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 were developed and distributed throughout South Central Pennsylvania. Preintervention and postintervention 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 preintervention 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. Postintervention survey data found 98% compliance with hay-hole cover installation and no subsequent reported hay-hole falls.
Conclusion: With the support of the Pennsylvania Amish Safety Committee, 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: Epidemiological study, Level III.
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http://dx.doi.org/10.1097/TA.0000000000001754 | DOI Listing |
Cureus
January 2024
Neurological Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, USA.
Hay-holes are a design feature in many traditionally built barns that serve as a portal through which stored hay is passed to the lower level where animals are fed. Unfortunately, children sometimes fall through the hay-hole to the concrete or packed earth below. Available data on the frequency and types of hay-hole injuries is limited.
View Article and Find Full Text PDFAm Surg
July 2023
Division of Trauma and Acute Care Surgery, Penn Medicine Lancaster General Health, Lancaster, PA, USA.
Hay-holes are openings on the second floor of barns used to drop feed to ground level. Hay-hole falls (HHFs) are a unique problem among Anabaptist communities, especially for children. To follow-up on our previous study that created the Anabaptist Youth Trauma Prevention Consortium with distribution of 231 hay-hole covers in South Central Pennsylvania, we compared a five-year period before cover distribution with the 5-year period after.
View Article and Find Full Text PDFInj Epidemiol
December 2019
1UPMC Children's Hospital of Pittsburgh, 4401 Penn Avenue, Faculty Pavilion, 07-63, Pittsburgh, PA 15224 USA.
Objectives: The purpose of this study was to examine the injury risk patterns among Amish children, many of whom may be exposed to uncommon injuries and limited access to care due to their agrarian lifestyle and remote communities.
Design: Retrospective Chart Review.
Methods: With IRB approval, we performed a retrospective review of Amish patients age ≤ 12 years presenting to a level I pediatric trauma center between January 1, 2005, and December 31, 2015.
J Trauma Acute Care Surg
February 2018
From the Trauma Services (B.W.G., S.J., E.H.B., R.D.B., J.A.M., F.B.R.), Lancaster General Health/Penn Medicine, Lancaster; Family and Community Medicine & Pediatrics (E.K.B.), Penn State Milton S. Hershey Medical Center, Hershey; Emergency Medicine (M.J.R.), Lancaster General Health/Penn Medicine, Lancaster; Department of Agricultural and Biological Engineering(D.M.), Pennsylvania State University, State College; Penn State Extension (K.M.), Pennsylvania State University, Lancaster; Penn State Hershey Children's Hospital (J.H.), Pediatric Trauma Program, Hershey; and Community Health and Wellness (S.L.), Lancaster General Health/Penn Medicine, Safe Kids Lancaster County, Lancaster, Pennsylvania.
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 were developed and distributed throughout South Central Pennsylvania.
Pediatr Emerg Care
July 2016
From the Divisions of *Pediatric Surgery, †Pediatric Neurosurgery, and ‡Newborn Medicine, Penn State Hershey Children's Hospital, Penn State Milton S. Hershey Medical Center, Hershey, PA.
Objective: Children who live, work, and play on farms with barn design that includes hay-holes are at risk for a particular type of fall. This study retrospectively reviews all children admitted to a pediatric trauma center with injuries due to fall through a hay-hole over a 19-year period. This study is the first to specifically describe hay-hole fall injuries.
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