Childhood Agricultural Safety and Health (CASH) Evaluation of a School-based curriculum: "Work Safe Work Smart"

Childhood Agricultural Safety and Health
Evaluation of a School-Based Agricultural Health & Safety Curriculum:
Work Safe Work Smart


Most adolescents (80%) work at some point during their high school years. Although there are many benefits to this work experience, there is also an increased risk of work-related injury among teens compared to older workers. In addition, in rural areas, youths frequently work in agriculture, one of the most hazardous industries in the U.S. and in Minnesota.

Although educational interventions have frequently been recommended as one approach to reducing work-related health risks to youth, few educational interventions have been developed and evaluated that encompass both agricultural and non-agricultural work hazards. Between 1997 and 2001, the National Institute for Occupational Safety and Health (NIOSH) provided funds to the MDH to develop and pilot test a curriculum that addresses occupational health and safety for rural Minnesota teens (NIOSH Grant R01CCR514360, 1997-2001, “Enhancing Agricultural Safety and Health Through Education”, David Parker, MD, PI; Teresa Hillmer, PhD, Project Director.)
Photo of young girl operating a skid steer

The Work Safe Work Smart curriculum was developed by a broad spectrum of educational and public health professionals and pilot tested in schools in three rural Minnesota counties during the 1999-2000 school year. The Work Safe Work Smart curriculum was designed to enhance adolescent knowledge, attitudes, and beliefs related to occupational health and safety. The curriculum consists of nine lessons that address topics such as agricultural and non-agricultural hazard recognition, injury prevention strategies, child labor laws, and the communication skills needed to discuss agricultural and other work-related safety concerns.

As a result of the successful development and pilot test of the Work Safe Work Smart curriculum, MDH was awarded a second grant from NIOSH during 2000-2004 to scientifically evaluate the effectiveness of the curriculum and its implementation in a diverse sample of rural Minnesota high schools. Another project goal was dissemination of the curriculum.

Evaluation Methods

In this project, a group-randomized study design was utilized. Schools from rural Minnesota counties were randomly selected from each of four agricultural regions and from each of three school sizes. Comparable schools from each category that agreed to participate were then randomly selected to teach the curriculum (an “intervention” school) or not teach the curriculum (“control” school). All participating schools administered three questionnaires to students, including one pre-test and two post-tests. These questionnaires were designed to evaluate seven outcomes that are likely predictors of future preventative behaviors: knowledge, intent, perceived benefits, perceived barriers, perceived susceptibility, perceived severity, and self-efficacy. Intervention schools were allowed to select classes and the grade (9th, 10th, or 11th) for teaching the curriculum.

Following recruitment and teacher training, 18 intervention schools (2,183 students) and 20 control schools (2,568 students) agreed to participate in the evaluation. Baseline (pre-test) data was collected in the Fall of 2001, preceding curriculum implementation. Post-test 1 was administered in the spring of 2002 (same school year as the curriculum); post-test 2 was administered in the fall of 2002 (i.e., the following school year).


The curriculum was successfully implemented in the 18 intervention schools, although two schools were not able to complete all nine lessons. Most schools elected to teach the curriculum in health or careers classes during the fall and winter of the 2001-02 school year. At the first post-test (during spring of the same school year in which the curriculum was taught), intervention students showed statistically significant differences on several outcomes compared to control students. Intervention students showed a greater awareness of their risk of workplace injuries (perceived susceptibility), reported a greater insight of potential life altering workplace injuries (perceived severity), and an increased understanding of hazard recognition, labor laws, and workplace injury prevention strategies (increased knowledge). There was limited evidence that intervention students more frequently intended to observe and practice safe work practices (intent) and that they would be less likely to be affected by barriers to safe work practices (perceived barriers).

The findings indicated that the curriculum was more effective among girls, freshmen (9th graders), those with a parental education beyond high school, non-Hispanics, and those students who were less likely to engage in risk-taking behaviors. Surprisingly, there was little evidence that farm residence, previous work history, previous farm work, or previous work injury were associated with greater intervention effectiveness.

At the second post-test (given in the fall of the following school year), one outcome (perceived severity) remained statistically significant. While further research would be needed to determine how best to sustain a longer term impact, one possible approach might be to include various components of the curriculum in different classes over several years.


The findings from this evaluation confirm that the Work Safe Work Smart curriculum can be an effective tool in changing student knowledge, attitudes, and beliefs about occupational health and safety. Such changes are thought to be important predictors of future preventative behaviors. Schools and educators looking for an occupational health and safety curriculum that encompasses both agricultural and non-agricultural hazards may find this curriculum a useful model.

Curriculum Availability

The Work Safe Work Smart curriculum is available without charge for educational use. For a printed copy or CD-ROM, please email workerhealth. The curriculum (whole or in parts) can also be downloaded from this page.

Project Funded By: NIOSH
Project Start: 2000
Project End: 2004
Grant Number: 5R01 OH004220
Principal Investigator and Contact: Allan Williams
Project Director: Cynthia D. Hickman

Occupational Health and Safety

Updated Thursday, June 28, 2012 at 03:12PM