Extension Wellness Ambassadors: Individual Effects of Participation in a Health-Focused Master Volunteer Program

We present findings from a pilot implementation of the Extension Wellness Ambassador Program, a health-focused master volunteer program, and briefly describe the program approach and purpose. Program participants received 40 hr of training and completed assessments of self-efficacy, physical activity, and functional fitness at baseline and 3-month follow-up. Paired-samples t-tests showed significant positive changes in mean for general self-efficacy, self-efficacy for practicing health behaviors, physical activity, and nearly all functional fitness measures. Our findings demonstrate that participation in a health-focused master volunteer program can positively influence participants\u27 lifestyle behaviors as they work to improve health and quality of life in their communities

Exploring Extension Agent Capacity and Readiness to Adopt Policy, Systems and Environmental Change Approaches

Introduction: 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. Method: 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\u27 stage of change regarding PSE change strategies. Descriptive statistics and response frequencies for all variables were calculated. Results: Survey responses (n = 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. Discussion: 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

Truth Be Told: Evidence of Wheelchair Users’ Accuracy in Reporting Their Height and Weight

Objectives To examine whether wheelchair users’ self-reports of height and weight differed significantly from direct measurements and whether weight category classifications differed substantially when based on self-reported or measured values. Design Single group, cross-sectional analysis. Analyses included paired t tests, chi-square test, analysis of variance, and Bland-Altman agreement analyses. Setting A university-based exercise lab. Participants Community-dwelling wheelchair users (N=125). Interventions Not applicable. Main Outcome Measure Participants’ self-reported and measured height, weight, and body mass index. Results Paired t tests revealed that there were significant differences between wheelchair users’ self-reported and measured values for height (difference of 3.1±7.6cm [1.2±3.0in]), weight (−1.7±6.5kg [−3.6±14.2lb]), and BMI (−1.6±3.3). These discrepancies also led to substantial misclassification into weight categories, with reliance on self-reported BMI underestimating the weight status of 20% of the sample. Conclusions Our findings suggest that similar to the general population, wheelchair users are prone to errors when reporting their height and weight and that these errors may exceed those noted in the general population

Exercise for Everyone: A randomized controlled trial of Project Workout On Wheels in promoting exercise among wheelchair users

This is the author's accepted manuscript. Made available by the permission of the publisher.Objective To compare the effectiveness of two home-based behavioral interventions to promote wheelchair users exercise adoption and maintenance over 12 months. Design Randomized controlled trial, with participants stratified into groups based on disability type (stable, episodic, progressive) and support partner availability. Setting Exercise occurred in participant preferred locations (e.g., home, recreation center), with physiological data collected at the university-based exercise lab. Participants One hundred twenty-eight inactive wheelchair users (64 women) with sufficient upper arm mobility for arm-based exercise enrolled. Participants on average were 45 years old, lived with their impairment for 22 years, with spinal cord injury (46.1%) most commonly reported as causing mobility impairment. Interventions Both groups received home-based exercise interventions. The staff-supported group (n= 69) received intensive exercise support, while the self-guided group (n= 59) received minimal support. Both received exercise information, resistance bands, instructions to self-monitor exercise, regularly-scheduled phone calls, and handwritten cards. Main Outcome Measures The primary outcome derived from weekly self-reported exercise. Secondary outcomes included physical fitness (aerobic/muscular) and predictors of exercise participation. Results The staff-supported group reported significantly greater exercise (~ 16 minutes/week) than the self-guided group over the year (t=10.6, p=0.00), with no significant between group difference in aerobic capacity (t=0.76, p=0.45) and strength (t=1.5, p=0.14). Conclusions Although the staff-supported group reported only moderately more exercise, the difference is potentially clinically significant as they also exercised more frequently. The staff-supported approach holds promise for encouraging exercise among wheelchair users, yet additional support may be necessary to achieve more exercise to meet national recommendations

Integrating Policies, Systems, and Environments (PSE) Work into FCS Extension Programming: Lessons Learned from a Multi-State Training

Public health efforts have emphasized changes to policies, systems and environments (PSEs) to improve health behaviors for individuals and communities. Extension has increasingly emphasized these approaches, particularly for work of Family and Consumer Sciences (FCS) agents. In part, this emphasis on PSEs in Extension has been driven by SNAP-Ed and other federally funded initiatives, such as the Centers for Disease Control and Prevention (CDC) High Obesity Programs (HOP). However, broader adoption and implementation of PSEs at the local level has lagged in some states for various reasons. These include limited understanding about PSE interventions and how this work fits with a traditional Extension emphasis on direct education. To address these issues, faculty and specialists from two states receiving funding in the CDC’s first HOP round planned, designed, and implemented a face-to-face, multi-state, multi-institution PSE training for FCS agents. This paper describes the multi-state training effort, barriers to PSE work in Extension, and offers best practices and implications for others seeking to provide similar training

Armor or Withdraw? Likely Litigation and Potential Adjudication of Shoreland Conflicts Along Michigan\u27s Shifting Great Lake Coasts

Michigan enjoys along its inland seas, the Laurentian Great Lakes, one of the longest coastlines in the U.S. Much of that shoreline is privately owned. Because of a confluence of development pressures and irrepressible physical dynamics, growing numbers of Great Lakes shoreland properties, built on shifting sandy shores, are at heightened risk of loss from coastal storm surge, inundation, erosion, and shoreline recession. In response, property owners are installing extensive hardened shoreline armoring structures like seawalls and revetments to arrest those erosional processes. Those structures, however, will substantially impair, if not ultimately destroy, the state’s natural coastal beaches and other shoreland resources, as well as accelerate erosion of neighboring shoreland properties. The clash of imperatives to protect shoreland properties versus conserve coastal resources signifies a wicked dilemma the State cannot avoid: armor or withdraw? More precisely, should we allow the armoring of Michigan’s Great Lakes shorelines in an attempt to fix in place shoreland properties, at great and ongoing private and public expense, and ultimately risk the loss of public trust resources? Or should we allow—and should we compel shoreland property owners to allow—natural processes to proceed, even though doing so will increase the rate at which privately owned shorelands naturally convert into state-owned submerged bottomlands? We cannot hope to simultaneously protect both the beach and the beach house along naturally receding Great Lakes shorelines; we must choose which interest to prioritize first, recognizing the cost of doing so by losing the other. In addition to the complex physical dynamics at play along Michigan’s Great Lakes coasts, there are evolving legal complexities as well. The State, as sovereign, enjoys police power authorities that encompass coastal shoreland management. The State has also long recognized the applicability of the public trust doctrine to its Great Lakes shores, and its constitution mandates the protection of natural resources. This article first analyzes current Michigan law to determine how those doctrines and mandates apply to Great Lakes shoreline armoring, particularly in terms of what to prioritize. Based on that assessment, we conclude that Michigan’s courts, legislature, and people have consistently and clearly prioritized protecting and conserving Great Lakes natural coastal resources above developing or impairing them for private use, except when such development truly serves larger public trust interests. In contrast, the administrative rules now used to execute those protections prioritize protecting the private beach house first, even at the expense of destroying the natural beach and impairing other public trust interests. This administrative approach was not inevitable— indeed it may be unlawful—and it has created strong expectations on the part of shoreland property owners, heightening the likelihood of litigation. The article then analyzes current Michigan law to determine how the courts might resolve disputes between property owners hoping to armor the shore and State or local constraints on such armoring. Here we find that while the Michigan courts have resolved a number of key questions regarding coastal shorelands, there is no caselaw addressing directly the lawfulness of shoreline armoring. Based on our review of relevant caselaw, we conclude the courts are not likely to find that the State lacks authority to regulate—or prohibit altogether—shoreline armoring to protect coastal resources. There is conflicting caselaw, however, upon which the courts could rely to find either that the current regulatory regime provides adequate protection of coastal resources, or alternatively that it is deficient. Finally, beyond questions of regulatory authority, the courts are not likely to find that reinvigorated regulatory efforts to prevent the destruction and impairment of public trust coastal resources from armoring—even those resulting in the accelerated loss of private properties—violate constitutional protections, especially if State reforms are undertaken with deliberation and care. If the courts conclude that current regulatory efforts are lawful and require no greater protection, then Michigan will likely see much of its Great Lakes shorelines armored and its natural coastal beaches destroyed. If they conclude that current regulatory efforts are deficient (or if they approve of reinvigorated protection efforts), however, then private shoreland properties may be lost to the lakes. Such losses cannot be avoided forever, especially along naturally receding shorelines, but they might occur sooner than would happen absent attempts to arrest shoreline erosion with armoring. As with most wicked policy dilemmas, the best response may not be at either extreme—always armor or always withdraw—but somewhere in between. Crafting that hybrid approach, and the appropriate rules for applying it, will be the most challenging course to navigate

Policy, Systems, and Environmental Change: A Planning Tool for Community Health Implementation

Extension educators across the United States are being asked to expand their direct education efforts to include policy, systems, and environmental (PSE) changes. However, professional development opportunities and tools are needed to familiarize Extension professionals with PSE change approaches, build their capacity to implement PSE change, and make the process relevant to their work. We describe a planning tool developed for a unique multistate PSE change intervention training and designed to facilitate the process of PSE change implementation at the local level. An example of the tool and recommendations for others wishing to use it are included

Two States, One Mission: Building Policy, Systems, and Environmental Change Capacity of County Extension Educators

Policy, systems, and environmental (PSE) change interventions are a key part of comprehensive nutrition and health education. Although Extension educators find value in PSE approaches and report being involved in PSE work, many still indicate a lack of understanding regarding PSE approaches. We describe a unique multistate training designed to increase Extension educators\u27 understanding, skills, and capacity related to implementing PSE change interventions. Data demonstrating success of the training are presented. Additionally, best practices for others wishing to create similar multistate programs conclude the article

Policy, Systems, and Environmental Change: A Planning Tool for Community Health Implementation

Extension educators across the United States are being asked to expand their direct education efforts to include policy, systems, and environmental (PSE) changes. However, professional development opportunities and tools are needed to familiarize Extension professionals with PSE change approaches, build their capacity to implement PSE change, and make the process relevant to their work. We describe a planning tool developed for a unique multistate PSE change intervention training and designed to facilitate the process of PSE change implementation at the local level. An example of the tool and recommendations for others wishing to use it are included

Two States, One Mission: Building Policy, Systems, and Environmental Change Capacity of County Extension Educators

Policy, systems, and environmental (PSE) change interventions are a key part of comprehensive nutrition and health education. Although Extension educators find value in PSE approaches and report being involved in PSE work, many still indicate a lack of understanding regarding PSE approaches. We describe a unique multistate training designed to increase Extension educators\u27 understanding, skills, and capacity related to implementing PSE change interventions. Data demonstrating success of the training are presented. Additionally, best practices for others wishing to create similar multistate programs conclude the article