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Norman-Burgdolf H, Barr M, Lacy ME, Smalls BL. Leveraging Cooperative Extension Services as a population health approach to reduce health disparities. J Rural Health 2024. [PMID: 38837444 DOI: 10.1111/jrh.12853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 05/09/2024] [Accepted: 05/17/2024] [Indexed: 06/07/2024]
Affiliation(s)
- Heather Norman-Burgdolf
- Department of Dietetics and Human Nutrition, College of Agriculture, Food & Environment, University of Kentucky, Lexington, Kentucky, USA
| | - Makenzie Barr
- Department of Dietetics and Human Nutrition, College of Agriculture, Food & Environment, University of Kentucky, Lexington, Kentucky, USA
| | - Mary E Lacy
- Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, Kentucky, USA
| | - Brittany L Smalls
- Department of Family and Community Medicine, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
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Robertson MN, Seitz HH, Downey LH, Hardman AM, Steen JS, Buys DR. Increasing Uptake of Prescription Drug Take-Back Boxes: Eliciting Preferences and Applying the Theory of Planned Behavior to Predict Use. HEALTH EDUCATION & BEHAVIOR 2024; 51:400-407. [PMID: 36124431 DOI: 10.1177/10901981221116778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study assesses adults' perceptions of and predictors of intention to use prescription drug take-back boxes. This mixed methods study utilized focus groups and an online survey to examine factors related to intention to use a prescription drug take-back box. This study was conducted in [State] during the spring and summer of 2018. Themes identified in focus group data included the importance of take-back box location, benefits of take-back box use (such as reducing opportunities for medication misuse), and barriers to take-back box use (such as lack of awareness, stigma associated with law enforcement). Survey results indicate that pharmacies are the most preferred take-back box location and that attitudes, subjective norms, and perceived behavioral control are statistically significant predictors of intention to use a take-back box. Results suggest that individuals are open to using take-back boxes in secure, convenient locations, but many are unaware of take-back boxes as an option for safe disposal. These findings have implications for health communication and policy efforts designed to increase the use of take-back boxes for prescription drug disposal.
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Affiliation(s)
| | - Holli H Seitz
- Mississippi State University, Mississippi State, MS, USA
| | - Laura H Downey
- Mississippi State University, Mississippi State, MS, USA
| | | | | | - David R Buys
- Mississippi State University, Mississippi State, MS, USA
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Weybright E, Phibbs S, Watters C, Myers A, Peavy M, Martin A. The Role of Cooperative Extension in Delivering Training and Technical Assistance to Support Evidence-Based Behavioral Health Practices in Rural Communities. Eval Health Prof 2024; 47:192-203. [PMID: 38790114 DOI: 10.1177/01632787241237515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2024]
Abstract
The opioid epidemic in the United States continues to disproportionately affect those in rural, compared to urban, areas due to a variety of treatment and recovery barriers. One mechanism to increase capacity of rural-serving providers is through delivery of training and technical assistance (TTA) for evidence-based programs by leveraging the Cooperative Extension System. Guided by the Interactive Systems Framework, the current study evaluates TTA delivered by the Northwest Rural Opioid Technical Assistance Collabroative to opioid prevention, treatment, and recovery providers on short- (satisfaction, anticipated benefit), medium-, (behavioral intention to change current practice), and long-term goals (changes toward adoption of evidence-based practices). We also evaluated differences in short- and medium-term goals by intensity of TTA event and rurality of provider. Surveys of 351 providers who received TTA indicated high levels of satisfaction with TTA events attended, expressed strong agreement that they would benefit from the event, intended to make a professional practice change, and preparation toward implementing changes. Compared to urban-based providers, rural providers reported higher intention to use TTA information to change current practice. We conclude with a review of remaining gaps in the research to practice pipeline and recommendations for moving forward.
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Affiliation(s)
- Elizabeth Weybright
- Department of Human Development, Washington State University, Pullman, WA, USA
- Extension Youth and Families Unit, Washington State University, Pullman, WA, USA
| | - Sandi Phibbs
- Oregon State University Center for Health Innovation, Oregon State University, Corvallis, OR, USA
| | - Cassandra Watters
- Department of Human Development, Washington State University, Pullman, WA, USA
| | - Allison Myers
- Extension Family and Community Health, Oregon State University, Corvallis, OR, USA
| | - Michelle Peavy
- Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University Spokane, Spokane, WA, USA
| | - Abbey Martin
- Oregon State University Center for Health Innovation, Oregon State University, Corvallis, OR, USA
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Beese S, Graves JM, Postma J, Oneal G. The four stages of neighborhood trust: Classic grounded theory. Public Health Nurs 2024. [PMID: 38639194 DOI: 10.1111/phn.13326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 03/26/2024] [Accepted: 03/28/2024] [Indexed: 04/20/2024]
Abstract
INTRODUCTION Neighborhoods are often overlooked as a determinant of health. Among recent research, the focus on "place-based effects," due to prolonged residential environmental exposure, has been of particular interest. These studies' purpose is to identify and examine how a healthy neighborhood is intentionally created to describe a transferable process-driven theory. METHOD A classic grounded theory approach was used in these studies. Data sources include individual in-depth interviews, historical documents, and a member-checking focus group, collected over 3-years. RESULTS Analysis generated the Four Stages of Neighborhood Trust Model, which is nested within the context of perceived neighborhood safety. The theory outlines a social process of four stages of neighborhood trust: (a) rules-based agreements, (b) shared values, (c) cooperation, and (d) neighborhood belonging. CONCLUSIONS We present the development of a process-driven theory that may be useful for public health nurses as they engage neighborhoods in health promotion activities. The stage of trust development will aid the nurse in identifying what is needed to move to the next stage in a healthy neighborhood process.
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Affiliation(s)
- Shawna Beese
- College of Agricultural, Human, and Natural Resource Sciences, Extension, Washington State University, Pullman, Washington, USA
- College of Nursing, Washington State University, Spokane, Washington, USA
| | - Janessa M Graves
- College of Agricultural, Human, and Natural Resource Sciences, Extension, Washington State University, Pullman, Washington, USA
- School of Medicine, University of Washington, Seattle, Washington, USA
| | - Julie Postma
- College of Agricultural, Human, and Natural Resource Sciences, Extension, Washington State University, Pullman, Washington, USA
| | - Gail Oneal
- College of Agricultural, Human, and Natural Resource Sciences, Extension, Washington State University, Pullman, Washington, USA
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Didinger C, Bunning M, Thompson H. A Translational Approach to Increase Pulse Intake and Promote Public Health through Developing an Extension Bean Toolkit. Nutrients 2023; 15:4121. [PMID: 37836405 PMCID: PMC10574132 DOI: 10.3390/nu15194121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 09/18/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023] Open
Abstract
Practical, affordable solutions need to be implemented to address global challenges confronting human and environmental health. Despite a myriad of benefits for people and the planet, beans and other pulses (e.g., chickpeas, cowpeas, dry peas, lentils) are under-consumed. To better understand consumer concerns and interests, a Food Habits Survey was conducted and the findings were incorporated into the Colorado State University Extension Bean Toolkit. Guided by the Information-Motivation-Behavioral Skills model, the toolkit included informational social media posts, cooking guidance, and an online class. A convenience sample of participants was recruited through Extension and university networks. After class participation, significant gains in knowledge of pulse nutrition, versatility, and cooking were observed, with an average increase of 1.5 points on a 5-point Likert scale (p < 0.001). Moreover, participants (n = 86) perceived a greater importance of motivators (e.g., nutrition, versatility, environmental benefits) and found barriers (e.g., flatulence, long cooking times, unfamiliarity) to be less discouraging. Most participants reported an intention to eat more pulses, and among those who completed the 1-month follow-up survey, pulse intake frequency increased (p = 0.004). Emphasizing motivating factors while simultaneously mitigating barriers to consumption can help reverse insufficient intake and promote healthy behavior change. Leveraging Extension or similar networks is one way to adopt a translational approach to better reach the public with this information.
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Affiliation(s)
- Chelsea Didinger
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO 80523, USA; (C.D.); (M.B.)
| | - Marisa Bunning
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO 80523, USA; (C.D.); (M.B.)
| | - Henry Thompson
- Cancer Prevention Laboratory, Colorado State University, Fort Collins, CO 80523, USA
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Norman-Burgdolf H, DeWitt E, Gillespie R, Cardarelli KM, Slone S, Gustafson A. Impact of community-driven interventions on dietary and physical activity outcomes among a cohort of adults in a rural Appalachian county in Eastern Kentucky, 2019-2022. Front Public Health 2023; 11:1142478. [PMID: 37124781 PMCID: PMC10140309 DOI: 10.3389/fpubh.2023.1142478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 03/22/2023] [Indexed: 05/02/2023] Open
Abstract
Several environmental level factors exacerbate poor health outcomes in rural populations in the United States, such as lack of access to healthy food and locations to be physically active, which support healthy choices at the individual level. Thus, utilizing innovative place-based approaches in rural locations is essential to improve health outcomes. Leveraging community assets, like Cooperative Extension, is a novel strategy for implementing community-driven interventions. This prospective cohort study (n = 152), recruited in 2019 and surveyed again in 2020 and 2021, examined individual level changes in diet and physical activity in one rural Appalachian county. During this time, multiple community-driven interventions were implemented alongside Cooperative Extension and several community partners. Across the three-year study, the cohort indicated increases in other vegetables and water and reductions in fruits and legumes. There were also reductions in less healthy items such as French fries and sugar-sweetened beverages. The cohort also reported being less likely to engage in physical activity. Our findings suggest that key community-driven programs may have indirect effects on dietary and physical activity choices over time. Outcomes from this study are relevant for public health practitioners and community organizations working within rural Appalachian communities to address health-related behaviors.
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Affiliation(s)
- Heather Norman-Burgdolf
- Department of Dietetics and Human Nutrition, College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY, United States
- *Correspondence: Heather Norman-Burgdolf,
| | - Emily DeWitt
- Department of Dietetics and Human Nutrition, College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY, United States
| | - Rachel Gillespie
- Department of Health, Behavior & Society, College of Public Health, University of Kentucky, Lexington, KY, United States
| | - Kathryn M. Cardarelli
- Department of Health, Behavior & Society, College of Public Health, University of Kentucky, Lexington, KY, United States
| | - Stacey Slone
- Dr. Bing Zhang Department of Statistics, College of Arts & Sciences, University of Kentucky, Lexington, KY, United States
| | - Alison Gustafson
- Department of Dietetics and Human Nutrition, College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY, United States
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Kennedy LE, Strayer TE, Balis LE. Addressing Health Inequities: An Exploratory Assessment of Extension Educators' Perceptions of Program Demand for Diverse Communities. FAMILY & COMMUNITY HEALTH 2022; 45:228-237. [PMID: 35985023 DOI: 10.1097/fch.0000000000000332] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Land grant universities are a key provider of community-based health promotion programs through the Cooperative Extension Service. However, Extension's current approach to addressing systemic social determinants of health is incomplete and inconsistent. The purpose of this study was to explore Extension health educators' perceptions of demand for health promotion programming targeting audiences most likely to experience health inequities. Health educators within 2 state Extension systems were invited to complete an online survey based on a capacity building model. Survey questions included rating perceptions of demand for programming for health disparate populations: low-income; Black and African American; Hispanic, Latino/a, Latinx; persons with disabilities; immigrants and refugees; and lesbian, gay, bisexual, and transgender. Analysis of variance and Bonferroni post hoc testing was used to determine differences in perceived demand between populations. Ninety-six educators completed the survey. Perceived demand for low-income population programming was significantly higher than for other populations. Perceived programming demand for immigrants and refugees and lesbian, gay, bisexual, and transgender people was significantly lower than for other populations. Individual and organizational-level factors, including racism and Extension's historical scope, likely contribute to the results. Engaging historically excluded Extension audiences requires time and resources to improve the Extension system and educator capacity for relationship building, trust building, and communication.
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Affiliation(s)
- Lauren E Kennedy
- Community Behavioral Health, Michigan State University Extension, East Lansing, Michigan (Dr Kennedy); Center for Quality Aging, Center for Health Services Research, Vanderbilt University Medical Center, Nashville, Tennessee (Dr Strayer); and Louisville Center, Pacific Institute for Research and Evaluation, Louisville, Kentucky (Dr Balis)
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Todić J, Scott J. Unincorporated Health: Understanding Residents' Perspectives on Factors Impacting Their Health and Emergent Place-Based Solutions. SOCIAL WORK IN PUBLIC HEALTH 2021; 36:317-329. [PMID: 33938399 DOI: 10.1080/19371918.2021.1900976] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Increased mortality rates and decreased life expectancy in the United States are associated with rurality, even after adjusting for poverty. In unincorporated rural communities, high population density may compound the negative health impact of the upstream factors associated with rurality, yet little is known about how this context contributes to residents' health. We conducted nine focus groups with youth and adults from March-July 2017 in two Texas unincorporated rural communities. Using ecosocial theory and applied thematic analysis for focus groups, we investigated social, political, and historical factors that affect health. We identified two primary themes: upstream barriers to community health and K-12 schools as facilitators of community health. K-12 schools, and full-service community schools, in particular, may have an important role in closing the rural-urban health gap, even in the context of structural constraints associated with unincorporated rural status.
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Affiliation(s)
- Jelena Todić
- Department of Social Work, The University of Texas at San Antonio, College for Health, Community and Policy, San Antonio, TX, USA
| | - Jennifer Scott
- School of Social Work, Louisiana State University, Baton Rouge, LA, USA
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