Recommendation 1: The AFF Program should establish strategic goals for the overall program and for separate subpopulations to provide a basis for improving program leadership, administrative oversight, and program evaluation.
AFF Program strategic goals should flow from the original enabling legislation, with the obvious expansion of the program to include strategic goals for forestry and fishing. The committee has highlighted the need for basic surveillance; worker health status assessment; design, field testing, and evaluation of efficacious interventions; provision of critical oversight mechanisms for professional education; and research to track key drivers that affect AFF worksites. Such goals must include capacity for NIOSH administration, inclusion of extramural centers, and a mechanism for external advice.
1.a: The AFF Program lacks a concerted effort and should focus its administrative efforts on improving program leadership, administrative oversight, and program documentation.
NIOSH is capable of deploying leadership across the AFF sectors. As mentioned in the ideal research program (Chapter 2), the committee recommends that a single person be charged with directing the entire program and overseeing, evaluating, and communicating its plans. However, content experts would be in charge of each arm of the program: a separate leader for agriculture, for forestry, and for fishing. Accordingly, the AFF Program should cultivate a proactive leadership approach that demonstrates inclusiveness and keen awareness of changes that take place across agriculture, forestry, and fishing.
NIOSH should specifically re-examine its internal coordination mechanisms, and implement simpler and more expedient means to ensure that all intramural program elements are functioning in a manner consistent with epidemiological insight and best management practices. The committee has serious reservations about the extraordinarily complex matrix system currently developed for program coordination, and instead recommends a relatively flat organization chart where