Absence of conflict of interest.
Citation
Highlights
- The study's objective was to examine the impact of AgrAbility projects on health outcomes.
- The study used a nonexperimental design to compare the quality of life (QOL) scores and independent living and working (ILW) scores between the treatment group and comparison group. Using survey data, the authors conducted statistical models to compare the outcomes between the groups.
- The study found significant relationships between the AgrAbility project and higher QOL scores and higher ILW scores.
- This study receives a low evidence rating. This means we are not confident that the estimated effects are attributable to AgrAbility projects; other factors are likely to have contributed.
Intervention Examined
AgrAbility Projects
Features of the Intervention
Since the 1990s, the U.S. Department of Agriculture and the Institute of Food and Agriculture has funded State or Regional AgrAbility Projects (SRAPs) to help farmers and ranchers with disabilities. The AgrAbility projects were designed to provide education, assistance, and practical solutions to farmers and ranchers with disabilities to advance their quality of life and ability to live and work independently. Components of the AgrAbility projects included: 1) on-site, face-to-face visits by SRAP teams to the individual's workplace and home; 2) assessments to identify changes needed in work practice and in modifications for work, home, and equipment; 3) detailed reports to State Vocational Rehabilitation and other funding sources to help acquire funds for individuals that cannot afford modifications; 4) referrals to other professionals (e.g., education, rehabilitation, behavioral health, legal, etc.) as needed; and 5) ongoing case management (sometimes involving other service providers). The program served adult farmers and ranchers with disabilities in states with SRAP teams. The states included Arkansas, Colorado, Kansas, Maine, North Carolina, Nebraska, Oklahoma, Pennsylvania, Texas, Virginia, Wisconsin, and West Virginia.
Features of the Study
The study used a nonexperimental design to compare the quality of life (QOL) scores and independent living and working (ILW) scores between individuals who received AgrAbility services (treatment group) and individuals who did not receive services (comparison group). The treatment group included farmers and ranchers with disabilities who contacted their state SRAP team about AgrAbility. A researcher recruited the comparison group members by contacting farmers and ranchers with disabilities he knew from states without funded AgrAbility projects and asked for referrals for additional farmers and ranchers with disabilities to contact. The study sample were selected from 27 states and included 325 adult farmers or ranchers with disabilities, with 225 in the treatment group and 100 in the comparison group. In both the treatment and comparison groups, the majority of sample members were male (67% vs. 75%), with a primary disability defined as other (35% vs. 41%). Larger percentages of treatment group members worked full time (59%) relative to the comparison group (25%). The primary data sources were the pre-intervention and post-intervention surveys where participants reported demographic information, QOL scores, and ILW scores. For the treatment group, pre-survey data was collected from February 20, 2007, to December 19, 2014, while post-survey data was collected from January 10, 2008, to January 20, 2016. For the comparison group, pre-survey data was collected from March 20, 2013, to April 29, 2014, while post-survey data was collected from June 4, 2014, to May 29, 2015. Only the comparison group was given an incentive to complete the surveys ($2 bill). The authors conducted statistical models to compare the outcomes of the treatment and comparison groups before and after the intervention.
Findings
Health
- The study found a significant relationship between the AgrAbility project and the quality of life (QOL) scores, with treatment group scores increasing from pre- to post-intervention.
- The study also found a significant relationship between the AgrAbility project and the independent living and working (ILW) scores, with treatment group scores increasing from pre- to post-intervention.
Considerations for Interpreting the Findings
Although the authors accounted for some baseline demographic characteristics between the treatment and comparison groups, they did not account for age or race/ethnicity which is required by the review protocol. The preexisting differences between the groups on these variables—and not the AgrAbility project—could explain the observed differences in outcomes. Therefore, the study is not eligible for a moderate causal evidence rating, the highest rating available for nonexperimental designs.
Causal Evidence Rating
The quality of causal evidence presented in this report is low because the author did not ensure that the groups being compared were similar before the intervention. This means we are not confident that the estimated effects are attributable to AgrAbility project; other factors are likely to have contributed.