Evaluation of Agricultural Heat-Related Illness Prevention Training in Colorado

Objective Agricultural workers have high rates of heat-related illnesses (HRI). State-level regulations regarding HRI prevention in agriculture have been evolving and include requirements for heat-related prevention training of workers. There has been limited evaluation of the effectiveness of HRI prevention training. This study aimed to evaluate a train-the-trainer HRI prevention program.Methods In 2024 and 2025, there were 13 train-the-trainer HRI prevention sessions held in English and Spanish in Colorado. The trainers then trained agricultural workers in their workplaces. Using the Kirkpatrick evaluation framework and a series of surveys and focus groups, changes in participant reaction levels, learning, behavior, and workplace outcomes were assessed. Descriptive statistics and paired t-test were used to analyze survey responses. Thematic analysis was used to analyze focus group data.Results Across 13 sessions, 143 trainers completed the train-the-trainer program, who then trained 1,270 agricultural workers. The trainers expressed high levels of satisfaction with the training and had significant improvement in their knowledge of HRI symptoms and prevention strategies. Training led to increased confidence among trainers in their ability to train workers. Trainers and agricultural workers reported adopting practices to prevent HRI.Conclusion This study provides evidence that a bilingual, regulatory-aligned train-the-trainer program can be an effective approach to build HRI prevention capacity among agricultural employers. The Colorado-based train-the-trainer HRI prevention program increased trainer knowledge and confidence and in turn improved agricultural worker workplace heat-related prevention practices. These changes may protect worker health while also improving their well-being and productivity in the long term.