Iran Occupational Health Journal

fa بررسی متغیرهای اثرگذار بر پیش‌بینی رفتار ایمنی کشاورزان، بر اساس مدل تلفیقی رفتار برنامه‌ریزی‌شده و تئوری اعتقاد بهداشتی Pesticides, Health Risk Behaviors, Farmers, Social determinants of health. کاربرد الگوهای تغییر رفتار Aplication of Behavior\'s change models پژوهشي Research زمینه و هدف: در طی سال&lrm;های اخیر، رشد علف&rlm;های هرز و افزایش مقاومت آفات سیب&rlm;زمینی (Solanum tuberosum L) نسبت به سموم شیمیایی، در دشت اردبیل قابل توجه بوده است. از آنجا که قالب کشاورزان سیب&rlm;زمینی&rlm;کار در منطقه، خرده مقیاس بوده و شناخت صحیحی نسبت به خطرات ایمنی سموم شیمیایی کسب نکرده&rlm;اند، توجه به رفتار ایمنی بیش از گذشته مورد اغماض قرار گرفته است. لذا هدف تحقیق، بررسی متغیرهای اثرگذار بر پیش&rlm;بینی رفتار ایمنی کشاورزان سیب&rlm;زمینی&rlm;کار دشت اردبیل، بر اساس مدل تلفیقی رفتار برنامه&rlm;ریزی&rlm;شده و تئوری اعتقاد بهداشتی بود. روش بررسی: این تحقیق از نوع توصیفی-پیمایشی بوده که در سال 1398 انجام شد. به روش نمونه&rlm;گیری چندمرحله&rlm;ای با انتساب متناسب، 370 کشاورز با کمک جدول بارتلت و همکاران انتخاب شدند. ابزار تحقیق، پرسشنامه&rlm;ای ساختاریافته بود و متغیرهای اصلی مربوط به دو مدل پرکاربرد در برآورد رفتار ایمنی (رفتار برنامه&rlm;ریزی&rlm;شده و تئوری اعتقاد بهداشتی) در قالب یک مدل تلفیقی تعیین شد. بروز رفتار ایمنی نیز در چهار مرحله تهیه و انبارداری، آماده&rlm;سازی، استفاده و پس از استفاده از سموم شیمیایی در مدل گنجانده شد. نهایتاً به کمک مدل معادلات ساختاری و نرم&lrm;افزارهای SPSS18 و AMOS20، ضمن تعیین برازش کلی مدل و مهم&rlm;ترین مرحله بروز رفتار ایمنی، متغیر&rlm;های تبیین&rlm;کننده رفتار ایمنی در میان کشاورزان بدست آمد. جهت تجزیه و تحلیل داده&rlm;ها نیز، از فرمول محاسبه سطوح رفتار ایمنی، مدل&rlm;یابی معادلات ساختاری و تحلیل مسیر استفاده شد. یافته&rlm;ها: مطابق نتایج، غالب کشاورزان (0/33 درصد)، دارای رفتار ایمنی نسبتاً ناایمن بودند. تحلیل مدل معادلات ساختاری نشان داد برازش مدل تلفیقی برای پیش&rlm;بینی رفتار ایمنی کشاورزان مطلوب بدست آمد و در مجموع مدل پیشنهادی توانست تا 73 درصد قدرت تبیین&rlm;کنندگی برای پیش&rlm;بینی بروز رفتار ایمنی را ایفا نماید. این مدل توانست بیشترین تبیین برای رفتار ایمنی را در مرحله "استفاده از سموم شیمیایی" (با 68 درصد قدرت تبیین&rlm;کنندگی) نشان دهد. مهم&rlm;ترین متغیرهای تبیین&rlm;کننده در بروز رفتار ایمنی نیز، به ترتیب مربوط به دانش (**35/0=β)، نگرش (**57/0=β) و اشاره به عمل (**35/0=β) بود؛ اما تأثیر سه متغیر سن، ارزش بهداشتی و موانع درک&rlm;شده در مدل معنی&rlm;دار بدست نیامد. همچنین، بهترین مسیرهای تبیین&rlm;کننده در بروز رفتار ایمنی، به ترتیب مربوط به مسیر نیت منجر به رفتار ایمنی (850/0)، اشاره به عمل منجر به نیت و سپس بروز رفتار ایمنی (297/0)، نگرش منجر به نیت و سپس بروز رفتار ایمنی (178/0) و هنجارهای ذهنی منجر به نیت و سپس بروز رفتار ایمنی (178/0) بدست آمد. نتیجه&rlm;&rlm;گیری: مدل تلفیقی تحقیق می&rlm;تواند در حد قابل قبولی تبیین&rlm;کننده بروز رفتار ایمنی در همه مراحل بکارگیری سموم شیمیایی (به ویژه مرحله استفاده از سموم شیمیایی) در میان کشاورزان باشد. اولویت دهی به برنامه&rlm;های آموزش کشاورزان جهت بهبود دانش در بکارگیری سموم شیمیایی و استفاده از رسانه&rlm;های محلی و ارتباط جمعی برای بهبود نگرش و اشاره به عمل، می&rlm;تواند نقش مؤثری بر ارتقای رفتار ایمنی کشاورزان داشته باشد. جلب مشارکت و همراهی معتمدان محلی، تعاونی&rlm;های تولیدی و تشکل&rlm;های کشاورزی جهت بهبود هنجارهای ذهنی کشاورزان در راستای ارتقای رفتار ایمنی بسیار اثرگذار خواهد بود. Background and aims: Weeds, pests, and diseases are becoming more and more resistant to agricultural pesticides, and this has, in turn, resulted in the use of more pesticides or more toxic pesticides among farmers. Along with the government’s incentive programs to increase production, the use of chemical pesticides has also been increased among farmers sharply. Farmers incur high costs by exposure to pesticides due to hospitalization of themselves and their families, medical services, and the loss of working days. The unsafe and excessive use of chemical pesticides also plays a role in the incidence of latent diseases such as diabetes, various cancers, Autism, Parkinson, etc., in addition to general symptoms. According to the theory of health belief, the safety behavior of farmers is inherently a kind of health behavior because, for farmers to have proper hygienic behaviors when using chemical pesticides, they must first feel threatened by them (perceived sensitivity). Then, they should understand the risk depth and its seriousness (perceived severity) and if they have a positive evaluation of the benefits, they will take preventive behaviors. Also, according to the planned behavior model, the variables of attitude, subjective norms, and control of perceived behavior ultimately lead to the accompaniment of intention to predict behavior in individuals. Due to the small size of farmers and the lack of knowledge as to the safety hazards of chemical pesticides, attention to safety behavior has been neglected more than ever. Therefore, this study aimed to investigate the variables affecting the prediction of safety behavior of potato farmers in the Ardabil plain based on a combined model of planned behavior and health belief theory. In recent years, weed outbreaks and increased resistance of potato (Solanum tuberosum L.) to chemical pesticides in the Ardabil plain have been significant. As the most important crop in Ardabil province, potatoes have been attacked by pests such as Colorado potato beetle and false whitefly more than ever. On the other hand, the increasing use of crop pests, the prevalence of low-quality imported pesticides, and the increased resistance of some pests to pesticides, such as the increased resistance of potato pests to the effectiveness of Metribuzin pesticide, which has increased the use of chemical pesticides by potato farmers have aggravated the problems. But, the common strategies of farmers to deal with them may lead to an increase in the use of pesticides or the use of pesticides with a higher degree of toxicity, which ultimately necessitates more and more comprehensive attention to safety behavior among potato farmers in the Ardabil plain. Methods: This study is a descriptive survey that was conducted in 2019. By the multi-stage sampling method with the proportional assignment, 370 farmers were selected using Bartlett et al.’s table (30). As such, the individuals participated in the study including 193 potato farmers from Ardabil County, 104 potato farmers from Namin County, and 73 potato farmers from Nir County. The study instrument was a structured questionnaire whose validity was assessed by estimating its content validity. Qualitative face validity was checked by a panel of experts (faculty members in the University of Mohaghegh Ardabili, and the University of Khuzestan in the field of chemical pesticide management in agriculture, specialists in Persian language and literature, and experts of occupational health). Content validity ratio (CVR) and content validity index (CVI) were used for quantitative content validity of the questionnaire (CVR> 0.59; CVI> 0.79). Convergent and diagnostic validity was used to ensure the construct validity of the research instrument. Also, the reliability of the research instrument was confirmed by calculating Cronbachchr('39')s alpha coefficient for each of the research variables (values obtained above 0.7). The main variables related to two widely used models in estimating safety behavior (planned behavior and health belief theory) were determined in the form of an integrated model. Incidence of safety behavior was also included in the model in four stages of preparation and storage, preparation, use, and after the use of chemical pesticides. Finally, with the help of the structural equation model and SPSS18 and AMOS20 software, while determining the overall fit of the model and the most important stage of safety behavior, the variables accounting for safety behavior among farmers were obtained. Results: According to the results as to the use of chemical pesticides, most farmers (33.0%) had relatively unsafe safety behavior. However, the lowest group of farmers (9.5% of respondents) exhibited completely safe behavior. Analysis of the structural equation model showed that the fit of the integrated model was obtained to predict the safety behavior of farmers; overall, the proposed model could play up to 73% of the explanatory power to predict the occurrence of safety behavior. This model could best account for safety behavior in the "use of chemical pesticides" stage (with 68% of explanatory power). The most important explanatory variables in the occurrence of safety behavior are related to knowledge (β=0.35**), attitude (β=0.57**), and cues to action (β=0.35**), respectively. But, the effect of the three variables of age, health value, and perceived barriers in the model was not significant. Also, the best explanatory pathways in the display of safety behavior were related to the path of intention leading to safety behavior (0.850), referring to action leading to intention and then the occurrence of safety behavior (0.297), attitude leading to intention and then the occurrence of safety behavior (0.178), and mental norms leading to intention and then the occurrence of safety behavior (0.178). Conclusion: The integrated study model can reasonably explain the occurrence of safety behavior in all stages of using chemical pesticides (especially the stage of using chemical pesticides) among farmers. Considering that the safety behavior of farmers in the region is not at a desirable level, it is necessary to conduct an in-depth needs assessment of farmerschr('39') knowledge of the four stages of safety behavior (preparation and storage, preparation of chemical pesticides, use of chemical pesticides and safety activities after use) through agricultural safety management programs in the region. Also, while identifying the major obstacles, educational and executive planning should be developed in all its stages. To improve the cues to action, it is suggested to use chemical pesticide hazard information programs in local mass media programs and print and written advertisements in the region as to alternative methods of chemical pesticides. Attracting the participation and cooperation of local trustees, production cooperatives, and agricultural organizations will also be very effective in improving the subjective norms of farmers to promote safety behaviors. Since most farmers are smallholders, it does not seem affordable to use safety behavior strategies (the supply of safety equipment and non-chemical pest control methods), the use of supporting subsides to purchase equipment, or the adoption of safety methods. Alternatives to chemical pesticides should be a priority in agricultural safety management programs in the region. آفت‌ کش‌ ها, رفتارهای مخاطره‌ آمیز سلامتی, کشاورزان‌, عوامل اجتماعی تعیین‌ کننده سلامت Agricultural pesticides, Safety behavior, Potato, Model of planned behavior, Health belief theory. 1122 1136 http://ioh.iums.ac.ir/browse.php?a_code=A-10-2964-1&slc_lang=fa&sid=1 Mojtaba Sookhtanlou مجتبی سوختانلو m.sookhtanlo@uma.ac.ir 13600319475328460038308 13600319475328460038308 Yes University of Mohaghegh Ardabili دانشگاه محقق اردبیلی Moslem Savari مسلم سواری savari@asnrukh.ac.ir 13600319475328460038309 13600319475328460038309 No University of Khuzestan دانشگاه خوزستان