Increasing Machine-Related Safety on Farms: Development of an Intervention Using the Behaviour Change Wheel Approach.

Farming is essential work, but it suffers from very high injury and fatality rates. Machinery, including tractors, are a leading cause of serious injuries and fatalities to farmers and farm workers in many countries. Herein, we document the systematic development of an evidence-based, theory-informed behaviour change intervention to increase machine-related safety on farms. Intervention development progressed through four phases. Phase 1 defined the problem in behavioural terms based a review of the literature, Phase 2 identified candidate intervention targets through a series of focus groups guided by the Capability-Opportunity-Motivation-Behaviour (COM-B) model and Phase 3 employed expert and stakeholder consultation guided by the Behaviour Change Wheel (BCW) to consider potential target behaviours and intervention components and finalise the intervention content. Phase 4 finalised the evaluation strategies with a team of agricultural advisors who supported the rollout and identified outcome measures for the first trial. The target intervention was the identification of blind spots of farm tractors, and three priority target behaviours (farm safety practices) were identified. Following Phase 3, the intervention comprised four components that are delivered in a group-based, face-to-face session with farmers. In Phase 4, the acceptability, feasibility, and fidelity of these components were identified as the outcome measures for the first trial of the intervention. The four-phase systematic method detailed here constitutes an initial template for developing theory-based, stakeholder-driven, behaviour-change-based interventions targeting farmers and reporting such developments.