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Clemson University

The Journal of Extension

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Articles 1 - 25 of 25

Full-Text Articles in Medicine and Health Sciences

When A Health Insurance Provider Says “No”: A Health Insurance Claim Navigation Tool, Dorothy Nuckols, Catherine Sorenson May 2024

When A Health Insurance Provider Says “No”: A Health Insurance Claim Navigation Tool, Dorothy Nuckols, Catherine Sorenson

The Journal of Extension

The purpose of health insurance is to pay for preventative and nonpreventative health care. Unfortunately, claim denials are frequent and most people do not contested these denials. Consumers lack both knowledge and self-efficacy to challenge their health insurance decision. Conflict is stressful can occur when a health insurance claim is denied unexpectedly. Faced with uncertainty of health care cost coverage, consumers are more likely to delay or forgo healthcare and jeopardize their health. To address this challenge, increase awareness of claim appeal processes and to provide consumer guidance, [STATE] Extension developed a Health Insurance Claim Navigation Tool.


A Needs Assessment Of Extension Staff To Implement Inclusive Programming For Adults With Intellectual/Developmental Disabilities, E. Andrew Pitchford, Christine Hradek, Jody Gatewood, Debra M. Sellers May 2024

A Needs Assessment Of Extension Staff To Implement Inclusive Programming For Adults With Intellectual/Developmental Disabilities, E. Andrew Pitchford, Christine Hradek, Jody Gatewood, Debra M. Sellers

The Journal of Extension

This study is a needs assessment of Extension staff in the state of Iowa to implement inclusive programming for individuals with intellectual and developmental disabilities (IDD). Electronic surveys were completed by Extension staff on their attitudes and beliefs toward people with IDD, inclusive programming, and training needs. Results showed that Extension staff had positive views, but that staff reporting personal experience with people with IDD had more positive attitudes and beliefs (p


Extension-Clinical Approach To Covid-19 Testing And Vaccination, Camden Bryan, Rhonda Matthews, Kapri Kreps, David Thornal, Danielle Mcfall, David Sudduth, Michelle Parisi May 2024

Extension-Clinical Approach To Covid-19 Testing And Vaccination, Camden Bryan, Rhonda Matthews, Kapri Kreps, David Thornal, Danielle Mcfall, David Sudduth, Michelle Parisi

The Journal of Extension

Vaccination rates against COVID-19 are lower in rural areas across the country, including SC. This paper highlights the work conducted by Clemson Cooperative Extension Service in SC to increase rural access to COVID-19 testing and vaccine services. Extension Agents engaged in clinical and community partnerships to coordinate COVID-19 vaccine and testing clinics in rural and underserved communities. Agents established 204 test clinics and 220 vaccination clinics. The total number of people tested and vaccinated was 9,331 and 2,037, respectively. The success of this project shows Extension agents can be instrumental in bridging the gap between clinical resources and rural communities.


Mixed Methods Evaluation Of Nutrition Education For Limited Resource Audiences, Amanda J. Skalka, Sarah L. Francis, Ulrike Genschel, Ruth E. Litchfield Apr 2024

Mixed Methods Evaluation Of Nutrition Education For Limited Resource Audiences, Amanda J. Skalka, Sarah L. Francis, Ulrike Genschel, Ruth E. Litchfield

The Journal of Extension

This paper presents an exploratory evaluation of pilot nutrition education programs, Plan Shop Save Cook (PSSC). Behavior change between two nutrition education programs, Buy Eat Live Healthy (BELH; n=92 and PSSC; n=42), was examined using pre- and post-program questionnaire responses. Both programs resulted in significant improvement in food resource management (FRM) behaviors; however, there was no significant difference in the amount of change between the programs. Qualitative data suggests participants perceived label reading as the most useful information provided in the PSSC programs. The current findings suggest short-term behavior change can be achieved with a limited dose program.


Leveraging 4-H To Address Emergent Health Needs During The Covid-19 Pandemic: Epidemiology Pilot Project, Anne Marie Iaccopucci, Marcel Horowitz, Dorina Espinoza, Roshan Nayak Apr 2024

Leveraging 4-H To Address Emergent Health Needs During The Covid-19 Pandemic: Epidemiology Pilot Project, Anne Marie Iaccopucci, Marcel Horowitz, Dorina Espinoza, Roshan Nayak

The Journal of Extension

4-H academics responded to the Covid pandemic by rapidly adapting CDC and other resources for virtual delivery. A statewide epidemiology project was taught to 48 youth with the goal of minimizing fears and confusion, increasing prevention measures, leveraging current topics for education, and bolstering the social-emotional health of youth participants. Results indicated that youth enjoyed the project and adopted behaviors to reduce the spread of infectious diseases, such as increased mask-wearing.


Extending Knowledge On Biosecurity In Small-Scale And Backyard Systems In The United States, Juliette Di Francesco, Amber Itle, Craig Mcconnel, Ragan Adams, Roselle Busch, Richard Van Vleck Pereira, Terry W. Lehenbauer, Beatriz Martínez-López, Alda F. A. Pires Mar 2024

Extending Knowledge On Biosecurity In Small-Scale And Backyard Systems In The United States, Juliette Di Francesco, Amber Itle, Craig Mcconnel, Ragan Adams, Roselle Busch, Richard Van Vleck Pereira, Terry W. Lehenbauer, Beatriz Martínez-López, Alda F. A. Pires

The Journal of Extension

The number of small-scale and backyard operations has increased in the United States during the past decade, but there is currently a lack of outreach efforts and readily-available educational materials targeting these farming systems. We developed a webinar series on biosecurity to provide training for small-scale and backyard producers, and training tools that can be used by local veterinarians and extension educators to disseminate knowledge and consistent recommendations more effectively. Fewer people attended the webinars than registered, suggesting a gap between interest in biosecurity and commitment to the topic. Participants in the webinar series reported a high level of satisfaction …


How To Build And Sustain A Transdisciplinary Community-Based Exercise Program For Older Adults, Stephen D. Ball Phd, Kristin Miller Ms, Kelsey J. Weitzel Ms, Breanne S. Baker Phd Mar 2024

How To Build And Sustain A Transdisciplinary Community-Based Exercise Program For Older Adults, Stephen D. Ball Phd, Kristin Miller Ms, Kelsey J. Weitzel Ms, Breanne S. Baker Phd

The Journal of Extension

We have built a community-based program called Stay Strong, Stay Healthy, which helps older adults improve muscle strength and flexibility while reducing fall risk. This report details lessons learned and keys to success for Extension practitioners. First, maximize the potential of your state’s Extension framework by building a program that centers around your target population and is fun and easy to implement. Second, partner with researchers who can help to improve program effectiveness and logistical feasibility on larger scales. Lastly, continue to evaluate and adapt based on feedback from those who utilize and implement the program.


Maximizing Dietary Knowledge And Behavior Through A Teens As Teachers Approach, Anaderi Iniguez, Erica L. Doering, Elizabeth H. Weybright Dec 2023

Maximizing Dietary Knowledge And Behavior Through A Teens As Teachers Approach, Anaderi Iniguez, Erica L. Doering, Elizabeth H. Weybright

The Journal of Extension

The teens as teachers model is a promising approach to impact teen behavior. The current study evaluated dietary knowledge and behavior among teen teachers participating in a 4-H youth development program (N = 46; Mage = 15.5 years; 67% female; 48% Hispanic; 38% White Non-Hispanic, 14% Other). A paired sample t test was conducted on pre-and post-program surveys to identify significant improvements in dietary knowledge and behaviors. Findings suggest teens as teachers is generally effective in promoting healthy dietary knowledge and behavior. We recommend this approach be disseminated within Extension 4-H youth development healthy eating active living programming.


Evaluating Physical Activity Resources To Support Health Equity In Arizona, Kathryn M. Orzech, Theresa A. Legros, Laurel Jacobs, Gregory Goodman, Ryan Lang Dec 2023

Evaluating Physical Activity Resources To Support Health Equity In Arizona, Kathryn M. Orzech, Theresa A. Legros, Laurel Jacobs, Gregory Goodman, Ryan Lang

The Journal of Extension

We evaluated physical activity (PA) resources in lower-income Arizona communities to support the Supplemental Nutrition Assistance Program – Education (SNAP-Ed) in pursuing equitable policy, systems, and environment (PSE) interventions. In 2017, 71 PA resources across 10 counties (65% parks) were rated using the Physical Activity Resource Assessment (PARA) tool. Accessibility was high, but condition scores and attractiveness varied across resources, with no rural/urban differences. Results suggest that Extension SNAP-Ed staff can be agents of change by assessing resource condition where physical activity health inequities may exist and then convening partners to begin to address needed changes.


Revisiting The Master Food Volunteer Program: Examining How To Enhance Nutrition Education In The United States, Stacey Viera, Lindsey Haynes-Maslow Sep 2023

Revisiting The Master Food Volunteer Program: Examining How To Enhance Nutrition Education In The United States, Stacey Viera, Lindsey Haynes-Maslow

The Journal of Extension

America’s diet-related illness crisis intersects with a lack of nutrition literacy, nutrition security, and systemic inequities. The Cooperative Extension Service’s (CES) national infrastructure could potentially provide equitable access to quality nutrition education in the US utilizing a Master Food Volunteer (MFV) model. This research brief examined preliminary evidence for the MFV model as a support for CES agents and paraprofessionals, and results show a paucity of evidence. Further research and a pilot program with pre-established measures for health-related knowledge and behaviors could elucidate the model’s potential to increase equitable access to evidence-based programming, nutrition, and implementation guidance.


Development And Evaluation Of Impact Statements For The Expanded Food And Nutrition Education Program (Efnep), Kylie Pybus, Ronald L. Gibbs Jr., Karen Franck, M. Catalina Aragón Sep 2023

Development And Evaluation Of Impact Statements For The Expanded Food And Nutrition Education Program (Efnep), Kylie Pybus, Ronald L. Gibbs Jr., Karen Franck, M. Catalina Aragón

The Journal of Extension

Extension professionals often communicate program outcomes to external stakeholders using impact statements. We developed and evaluated four impact statements for the Expanded Food and Nutrition Education Program (EFNEP). We drafted the statements after conducting literature reviews for core content areas of EFNEP that include diet quality, food resource management, physical activity, and food safety. Subsequently, we evaluated the statements by facilitating expert panels made up of subject matter experts and communication professionals (n=14) from 12 Land-grant Universities. These impact statements aim to support EFNEP and other Extension professionals when communicating program value with key external stakeholders.


Lessons Learned For Engaging Latino Families In Community-Based Programs, Alejandro Reyes Peralta, Ghaffar Ali Hurtado Choque, Marla Reicks, Silvia Alvarez De Davila, Darya Soltani Aug 2023

Lessons Learned For Engaging Latino Families In Community-Based Programs, Alejandro Reyes Peralta, Ghaffar Ali Hurtado Choque, Marla Reicks, Silvia Alvarez De Davila, Darya Soltani

The Journal of Extension

A family-skills program for Latino fathers and youth was implemented to prevent youth obesity. Lessons learned focused on practices to address barriers to engagement and retention among fathers and youth within the Latino community. Program development issues included selection of organizations, facilitators, language, and delivery methods. Implementation issues included timing and location. Cultural issues regarding learner needs, and teaching and implementation methods need to be considered. Using the lessons learned, Extension professionals can create impactful programs that engage and retain Latino fathers and youth.


Assessing The Snap Consumer Environment At Farmers Markets, Gabrielle C. Young, Sarah Misyak, Meredith Ledlie Johnson, Natalie E. Martin, Elena Serrano May 2023

Assessing The Snap Consumer Environment At Farmers Markets, Gabrielle C. Young, Sarah Misyak, Meredith Ledlie Johnson, Natalie E. Martin, Elena Serrano

The Journal of Extension

The SNAP at Farmers Market Environmental Assessment was developed as a tool for market managers to examine SNAP participant accessibility for redeeming SNAP benefits at farmers markets. By completing the SNAP at Farmers Market Environmental Assessment, the tool can serve as a guide for providing practical next steps for market improvement. Extension practitioners and researchers, including SNAP-Ed staff, can use the assessment tool to support policy, systems, and environment change efforts that promote access to local, high-quality foods by SNAP consumers, the redemption of SNAP benefits, and potentially increased sales at farmers markets.


Live Well, Eat Well, Be Active With Diabetes Curriculum Improves Type 2 Diabetes Management, Lauren Amaya, Dana Baldwin, Kathy Enyart, Arleen James, Tommie M. James, Penny R. King, Jan Maples, Lindy Peterman, Sara Randolph, Dea Rash, Kelsey Ratcliff, Joy Rhodes, Jessica Riggin, Janis Risley, Danette Russell, Janice Hermann May 2023

Live Well, Eat Well, Be Active With Diabetes Curriculum Improves Type 2 Diabetes Management, Lauren Amaya, Dana Baldwin, Kathy Enyart, Arleen James, Tommie M. James, Penny R. King, Jan Maples, Lindy Peterman, Sara Randolph, Dea Rash, Kelsey Ratcliff, Joy Rhodes, Jessica Riggin, Janis Risley, Danette Russell, Janice Hermann

The Journal of Extension

Type 2 diabetes is a complex disease with several modifiable lifestyle factors. The Extension ‘Live well, Eat well, be Active with Diabetes’ curriculum provides four 90-minute lessons teaching individuals to live well, eat well, and be active with diabetes. Fourteen Extension educators implemented and evaluated the curriculum with 107 participants. Participants reported the program helped them feel better able to take care of their health. We observed significant differences in participants’ retrospective pre and post ‘Live well,’ ‘Eat well’ and ‘be Active’ total scores. Extension has a unique opportunity to educate individuals so they may better manage their diabetes.


Protecting Cattle Feedyard Workers In The Central States Region: Exploring State, Regional, And National Data On Fatal And Nonfatal Injuries In Agriculture And The Beef Production Sector, Athena K. Ramos, Suraj Adhikari, Risto Rautiainen, Aaron Yoder Sep 2022

Protecting Cattle Feedyard Workers In The Central States Region: Exploring State, Regional, And National Data On Fatal And Nonfatal Injuries In Agriculture And The Beef Production Sector, Athena K. Ramos, Suraj Adhikari, Risto Rautiainen, Aaron Yoder

The Journal of Extension

Working in agriculture can be dangerous. Despite ongoing efforts of Extension, animal production worker safety has not been adequately addressed. We present state, regional, and national counts and rates on fatal and nonfatal injuries in agriculture and animal production using publicly available data from the Bureau of Labor Statistics. We found that animal production had a high number of fatal injuries and a higher rate of nonfatal injuries than the average within agriculture. More needs to be done to protect livestock workers from injury. Extension professionals can play a key role in increasing safety knowledge and changing behaviors.


Minnesota Cottage Food Industry: Insights From Extension Food Safety Education, Morrine Omolo, Regina Mcgoff, Suzanne Driessen, Katherine Brandt, Joanne Slavin, Michael Schmitt Sep 2022

Minnesota Cottage Food Industry: Insights From Extension Food Safety Education, Morrine Omolo, Regina Mcgoff, Suzanne Driessen, Katherine Brandt, Joanne Slavin, Michael Schmitt

The Journal of Extension

The cottage food industry has become a significant part of the food supply in Minnesota, most likely as a result of the growing consumer demand for locally produced, minimally processed and value-added foods. Using post-training evaluations, we characterized the cottage food producers in Minnesota and assessed the impact of our food safety course. The results showed that the producers are mostly white women (71%), producing and selling a variety of products. The learners gained knowledge to safely produce and handle homemade food products for direct sale to consumers. Majority (80%) of the learners were satisfied with the course.


Covid-19 Prevention Behaviors In A Cooperative Extension Audience: Findings From A Nutrition Education Study, Matthew Greene, Catherine Ruth Losavio, Denise Holston Sep 2022

Covid-19 Prevention Behaviors In A Cooperative Extension Audience: Findings From A Nutrition Education Study, Matthew Greene, Catherine Ruth Losavio, Denise Holston

The Journal of Extension

The COVID-19 pandemic has dramatically impacted the delivery of nutrition education through Cooperative Extension. This study aimed to identify a Cooperative Extension audience’s attitudes towards virus prevention behaviors, preferred sources of information regarding COVID-19, and nutrition education preferences during the pandemic. We distributed an online survey to 477 potential nutrition education participants including questions about behaviors like mask wearing, preferences for virtual nutrition lesson delivery, and attitudes towards sources of information about COVID-19. Attitudes towards mask wearing and preferred sources of information differed significantly by race, income, and age. These differences have serious implications for future outreach and program delivery.


Facilitators And Barriers To Farmers’ Market Use In A Rural Area, Soghra Jarvandi, Kristen Johnson, Karen Franck Jun 2022

Facilitators And Barriers To Farmers’ Market Use In A Rural Area, Soghra Jarvandi, Kristen Johnson, Karen Franck

The Journal of Extension

Farmers’ markets may improve access to healthful foods in rural areas. Our objective was to identify facilitators and barriers to farmers’ market use in a rural county. We collected data via surveys, focus group sessions, and key informant interviews. Study participants identified the two existing farmers’ markets as community assets. Barriers to use farmers’ markets included inconvenient market hours, not accepting nutrition assistance program benefits, limited transportation, and limited variety. Interventions to improve food access should include ways to meet the needs of specific populations such as low-income residents and residents living in outlying areas without farmers’ markets.


Lessons Learned Recruiting Comparison Elementary Schools For Impact Evaluation Of Snap-Ed Interventions, Amanda Linares, Phoebe Harpainter, Kaela Plank, Gail Woodward-Lopez Jun 2022

Lessons Learned Recruiting Comparison Elementary Schools For Impact Evaluation Of Snap-Ed Interventions, Amanda Linares, Phoebe Harpainter, Kaela Plank, Gail Woodward-Lopez

The Journal of Extension

To determine the effectiveness of Supplemental Nutrition Assistance Program- Education (SNAP-Ed) nutrition and physical activity programming in elementary schools, it is necessary to recruit socioeconomically similar comparison schools not receiving SNAP-Ed programming. We developed a flexible recruitment strategy to tailor our approach to each individual school district and site. Here we discuss the lessons learned during the 10-month recruitment period, including early outreach, emphasizing participation benefits, leveraging and building relationships, and visiting sites.


Fad Diets: Professional Development Needs Among Nutrition Agents In Select Southern States, Abigail P. Mcalister, Vicky L. Green, Simone Camel, Mary C. Fontenot, Janet F. Pope May 2022

Fad Diets: Professional Development Needs Among Nutrition Agents In Select Southern States, Abigail P. Mcalister, Vicky L. Green, Simone Camel, Mary C. Fontenot, Janet F. Pope

The Journal of Extension

Because FCS agents teach communities about dietary guidelines, it is important that they are aware of the latest nutrition research. This study assessed FCS agents’ knowledge of popular fad diets (low-carbohydrate, intermittent fasting, detoxes and cleanses) and their potential adverse effects, and its relationship among location, certifications, years of experience, professional association memberships, and education. Agents in Louisiana, Texas, Arkansas, and Mississippi were emailed a survey. RDN, DTR, and CHES certifications had significant associations (p = 0.03) with knowledge of adverse effects of fad diets. Agents who hold these credentials may have more knowledge about adverse effects of fad diets.


Adapting Ripple Effect Mapping To A Virtual Survey Format, Matthew D. Greene, Jessica Stroope, Denise Holston Feb 2022

Adapting Ripple Effect Mapping To A Virtual Survey Format, Matthew D. Greene, Jessica Stroope, Denise Holston

The Journal of Extension

Community development projects continue despite the COVID-19 pandemic. Participatory evaluation of these projects is crucial. Ripple effect mapping (REM) is a participatory approach to evaluation that captures coalition and community member perspectives on program outcomes and impacts. In response to COVID-19, the Louisiana State University AgCenter Healthy Communities Initiative adapted REM for online delivery. The REM evaluation was found to be an effective way for community coalitions to reflect on outcomes and impacts and to motivate continued engagement.


Cultural Sensitivity: A Requirement When Developing Food Safety Interventions, Lillian Nabwiire, Angela M. Shaw, Gail R. Nonnecke, David D. Minner, Ellen Johnsen, Louis E. Petersen Jr Jan 2022

Cultural Sensitivity: A Requirement When Developing Food Safety Interventions, Lillian Nabwiire, Angela M. Shaw, Gail R. Nonnecke, David D. Minner, Ellen Johnsen, Louis E. Petersen Jr

The Journal of Extension

Extension materials that are sensitive to changing demographics and culture increase relevance and compliance with food safety practices. Produce safety extension materials were developed for U.S. Virgin Islands (USVI) produce growers to help with compliance with a new food safety rule. We developed employee training materials based on a needs assessment and behavioral change was evaluated six months after dissemination. The original materials were not seen as culturally appropriate but after modifications, improvements in food safety practices and behavior changes were observed. These results suggest that extension educators should seek feedback from target populations about potential interventions before implementation.


Kentucky Equestrians: Defining Socioeconomic Contexts For Extension Programming, Kimberly I. Tumlin, Karin Pekarchik, Steven Claas Sep 2021

Kentucky Equestrians: Defining Socioeconomic Contexts For Extension Programming, Kimberly I. Tumlin, Karin Pekarchik, Steven Claas

The Journal of Extension

Understanding relationships between demographic and economic factors and equestrian participation could improve horse program design. We implemented an online survey that characterized associations of participation in equine activities, socioeconomic factors, and economic factors with age. Seventy-five percent of respondents ride, and 34% are recreational, non-competitive participants. Respondents were mostly female, and many participate in the sport throughout life. Many respondents indicated they overspent on equestrian activities. Horse programs should incorporate information and activities that address issues unique to females, should develop skills required by amateur or recreational riders, and should incorporate information on financial wellness.


4-H Student Nutrition Advisory Councils Support Positive Youth Development And Health Outcomes Among Underserved Populations, Shannon Klisch, Katherine E. Soule Sep 2021

4-H Student Nutrition Advisory Councils Support Positive Youth Development And Health Outcomes Among Underserved Populations, Shannon Klisch, Katherine E. Soule

The Journal of Extension

4-H SNAC Clubs engage youth in low-income schools with majority Latinx enrollment in leadership activities to increase schoolwide health and wellness. 4-H SNAC Clubs aim to develop youth health leaders, establish youth-adult partnerships, and increase access to 4-H in Latinx communities. Outcomes related to healthful living and positive youth development were assessed using the Teen Teacher Retrospective Survey (n=59) across five 4-H SNAC Clubs. Results show positive outcomes related to self-reported health behaviors for students and their families and leadership development. 4-H SNAC Clubs can increase access to 4-H among Latinx youth and support healthier communities through the Supplemental Nutrition …


Food Availability And Cost Patterns In Mississippi Retail Stores Participating In The Supplemental Nutrition Assistance Program, Virginia B. Gray, Sylvia H. Byrd, Laura Downey May 2021

Food Availability And Cost Patterns In Mississippi Retail Stores Participating In The Supplemental Nutrition Assistance Program, Virginia B. Gray, Sylvia H. Byrd, Laura Downey

The Journal of Extension

Research has suggested that availability of healthful food varies according to rurality/urbanicity, Supplemental Nutrition Assistance Program (SNAP) participation, and sociodemographic variables. We investigated differences in variety and cost of fruits and vegetables in convenience stores, grocery stores, and supermarkets across Mississippi. We collected data using the Nutrition Environment Measures Survey–Corner Store. Among stores surveyed (n = 453), fruit and vegetable variety was greater in nonmetro versus metro areas for convenience and grocery stores but not supermarkets. Elucidation of food availability in retail establishments serving SNAP Education (SNAP-Ed) clients is valuable for planning outreach efforts; smaller retailers may be important …