Background: Action Plans: 1996- 2010, The first U.S. National Action Plan for Childhood Agricultural Injury Prevention was developed over an 18-month period, then published in April, 1996.1 Under the leadership of the National Institute for Occupational Safety and Health (NIOSH), our nation officially launched a National Childhood Agricultural Injury Prevention Initiative, with an annual allocation of federal funding that was augmented by financial support from the private sector. The public attention, combined with expanded public and private funding during the late 1990s, sparked an outpouring of energy, concern and commitment to protect children from the acute and chronic consequences of agricultural trauma and disease. In a subsequent, related effort a National Adolescent Farmworker Occupational Health and Safety Advisory Committee, representing employers and hired farmworkers, generated three goals and 12 recommendations with the aim of encouraging constructive opportunities for young agricultural workers, many of whom were immigrants hired for seasonal jobs such as harvesting fruits and vegetables. Its report, Migrant and Seasonal Hired Adolescent Farmworkers: A Plan to Improve Working Conditions, was released in November, 2001.2 To build on this momentum, a multi-staged process was undertaken to evaluate the impact of the 1996 plan, integrate topics from the migrant/seasonal farmworker plan, and then employ consensus development methods to generate new strategies and realign priorities. By this time, data had revealed that more than half of injured children on farms were not working at the time of injury, thus, several new recommendations were warranted. The 2001 Summit on Childhood Agricultural Injury Prevention involved a core team that conducted an array of assessment activities, then convened a twoday Summit with 100 individuals, assigned into seven topical working groups. Group recommendations were synthesized and clustered into three themes: leadership, nonworking children, and working youth. The Progress Report and Updated National Action Plan from the 2001 Summit was released in April 2002.3 Nearly a decade had passed since the 2001 plan was released and it was time to review current strategies for continuation, modification or deletion, including allocation of funds for this initiative. Conditions in agriculture as well as general injury prevention were evolving. Increasingly, the public had become aware that traumatic injuries and deaths of children younger than 18 years are preventable. Once again, with support from NIOSH, an assessment of progress to date and a review of priorities were undertaken. Methods for Developing the 2012 National Action Plan: The process for developing this 2012 action plan took advantage of lessons learned from previous efforts and relied heavily on a core group of individuals (Appendix A) with extensive experience in national-level endeavors. Over an 18-month period an assessment of published research was conducted, childhood agricultural injury data were analyzed, and changing patterns of agricultural production and demographics of workers were reviewed. In late 2010, 12 advisors to the National Children's Center for Rural and Agricultural Safety and Health (Appendix B) reviewed preliminary assessments and suggested methods for ensuring the 2012 national action plan was comprehensive and scientifically sound. Scholars in various disciplines generated recommendations for research, programs, policy, dissemination and other topics based upon their areas of expertise. Topics addressed by these experts expanded into formal manuscripts with specific recommendations that were then subjected to review by their peers for further refinement. The result of this process was a dedicated issue of the Journal of Agromedicine: Practice, Policy & Research (Appendix C). The core team met in-person and via teleconference often to propose and refine goals and their respective strategies. The initial draft was reviewed by Advisors to the National Children's Center in April 2011. A revised version was reviewed by additional stakeholders and discussed during a meeting of the Childhood Agricultural Safety Network (Appendix D) in June 2011. By September of that year, a further revision of the plan was posted on the Internet, requesting public feedback. Over a six-week period, 56 substantive and detailed suggestions for the plan were received, many from farm organizations and farm parents. Perspectives of the farming community regarding traditions and rights were acknowledged. By January 2012, the Goals and Strategies of this plan were finalized.
National Children's Center for Rural and Agricultural Health and Safety, Marshfield Clinic Research Foundation, 1000 North Oak Avenue, Marshfield, WI 54449-5790