Date of Award

2026

Document Type

Scholarly Project

Degree Name

Doctor of Occupational Therapy (OTD)

Department

Occupational Therapy

First Advisor

Dr. Anne Haskins

Abstract

Introduction: Accessible healthcare is essential for farmers due to their limited available time and hazardous job duties (Hildebrand et al., 2019; Hopkins et al., 2023; Salmon et al., 2025; U.S. Department of Agriculture, 2023). Due to the high incidence of injuries that occur within the profession, it is crucial that farmers seek appropriate healthcare services to address these concerns. However, a significant barrier for seeking healthcare assistance is the limited cultural competence among healthcare professionals in understanding the unique needs within farming communities (Gordon et al., 2024; Hildebrand et al., 2019; Hopkins et al., 2023; Purc-Stephenson et al., 2024). The purpose of this study was to explore the lived experiences of farmers who encountered health professionals who may or may not have understood farming culture, to better inform healthcare professionals to improve the quality of care provided to this population.

Methods: A literature review was conducted as a means of a needs assessment. The phenomenological design was used to enable conversations about individualized lived experiences with participants who are farmers and completion of an environmental assessment to understand the farm as the participants home and work environment. A combination of convenience and purposive sampling was used following institutional review board approval and participant informed consent. The chosen environmental assessment was the On Farm Check List for OSHA Compliance, a farm safety screening tool that was created by The University of Nebraska (University of Nebraska Medical Center, College of Public Health, n.d.). Interview questions were created with the use of the Person-Environment-Occupation model to ensure all aspect of a farmer were addressed (Law et al., 1996). Interviews were held for 60 minutes using a virtual meeting room.

Results: The On Farm Check List for OSHA compliance resulted in 11 out of 23 items within regulation. Codes were created based on participants’ phrases identified from interview and grouped into categories. Themes that have emersed from the data include the role of healthcare professionals’ disposition for providing client-centered care, the physically demanding and unpredictable experience of farming as a way of life, and shared responsibilities among farming communities. The final assertion is the essence of healthcare for farmers involves navigating collaborative health decisions shaped by identity, work, and community where client-centered care depends on healthcare professionals who recognize and adapt to the realities of farming.

Conclusion: The categories and themes that have emersed, indicate that farmers require an integrated approach. All factors within their lives are interconnected, and for the farming population, agriculture is almost always at the center of their concern.

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