JHSE Volume 9, Number 1 Cover
Denise Holston
Louisiana State University
Jessica Stroope
Louisiana State University
Melissa Cater
Louisiana State University
PDF

Keywords

community-based obesity prevention
focus group discussions
Cooperative Extension Service
community coalitions

How to Cite

Holston, D., Stroope, J., & Cater, M. (2021). Facilitators and Barriers to Implementation of Community-Based Socio-Ecological Approaches to Obesity Prevention Among Cooperative Extension Agents. Journal of Human Sciences and Extension, 9(1), 139-155. Retrieved from https://www.jhseonline.com/article/view/1070

Abstract

Perceptions, knowledge, and attitudes of Cooperative Extension Service (CES) Family and Consumer Science (FCS) agents related to the planning and implementation of community-based multi-level ecological obesity prevention strategies were identified through qualitative, exploratory research. Focus group discussions (FGD) were conducted in the five regions of the Louisiana State University CES (LSU AgCenter). Participants included CES FCS Extension agents (n = 35; 97% of agents). Participants were female and responsible for conducting programming in parishes (counties). Thematic analysis of data found principal factors that influenced FCS Extension agents’ perceived ability to plan and implement community-based multi-level obesity prevention approaches to include knowledge of the socio-ecological model, beliefs about roles of CES, funding, human resources, community connectedness, community buy-in, guidance, and internal support. Assessing what FCS agents perceived as barriers and facilitators to implementing community-based obesity prevention approaches provided valuable direction to the state FCS office. Understanding gaps in knowledge, professional development needs, and existing strengths will help make the transition to community-based obesity prevention initiatives more effective. These findings may be beneficial to other CES and public health agencies implementing multi-level, community-based obesity prevention programs in partnership with community coalitions.

PDF

References

Anderson, L. M., Adeney, K. L., Shinn, C., Safranek, S., Buckner‐Brown, J., & Krause, L. K. (2015). Community coalition‐driven interventions to reduce health disparities among racial and ethnic minority populations. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD009905.pub2

Braun, B., Bruns, K., Cronk, L., Fox, L. K., Koukel, S., Rice, C., Rodgers, M., Samuel, J., Vail, A., & Warren, T. (2014). National framework for health and wellness (p. 23). Report prepared for the National Institute of Food and Agriculture. https://nifa.usda.gov/resource/national-framework-health-and-wellness

Carter, W. M. (2019). Improving physical activity and outdoor recreation in rural Alabama through community coalitions. Preventing Chronic Disease, 16. https://doi.org/10.5888/pcd16.190062

Coenen, M., Stamm, T. A., Stucki, G., & Cieza, A. (2012). Individual interviews and focus groups in patients with rheumatoid arthritis: A comparison of two qualitative methods. Quality of Life Research, 21(2), 359–¬370. https://doi.org/10.1007/s11136-011-9943-2

Crosby, R., & Noar, S. M. (2011). What is a planning model? An introduction to PRECEDE-PROCEED. Journal of Public Health Dentistry, 71(s1), S7–S15. https://doi.org/10.1111/j.1752-7325.2011.00235.x

Frieden, T. R. (2010). A framework for public health action: The health impact pyramid. American Journal of Public Health, 100(4), 590–595. https://doi.org/10.2105/AJPH.2009.185652

Gantner, L., & Olson, C. M. (2012). Evaluation of public health professionals’ capacity to implement environmental changes supportive of healthy weight. Evaluation and Program Planning, 35(3), 407–416. https://doi.org/10.1016/j.evalprogplan.2012.01.002

Glaser, B. G. (1965). The constant comparative method of qualitative analysis. Social Problems, 12(4), 436–445. https://doi.org/10.2307/798843

Golden, S. D., & Earp, J. A. L. (2012). Social ecological approaches to individuals and their contexts: Twenty years of health education & behavior health promotion interventions. Health Education & Behavior, 39(3), 364–372. https://doi.org/10.1177/1090198111418634

Green, L., Daniel, M., & Novick, L. (2001). Partnerships and coalitions for community-based research. Public Health Reports (Washington, D.C.: 1974), 116 (Suppl 1), 20–31. https://doi.org/10.1093/phr/116.S1.20

Green, L. W., & Kreuter, M. (2004). Health program planning: An educational and ecological approach (4th ed.). McGraw-Hill Humanities/Social Sciences/Languages.

Guest, G., Namey, E., & McKenna, K. (2017). How many focus groups are enough? Building an evidence base for nonprobability sample sizes. Field Methods, 29(1), 3–22. https://doi.org/10.1177/1525822X16639015

Hacker, K. (2013). Community-based participatory research. Sage.

Israel, B. A., Coombe, C. M., Cheezum, R. R., Schulz, A. J., McGranaghan, R. J., Lichtenstein, R., Reyes, A. G., Clement, J., & Burris, A. (2010). Community-based participatory research: A capacity-building approach for policy advocacy aimed at eliminating health disparities. American Journal of Public Health, 100(11), 2094–2102. https://doi.org/10.2105/AJPH.2009.170506

Krueger, R. A., & Casey, M. A. (2000). Focus groups: A practical guide for applied research. Sage.

Lu, A. H., Dickin, K., & Dollahite, J. (2014). Development and application of a framework to assess community nutritionists’ use of environmental strategies to prevent obesity. Journal of Nutrition Education and Behavior, 46(6), 475–483. https://doi.org/10.1016/j.jneb.2014.05.014

Middleton, G., Henderson, H., & Evans, D. (2014). Implementing a community-based obesity prevention programme: Experiences of stakeholders in the north east of England. Health Promotion International, 29(2), 201–211. https://doi.org/10.1093/heapro/das072

Schwarte, L., Samuels, S. E., Boyle, M., Clark, S. E., Flores, G., & Prentice, B. (2010). Local public health departments in California: Changing nutrition and physical activity environments for obesity prevention. Journal of Public Health Management and Practice, 16(2), E17–28. https://doi.org/10.1097/PHH.0b013e3181af63bb

Schwarte, L., Samuels, S. E., Capitman, J., Ruwe, M., Boyle, M., & Flores, G. (2010). The Central California regional obesity prevention program: Changing nutrition and physical activity environments in California’s heartland. American Journal of Public Health, 100(11), 2124–2128. https://doi.org/10.2105/AJPH.2010.203588

Sliwa, S., Goldberg, J. P., Clark, V., Junot, B., Nahar, E., Nelson, M. E., Tovar, A., Economos, C. D., Collins, J., Edwards, R., & Hyatt, R. R. (2011). Using the community readiness model to select communities for a community-wide obesity prevention intervention. Preventing Chronic Disease, 8(6). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3221589/

Smathers, C., & Lobb, J. M. (2015). Extension professionals and community coalitions: Professional development opportunities related to leadership and policy, system, and environment change. Journal of Extension, 53(6), Article v53-6a1. https://www.joe.org/joe/2015december/a1.php

Smathers, C., Washburn, L., Toomey, M., Johannes, E., Iaccopucci, A. M., & Johnston, K. (2018). Organizational readiness to engage in policy, system, and environment changes supporting positive youth development for health: Case studies from the Cooperative Extension System framed by the transtheoretical model. Journal of Human Sciences and Extension, 6(2). https://www.jhseonline.com/article/view/722

Stark, C. M., Devine, C. M., & Dollahite, J. S. (2017). Characteristics associated with the application of an ecological approach to preventing childhood obesity. Public Health Nutrition, 20(1), 174–182. https://doi.org/10.1017/S1368980016001798

Stark, C. M., Graham-Kiefer, M. L., Devine, C. M., Dollahite, J. S., & Olson, C. M. (2011). Online course increases nutrition professionals’ knowledge, skills, and self-efficacy in using an ecological approach to prevent childhood obesity. Journal of Nutrition Education and Behavior, 43(5), 316–322. https://doi.org/10.1016/j.jneb.2011.01.010

Story, M., Kaphingst, K. M., Robinson-O’Brien, R., & Glanz, K. (2008). Creating healthy food and eating environments: Policy and environmental approaches. Annual Review of Public Health, 29, 253–272. https://doi.org/10.1146/annurev.publhealth.29.020907.090926

Suglia, S. F., Shelton, R. C., Hsiao, A., Wang, Y. C., Rundle, A., & Link, B. G. (2016). Why the neighborhood social environment is critical in obesity prevention. Journal of Urban Health, 93(1), 206–212. https://doi.org/10.1007/s11524-015-0017-6

Thomas, L. N., Hill, T. F., Gaines, A., & Dollahite, J. S. (2016). Implementing smarter lunchrooms makeovers in New York State middle schools: An initial process evaluation. Archives of Public Health, 74(1), Article 41. https://doi.org/10.1186/s13690-016-0153-9

University of Tennessee. (2016). Regional Nutrition Education and Obesity Prevention Center for Excellence (Policy, Systems, and Environmental Change Center). http://snapedpse.org/

U.S. Department of Agriculture and the Food and Nutrition Service. (2016). Supplemental Nutrition Assistance Program: Nutrition education and obesity prevention grant program. https://www.federalregister.gov/documents/2016/03/31/2016-07179/supplemental-nutrition-assistance-program-nutrition-education-and-obesity-prevention-grant-program

USDA and the National Institute of Food and Agriculture. (2017a). EFNEP program policies. https://nifa.usda.gov/sites/default/files/program/EFNEP%20Program%20Policies%20(onscreen%20version).pdf

USDA and the National Institute of Food and Agriculture. (2017b). Impacts and reporting: National EFNEP reports | National Institute of Food and Agriculture. https://nifa.usda.gov/efnep-national-data-reports

Wallace, H. S. (2019). Community coalitions for change and the policy, systems, and environment model: A community-based participatory approach to addressing obesity in rural Tennessee. Preventing Chronic Disease, 16. https://doi.org/10.5888/pcd16.180678

Wang, S. L. (2014). Cooperative Extension System: Trends and economic impacts on U.S. agriculture. Choices, 29(1). https://www.choicesmagazine.org/choices-magazine/submitted-articles/cooperative-extension-system-trends-and-economic-impacts-on-us-agriculture

Weiss, E. S., Anderson, R. M., & Lasker, R. D. (2002). Making the most of collaboration: Exploring the relationship between partnership synergy and partnership functioning. Health Education & Behavior, 29(6), 683–698. https://doi.org/10.1177/109019802237938

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.