Evaluating the impact of a train-the-trainer heat-related illness prevention training program among Colorado agricultural workers

Abstract

Agricultural workers are at a high risk for heat-related illnesses due to exposure to extreme environmental conditions. In recent years, regulations for heat stress prevention in agricultural workers have been evolving, leading several states to implement rules that address the increasing risks. Although many efforts have been focused on establishing these strategies, adherence remains insufficient and the evaluation of the effectiveness of heat illness prevention trainings has been limited. The objective of this study was to evaluate the effectiveness of a training strategy focused on preventing heat-related illnesses among agricultural workers in Colorado under a train-the-trainer model adapted from the Western Agricultural Health and Safety Center at the University of California Davis materials in accordance with Colorado State regulations. In spring 2024, five virtual training sessions were held in English and Spanish, allowing 64 trainers to complete the training. During the same season, the trainers then trained over 750 farmworkers in Colorado. Using Kirkpatrick's framework and a series of surveys and focus groups, the evaluation assessed changes in the level of reaction, with trainers reporting high satisfaction with the training. The learning level assessment showed significant improvement in trainers' knowledge and the ability to recognize symptoms, understand the risk of heat stress, and strategies to prevent it. At the behavioral level, trainers and farmworkers reported adopting positive changes in their work practices. Finally, the results showed an increase in risk awareness, the importance of participatory leadership, and greater confidence among trainers and workers in protecting themselves from the risk of heat illness. The findings demonstrated that a strategically structured program adapted to agricultural worker's needs can lead to significant changes in learning, workplace behaviors and overall, a better-established safety culture. These activities not only protect workers' health but may also improve their well-being and productivity in the long term.