1 Department of Agricultural and Human Sciences, NC State University, Raleigh, NC, USA.
2 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Am J Health Promot. 2019 Jun;33(5):736-744. doi: 10.1177/0890117118821845. Epub 2019 Jan 30.
To better understand the barriers to implementing Supplemental Nutrition Assistance Program Education (SNAP-Ed) direct education programming in rural communities, as well as strategies to overcome these barriers. This includes (1) barriers to implementing direct education in rural communities, and (2) facilitators to overcoming direct-education barriers in rural communities.
This was a qualitative study that included in-depth interviews.
Fifteen states across all 7 SNAP-Ed regions.
Participants were eligible if they (1) were SNAP-Ed staff who were involved with implementing programs; (2) implemented at least 50% of their programming in rural communities, and (3) worked in their role for at least 12 months. Twenty-seven (n = 27) staff participated in interviews.
Online surveys ascertained if participants were interested in participating in a 60-minute interview about implementing SNAP-Ed in rural communities. Interviews were semistructured and focused on the barriers and facilitators to implementing SNAP-Ed direct-education nutrition programming in rural areas.
Qualitative interviews were analyzed using content analysis in Atlas.ti.
Barriers to implementing direct education in rural communities included lack of healthy food and physical activity infrastructure to reinforce messages taught in class, funding restrictions, transportation for SNAP-Ed staff and the perception that this was also a problem for participants, and SNAP-Ed staff being seen as "outsiders" (not from the community). Facilitators included partnering with other organizations to increase recruitment and retention of SNAP-Ed participants, buy-in from local leaders, and SNAP-Ed staff being from the community.
Partnerships between SNAP-Ed programs and non-SNAP-Ed organizations were essential in helping to recruit and retain participants. The SNAP-Ed staff should get buy-in from local leaders before starting direct-education programming. The SNAP-Ed programs should explore innovative delivery modalities including online and text messaging due to transportation issues in widespread rural geographies. Lastly, more work should be done to complement SNAP-Ed direct education with policy, systems, and environmental change initiatives.
更好地了解在农村社区实施补充营养援助计划教育（SNAP-Ed）直接教育计划的障碍，以及克服这些障碍的策略。这包括（1）在农村社区实施直接教育的障碍，以及（2）克服农村社区直接教育障碍的促进因素。
这是一项定性研究，包括深入访谈。
所有 7 个 SNAP-Ed 地区的 15 个州。
如果他们（1）是参与实施计划的 SNAP-Ed 工作人员；（2）在农村社区实施至少 50%的计划；（3）在其角色中工作至少 12 个月，则有资格参加。27 名（n = 27）工作人员参加了访谈。
在线调查确定参与者是否有兴趣参加关于在农村社区实施 SNAP-Ed 的 60 分钟访谈。访谈采用半结构化方式，重点关注在农村地区实施 SNAP-Ed 直接教育营养计划的障碍和促进因素。
使用 Atlas.ti 对定性访谈进行内容分析。
在农村社区实施直接教育的障碍包括缺乏健康食品和体育活动基础设施来强化课堂上教授的信息、资金限制、SNAP-Ed 工作人员的交通以及参与者也认为这是一个问题，以及 SNAP-Ed 工作人员被视为“局外人”（不是来自社区）。促进因素包括与其他组织合作，以增加 SNAP-Ed 参与者的招募和保留、当地领导人的认可，以及 SNAP-Ed 工作人员来自社区。
SNAP-Ed 计划与非 SNAP-Ed 组织之间的合作对于帮助招募和保留参与者至关重要。在开始直接教育计划之前，SNAP-Ed 工作人员应获得当地领导人的认可。SNAP-Ed 计划应探索创新的交付模式，包括在线和短信服务，因为在广泛的农村地区存在交通问题。最后，应做更多的工作，通过政策、系统和环境变化倡议来补充 SNAP-Ed 直接教育。
