Department of Family and Consumer Sciences, Institute of Agriculture, University of Tennessee, Knoxville, TN, United States.
Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, KY, United States.
Front Public Health. 2022 May 26;10:856788. doi: 10.3389/fpubh.2022.856788. eCollection 2022.
Enhanced Extension outreach strategies combine traditional direct education programs with public health approaches like policy, systems, and environmental (PSE) change. However, the Cooperative Extension system and county-based Family and Consumer Sciences (FCS) Extension agents have historically prioritized direct education programming and diffusion of enhanced outreach strategies has varied. Extension personnel may lack capacity and readiness for successful PSE change implementation. This study explored perceived acceptability, capacity, and readiness for PSE change work among FCS Extension agents in two states.
A survey was developed framed by selected domains from the Consolidated Framework for Implementation Research: Intervention Characteristics, Inner Setting, Characteristics of Individuals, and Process. All questions utilized a 5-point Likert scale, except for an item examining respondents' stage of change regarding PSE change strategies. Descriptive statistics and response frequencies for all variables were calculated.
Survey responses ( = 116) indicated PSE change work was perceived as valuable. Potential barriers included perceived complexity, organizational readiness issues (e.g., reporting and evaluation structures; performance incentives), and worries about stakeholder responses in shifting away from direct education. Responses indicated self-efficacy for skills important in implementing PSE change. Most respondents (53%) indicated being at the pre-contemplation or contemplation stage of change in pursuing PSE change work.
Combining PSE change strategies and direct education programming allows Extension to do what it does best - provide effective programs to improve and sustain health and wellbeing of individuals and families. Findings are informative for others aiming to build capacity within community educators, Extension and public health professionals to implement PSE change.
增强型扩展外展策略将传统的直接教育计划与政策、系统和环境 (PSE) 改变等公共卫生方法相结合。然而，合作推广系统和基于县的家庭和消费者科学 (FCS) 推广代理历来优先考虑直接教育计划，扩展外展策略的传播情况各不相同。推广人员可能缺乏成功实施 PSE 变革的能力和准备。本研究探讨了两个州的 FCS 推广代理对 PSE 变革工作的感知可接受性、能力和准备情况。
该调查是根据实施研究综合框架中的选定领域制定的：干预特征、内部环境、个体特征和过程。除了检查受访者对 PSE 变革策略的变革阶段的一个项目外，所有问题都使用 5 点李克特量表。计算了所有变量的描述性统计和响应频率。
调查回应（n=116）表明，PSE 变革工作被认为是有价值的。潜在的障碍包括感知的复杂性、组织准备问题（例如，报告和评估结构；绩效激励），以及担心在从直接教育转向时利益相关者的反应。回应表明在实施 PSE 变革方面具有实施重要技能的自我效能感。大多数受访者（53%）表示在追求 PSE 变革工作时处于准备或考虑阶段。
将 PSE 变革策略与直接教育计划相结合，使推广能够发挥其最大优势 - 提供有效的计划，以改善和维持个人和家庭的健康和福祉。这些发现为其他旨在培养社区教育者、推广和公共卫生专业人员实施 PSE 变革能力的人提供了信息。
