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).
Fam Community Health. 2022;45(4):228-237. doi: 10.1097/FCH.0000000000000332.
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.
赠地大学通过合作推广服务是社区健康促进项目的主要提供者。然而，推广目前解决系统性社会健康决定因素的方法并不完整和一致。本研究的目的是探讨推广健康教育者对针对最有可能经历健康不平等的受众的健康促进计划的需求的看法。邀请了 2 个州推广系统内的健康教育者根据能力建设模型完成在线调查。调查问题包括对针对健康差异人群的项目需求的看法进行评分：低收入人群；非裔美国人；西班牙裔、拉丁裔或拉丁裔；残疾人士；移民和难民；以及女同性恋、男同性恋、双性恋和跨性别者。方差分析和 Bonferroni 事后检验用于确定不同人群之间感知需求的差异。96 名教育工作者完成了调查。针对低收入人群的项目需求的认知明显高于其他人群。对移民和难民以及女同性恋、男同性恋、双性恋和跨性别者的编程需求明显低于其他人群。个人和组织层面的因素，包括种族主义和推广的历史范围，可能导致了这些结果。让历史上被排斥的推广受众参与进来，需要时间和资源来改善推广系统和教育者建立关系、建立信任和沟通的能力。
