Evaluating Fidelity to the National Extension Dining with Diabetes Program: Challenges and Opportunities

The objective of this study was to evaluate fidelity to the Dining with Diabetes (DWD) program. Data were gathered cross-sectionally in 2019 using class profile forms (i.e., checklists) containing items reflecting the core components of DWD: delivery personnel, curriculum, hands-on cooking, and goal setting. Fidelity was calculated as the proportion of core components completed as intended. Educators (N = 9) completed class profile forms for 10 complete DWD programs (i.e., all four classes). Fidelity to components of completed DWD programs and individual DWD classes was high (over 70% in each category). Overall, fidelity was high, and adaptations reported likely did not detract from effectiveness (e.g., a 2-hour class lasted 2.5 hours). However, the response rate was low and may not reflect those who deliver with lower fidelity. Assessing fidelity should be incorporated as a standard part of community-based diabetes management program evaluation; these data can inform changes to programs to make them more effective in the “real world.

Unifying Multi-State Efforts Through a Nationally Coordinated Extension Diabetes Program

The Cooperative Extension System translates research to practice and “brings the University to the people” throughout the U.S. However, the system suffers from program duplication and is challenged to scale-out effective programs. One program, Dining with Diabetes (DWD), stands out for its dissemination to multiple states. DWD is a community-based program aimed at improving diabetes management, nutrition, and physical activity behaviors. DWD was coordinated through a national working group and implemented by state Extension systems. A pragmatic, quasi-experimental study was conducted to determine the effectiveness of the national coordination model and the overall impact of DWD. Four states reported data representing 355 DWD participants. Significant differences were found in diabetes management behaviors and knowledge from pre to post- program. However, there were challenges with data analysis due to state differences in data management. We detail the transition from one state to a national workgroup, strengths and challenges of the national model, and implications for other Extension programs

Instructor Influence on Self-Efficacy in Women with Gestational Diabetes Mellitus

Gestational diabetes mellitus (GDM) develops during pregnancy with national occurrence rates of approximately 7.5% of pregnant women or about 88% of all cases of diabetes in pregnancy (Buchanan & Xiang, 2005). Adverse outcomes associated with GDM create higher medical costs for prenatal care, labor and delivery of baby, and extended postpartum recovery. Education, using experiential learning, for proper self-care practices of meal management and blood sugar monitoring is a vital component of GDM treatment. The first study included selection of pregnant women with GDM occurred during a five month period of time in three southeast Idaho locations, which resulted in 12 participants. The 18-item Diabetes Self-Efficacy Scale (DSES) developed by Hurley & Shea (1992) was used, with three additional question added to assess teacher influence and number of visits for diabetes education. Although no significance was shown among responses, an increasing trend occurred in certainty of perceived ability to perform diabetes self-care practices in all areas except exercise. The two descriptive questions to describe instructor influence provided valuable narrative to inform practitioners about their influence on their client's GDM education. The second study examined three andragogically based university program areas: Family and Consumer Sciences Education, Recreation Management, and Health Science. The results found a significant moderate positive relationship between student perceptions about their program preparation and students reported experiential learning opportunities using Schwarzer's General Self-Efficacy scale. The research demonstrated the students entered the programs with a high level of self-efficacy and the rigors of higher education in the selected programs do not diminish student self-efficacy.Thesis (Ph.Ed., Curriculum & Instruction)--University of Idaho, May 201