The AFF Program created a separate goal for its educational, knowledge diffusion, and technology transfer activities, which has created a separation of research from the dissemination functions. These dissemination activities would be integrated in all of the research priorities. In discussing the ideal AFF research program in Chapter 2, the committee recognized the needed role of research in knowledge diffusion and technology transfer to reach the at-risk populations. However, the separate goal continues to compartmentalize this outreach interaction as distinct from the processes used to inform the research questions, methods, and analyses. In part, this is a reflection of the logic model that guides the review. The concept of broader deliberation and decisionmaking among researchers and populations-at-risk from the inception of research ideas to their diffusion to the vulnerable populations is not explored in depth.

Although there are substantial efforts to reach working populations, most NIOSH materials were provided through Web sites or written materials. This reflects a lack of understanding of the worker populations in agriculture. Some researchers have addressed the need to modify messages for farming populations (Grieshop et al., 1995; Cole, 2000, 2002; Morgan et al., 2002). The changing profile of the working populations involved in agriculture, forestry, and fishing needs to be taken into account in the development of programs designed to reach workers. Immigrant workers clearly have different cultural views of safety and disease that need to be assessed if culturally relevant information is to be provided. Farmers, ranchers, fishermen, and loggers similarly have specialized cultural contexts related to perceptions of risk and safety practices that influence adoption of new practices (Morgan et al., 2002; Freeman et al., 2003; Helmkamp et al., 2004; Effland, 2005). Incorporating representatives of target populations into the priority-setting process and actual dissemination processes would increase the likelihood of successful outreach and impacts.

Much of the legislation that addresses worker health and safety is not applicable to farmers and ranchers, and many of the relevant regulations are not enforced (Murphy, 1992; Cole, 2002). Therefore, the effectiveness of legislation in reaching AFF working populations is questionable, yet legislation remains an important tool in the diffusion and implementation of new knowledge and technologies.

Most education programs ignore the role of well-established habits in maintaining behavior and preventing the adoption of new behaviors (Murphy, 1992; Cole, 2002; Freeman et al., 2003). Failing to take habits and culture into account limits the ability of programs to modify behavior so as to increase safety and improve health. As noted above, multifaceted programs appear most successful and provide a rationale for using social marketing techniques.

The recommendations in Chapter 12 will address these issues, especially the need for an integrated model of NIOSH research and diffusion programs.

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