidence interval : 87.8 - 100.0 % ) in intervention villages received general information about how to raise poultry . Farmers in intervention villages reported to have made more changes ( ≥1 biosecurity related practice during the study period ) compared with that of control villages ( 70.0 % ( 260/372 ) vs. 22.6 % ( 85/377 ) , p value<0.01 ) . When observing biosecurity-related practice s in intervention villages , overall scores increased significantly ( p<0.05 ) . Practice s such as use of quarantine cages for new and sick birds , limitation of people movement in backyards and waste management reached high scores during the 15-months period within five of the nine intervention villages . Cascade training managed to reach out to almost all villagers and significantly influence changes in biosecurity practice s in the community . However , further follow-ups are needed to assess whether practice s-related changes persist over a longer period of time The large-scale use of agrochemicals has raised environmental and human health concerns . A comprehensive intervention strategy for improving agrochemical safety among rice farmers in Thail and is lacking . The objective of this study is to develop a model in order to improve farmers ’ health and prevent them from being exposed to agrochemical hazards , in addition to evaluating the effectiveness of the intervention in terms of agrochemical safety . This study was conducted between October 2009 and January 2011 . It measures changes in the mean scores of agrochemical knowledge , health beliefs , agrochemical use behaviors , and in-home pesticide safety . Knowledge of agrochemical use constitutes a basic knowledge of agrochemicals and agrochemical safety behaviors . Health beliefs constitute perceived susceptibility , severity , benefits , and barriers to using agrochemicals . Agrochemical use behaviors include self-care practice s in terms of personal health at specific times including before spraying , while spraying , during storage , transportation , waste management , and health risk management . Fifty rice farmers from Khlong Seven Community ( study group ) and 51 rice farmers from Bueng Ka Sam community ( control group ) were r and omly recruited with support from community leaders . The participants were involved in a combination of home visits ( ie , pesticide safety assessment s at home ) and community participatory activities regarding agrochemical safety . This study reveals that health risk behaviors regarding agrochemical exposure in the study area are mainly caused by lack of attention to safety pre caution s and the use of faulty protective gear . After 6 months , the intervention program showed significant improvements in the overall scores on knowledge , beliefs , behaviors , and home pesticide safety in the study group ( P < 0.05 ) . Therefore , this intervention model is effective in improving agrochemical safety behaviors among Khlong Seven Community rice farmers . These findings demonstrate that a multi-approach model for improving agrochemical safety behaviors can lead to sustainable prevention of agrochemical hazards for farmers A culturally appropriate educational intervention was developed and directed towards farming families in Menoufia governorate , Egypt , to improve their knowledge and practice s in protecting their children from exposure to pesticides . Parents were r and omly assigned to either a lecture or videotape training group .  Ability to recall information or improve practice s among parents was evaluated in 3 sessions : pretraining and 2 weeks and 1 month after training . Knowledge and practice scores after training of younger and more educated participants were significantly higher than older , less educated participants . Knowledge and practice performance of the videotape group was better than the lecture group and in both groups the improvement of knowledge scores after training was significantly higher than that of practice scores Limited research has explored pesticide injury prevention among American Indian farmers . In a five-year agricultural intervention , a university-community partnership , including the University of New Mexico School of Medicine , New Mexico State University , Shiprock Area Cooperative Extension Service , and Navajo Nation communities , used a culturally relevant model to introduce and maintain safe use of integrated pest management techniques . We applied the Diffusion of Innovations theory and community-based approaches to tailor health promotion strategies for our intervention . In a longitudinal study with repeated measures , we trained six " model farmers " to be crop management experts in pesticide safety , application , and control . Subsequently , these model farmers worked with 120 farm families r and omized into two groups : intervention ( Group 1 ) and delayed intervention ( Group 2 ) . Measurements included a walk-through analysis , test of knowledge and attitudes , and yield analysis . Both groups demonstrated improvements in pesticide storage behaviors after training . Test scores regarding safety practice s improved significantly : from 57.3 to 72.4 for Group 1 and from 52.6 to 76.3 for Group 2 . Group 1 maintained their knowledge and safety practice s after the intervention . Attitudes about pesticides and communication of viewpoints changed across the study years . With pesticides and fertilizer , the number of corn ears increased by 56.3 % and yield ( kg m(-2 ) ) of alfalfa increased by 41.2 % . The study combined traditional farming practice s with culturally relevant approaches and behavior change theory to affect knowledge , safety practice s , attitudes , communication channels , and crop yield . Storage behaviors , use of pesticides and safety and application equipment , and safety practice knowledge changed significantly , as did attitudes about social networking , social support , and the compatibility and relative advantage of pesticides for farms Allergic occupational asthma is frequent in farming population s. As educational interventions can improve disease management , the short-term effect of an educational intervention in asthmatic farmers was evaluated on the basis of spirometric indices and exhaled nitric oxide fraction ( FeNO ) .  Farmers with occupational asthma ( n = 81 ) , mostly sensitised against cow d and er and storage mites , participated in a 1-day educational programme . Outcome measures were assessed at baseline and after 4–6 weeks , using FeNO , lung function and a question naire . Results were compared with those of a control group without intervention ( n = 24 ) . In the educational group , the proportion of subjects reporting work-related symptoms was reduced after the intervention . The FeNO decreased from a geometric mean of 28.2 to 25.7 ppb , and , in subjects with an elevated ( > 35 ppb ) baseline FeNO ( n = 32 ) , from 59.7 to 49.2 ppb . The corresponding changes in the control group were 25.6 versus 27.7 ppb and 49.5 versus 48.1 ppb . Spirometric results were unaltered in the two groups . Thus exhaled nitric oxide fraction , a marker of allergic airway inflammation , indicated a beneficial effect of a short-term educational intervention in farmers with occupational asthma . This suggests a potential for exhaled nitric oxide fraction in assessing the efficacy of preventive measures within a short time with higher sensitivity than spirometry PURPOSE Farm youth continue to experience high rates of injury and deaths as a result of agricultural activities . Farm machinery , especially tractors , is the most common cause of casualties to youth . A Roll-Over Protection Structure ( ROPS ) along with a fastened seatbelt can prevent almost all injuries and fatalities from tractor overturns . Despite this knowledge , the use of seatbelts by farmers on ROPS tractors remains low . This study treats farm safety as a family issue and builds on the central role of parents as teachers and role models of farm safety for youth . METHODS This research study used a longitudinal , repeated- measures , r and omized-control design in which youth 10 - 19 years of age were r and omly assigned to either of two intervention groups ( parent-led group and staff-led group ) or the control group . RESULTS Fathers in the parent-led group were less likely to operate ROPS tractors without a seatbelt compared with other groups . They were more likely to have communicated with youth about the importance of wearing seatbelts on ROPS tractors . Consequently , youth in the parent-led group were less likely to operate a ROPS tractor without a seatbelt than the control group at post-test . CONCLUSIONS This r and omized control trial supports the effectiveness of a home-based , father-led farm safety intervention as a promising strategy for reducing youth as well as father-unsafe behaviors ( related to tractor seatbelts ) on the farm . This intervention appealed to fathers ' strong motivation to practice tractor safety for the sake of their youth . Involving fathers helped change both father as well as youth unsafe tractor-seatbelt behaviors We conducted a r and omised community controlled trial to estimate the effectiveness of health and pig-management education intervention in reducing the incidence rate of porcine cysticercosis caused by Taenia solium in Mbulu District , northern Tanzania , between April 2002 and July 2004 . We included a r and om sample of 827 pig-keeping households from  
    Output:
    
Interventions that used evidence -based theories , which took into account cultural aspects and individual factors , used biomarkers as a behavior change measurement , and involved the community in the development of the intervention had the best results in terms of behavior change .