Promoting Independence in Agriculture AANTWPeerSupport10.3107 (Rev. 10.1807b) AgrAbility NTW Peer Support Update Sacramento, CA 3:45-5:30 October 31, 2007

Promoting Independence in Agriculture

AANTWPeerSupport10.3107 (Rev. 10.1807b)

AgrAbility NTW Peer Support UpdateSacramento, CA3:45-5:30 October 31, 2007

By Robert J. Fetsch, Extension Specialist

& Director, Colorado AgrAbility Project,

Human Development & Family Studies

Colorado State University


In Last Year’s EvaluationsYou Asked for…

• Have an update on State’s programs.

• More information on the “assessment” of possible peer supporters.

• New data acquired.

• Dr. Fetsch’s raw or analyzed data.


More Information on Our “Assessments.”

• One of our successes was the Detailed Screening Process we used to find people who are ready.

• Cf. Denial-Acceptance Continuum.

• Cf. Telephone Interview protocol.


Available Resources• Fact Sheet: Peer Support• Checklist• Denial-Acceptance Continuum• Dear John Doe Letter• Telephone Script to Screen Farmers/Ranchers

Who Are Ready.• Telephone Script to Screen Caregivers Who

Are Ready


Three Trainings

• AANNPST—7 CO farmers, ranchers, & caregivers 7/15/04 Denver, CO

• AANNPST TtT—19 AgrAbility staff 5/10-11/05 Kansas City, KS

• AgrAbility Peer Advocate Training—7-9 OK farmers & ranchers 4/18-19/06 Stillwater, OK


Program Changes

• From 8 hours on 1 day to 4 hours (PM) plus overnight plus 4 hours (AM).


Successes

• We delivered 3 trainings.

• We have empirical results and an article on peer support training with farmers and ranchers with disabilities and with comparisons to population norms and with pretest-posttest changes.


Brief Review of the Literature

• Four peer support studies were found with experimental-control designs.

• Training ranged from 2.5 hours to day-long training.

• No studies reported successes with farmers/ranchers with disabilities.



• Peer support literature is long on theory and short on empirical impacts.

• Four peer support studies were found with experimental-control designs.– 206 first-time mothers in peer support decided to

breastfeed earlier and continue longer.– 42 new mothers identified as high risk for post-

partum depression reduced depressive symptoms.



• Four peer support studies were found with experimental-control designs.– 115 primary caregivers of individuals with

Alzheimer’s decreased depression symptoms.– 136 individuals with Multiple Sclerosis became

more realistic, made negative appraisal of one’s abilities, reduced self-efficacy, increased use of blaming coping strategies, and increased external locus of control.



• Peer support theory hypothesizes improvements in social skills, optimism, goal achievement, problem solving, acceptance of disability,and reductions in denial, withdrawal, stress, depression, anger and blame, reassessment and reaffirmation, coping, self-esteem, hope, and optimism.


Measures Used in the Colorado Study

• Acceptance of Disability Scale• McGill Quality of Life Questionnaire• Problem Solving Inventory• CES-D (Depression) Scale• Hostility Scale• State-Trait Anger Expression Inventory• Overview of chronic pain, stress, anger, depression,

self-esteem, and perception of financial situation, and demographics.


Results

• Immediate anecdotal feedback was quite positive. Participants were:– Excited, enthusiastic– Appreciated “normalizing” their experience– Gave rave reviews about learning the 7 skills to

provide effective peer support

• What were post-test (8 weeks later) to follow-up (6 months later) changes?

0

1

2

3

4

5

6

7

8

9

10

K nowledge R apport L is tening P roblemS olving

P re-test

P ost-test

Posttest-Followup Skill Levels of Colorado AgrAbility Peer Support Participants (n = 7; n = 3)

0

1

2

3

4

5

6

7

8

9

S potting S igns Making R eferrals P rovidingE ffective P eer

S upport

P re-test

P ost-test

Posttest-Followup Skill Levels of Colorado AgrAbility Peer Support Participants (n = 7; n = 3)


Results

• How similar/different was our sample from population means?

Comparison of Colorado Group Mean Scores (N = 7)with Those of Non-Agricultural Populations (N = 1,266; 654)

(p < .05)

Comparison of Colorado Group Mean Scores (N = 6-7)with Those of Non-Agricultural Populations (N = 143)

(p < .05)

Comparison of Colorado Group Mean Scores (N = 6-7)with Those of Non-Agricultural Populations (N = 143)

(p < .05)

Comparison of Colorado Group Mean Scores (N = 3)with Those of Non-Agricultural Populations (N = 498)

(p < .05)

Comparison of Colorado Group Mean Scores (N = 3)with Those of Non-Agricultural Populations (N = 1,182; 1,182; 498) (p <

.05)


Results

• CAP’s small group mean scores were significantly better than the population mean scores on:– Self-esteem levels– State Hope levels– McGill Quality of Life levels


Results

• CAP’s females scored significantly higher than the population on:– Problem solving confidence levels– State Anger– Trait Anger– Anger In


Results

• What were pre-test to post-test changes?• None of the pretest-posttest group

differences were statistically significantly different.

• Hostility levels fell at a level that approached statistical significance (Pretest M = 10.29; Posttest M = 9.29, p = .086).


Conclusions

• It is striking that the present sample scored significantly higher on so many indicators of health well being.

• The findings speak well of the good work that our farmers, ranchers, and caregivers did on their own over the years to deal well with denial, anger, blame, depression and unfinished business related to their acquired disabilities & conditions.


Conclusions

• The findings attest to the strength, stamina, hard work, and resilience of our peer support advocates.

• The findings verify the effectiveness of the screening technique CAP used to identify ranchers, farmers, and caregivers who were ready.


Recommendations

• For all of us:– Continue screening well to select those

who have accepted their disabilities and who experience joy of life.

– Be vigilant and tune in to signs of high denial, anger, depression, and suicidal thinking and refer to appropriate professionals.


Recommendations

• For those of us who continue to offer 8 hours of training:– We invite you to use our pre-post surveys

to replicate the CAP study so we can compare apples with apples.

– E-mail me ([email protected]) or call me (970-491-5648) for copies.


Recommendations

• For those of us who want to achieve better pre-post survey results:– Consider using CAP’s pre-post-follow-up

surveys to assess your results.– Offer two full days of training over a 2-4

week period.


Recommendations

• For those of us who want to achieve better pre-post survey results:– Incorporate multi-component training that includes

AANNPST Curriculum, experiential learning and practice of problem solving, management of stress, depression, anger, hostility, and enhancement of self-esteem and practice ways of enhancing hope levels.


Conclusions

• This empirical study with ranchers and farmers with disabilities:– Identifies ranchers/farmers’ strengths and

resilience.– Provides affirmation to ranch/farm families

who are second only to non-construction laborers in disability rates and work-related death rates.


Conclusions

• This empirical study with ranchers and farmers with disabilities:– Provides empirical evidence that CAP’s

sample was able to bounce back.– Provides hope that others with acquired

disabilities can grow stronger in hope, self-esteem and quality of life.


Conclusions

• This empirical study with ranchers and farmers with disabilities:– Encouragement to farm/ranch caregivers

that they too can improve their anger management and problem solving confidence skills.


Challenges

• Getting farmers/ranchers with disabilities to call our peer support advocates.


Next Steps• We hired a skilled MFT graduate student to

promote Peer support.• She is beginning to make 1:1 calls to all 6 of

our peer support advocates to check in and assess their training needs.

• She and I are considering offering a 1.5-2.0 day training.

• We’re working with KS, OK, NE, WY, and others of you who are interested?


From previous research,what do we not know?

• Whether 2 day peer support trainings are effective with groups of farmers/ranchers with disabilities and caregivers.

• CO is poised to find out!

• Won’t you join us?


Thank you very much!

Documents

Promoting Independence in Agriculture AANTWPeerSupport10.3107 (Rev. 10.1807b) AgrAbility NTW Peer Support Update Sacramento, CA 3:45-5:30 October 31, 2007