Preliminary Results of a Novel Hay-Hole Fall Prevention Initiative

ABSTRACT BACKGROUND Hay-hole falls are a prevalent source of trauma among Anabaptists—particularly Anabaptist youth. We sought to decrease hay-hole falls in South Central Pennsylvania through the development and distribution of all-weather hay-hole covers to members of the at-risk Anabaptist community. METHODS Following the creation of a rural trauma prevention syndicate, hay-hole cover prototypes co-designed and endorsed by the Pennsylvania Amish Safety Committee (PASC) were developed and distributed throughout South Central Pennsylvania. Pre- and post-intervention surveys were distributed to recipients to gain an understanding of the hay-hole fall problem in this population, to provide insight into the acceptance of the cover within the community, and to determine the efficacy of the cover in preventing falls. RESULTS A total of 231 hay-hole covers were distributed throughout eight rural trauma-prone counties in Pennsylvania. According to pre-intervention survey data, 52% of cover recipients reported at least one hay-hole fall on their property, with 46% reporting multiple falls (median fall rate: 1.00 [1.00-2.00] hay-hole falls per respondent). The median self-reported distance from hay-hole to ground floor was 10.0 (8.00-12.0) feet, and the median number of hay-holes present on-property was 3.00 (2.00-4.00) per respondent. Post-intervention survey data found 98% compliance with hay-hole cover installation and no subsequent reported hay-hole falls. CONCLUSION With the support of the PASC, we developed a well-received hay-hole cover which could effectively reduce fall trauma across other rural communities in the United States. LEVEL OF EVIDENCE Level III; Epidemiological study Corresponding Author: Frederick B. Rogers, MD, MS, FACS; frogers2@lghealth.org, 555 N. Duke St., Lancaster, PA 17602, 717-544-5945 (tel), 717-544-5944 (fax) Funding: The following entities provided grant funding for hay hole cover development and distribution. 1. American Trauma Society, Pennsylvania Division 2. National Children’s Center for Rural & Agricultural Health & Safety 3. Agricultural Safety & Health Council of America 4. Penn State Hershey Children’s Miracle Network Disclosure Statement: The above authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article. This study was awarded the Cox-Templeton Injury Prevention Paper Award at the 30th Annual Scientific Assembly of the Eastern Association for the Surgery of Trauma on January 12, 2017 in Hollywood, Florida. © 2017 Lippincott Williams & Wilkins, Inc.

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