Browsing by Author "Ramalingam, NithyaPriya S."

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    Beginning With the End in Mind: Contextual Considerations for Scaling-Out a Community-Based Intervention
    Balis, Laura E.; Strayer, Thomas E., III; Ramalingam, NithyaPriya S.; Harden, Samantha M. (Frontiers, 2018-12-10)
    Introduction: A number of effective physical activity programs for older adults exist, but are not widely delivered within community settings, such as the Cooperative Extension System. The purpose of this paper was to determine if an evidence-based intervention (EBI) developed in one state Extension system could be scaled-out to a new state system. Methods and results: The RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework was used to guide an iterative evaluation of three translational stages. Stage 1: Before program adoption, Extension health educators were surveyed and interviewed to assess physical activity programming perceptions and factors that may influence their decision to attend training or deliver the program in practice. Results indicated that a virtual, scalable training protocol would be necessary and that training needed to include hands-on instruction and be catered to those who were less confident in physical activity program delivery. Stage 2: Training attendees were surveyed pre- and post-training on factors related to the adoption-decision making process and contacted post-training to assess program delivery status. Training did not influence perceptions of the program, intent to deliver, or confidence in delivering the program. Stage 3: During program implementation, the program was evaluated through the RE-AIM framework by surveying across three key stakeholder groups: (1) program participants, (2) potential delivery personnel, and (3) Extension administrators. Findings indicate that the program has the potential to reach a large and representative proportion of the target audience, especially in rural areas. However, adoption and implementation rates among Extension health educators and community partners were low and data collection for effectiveness, implementation, and maintenance was a challenge. Conclusion: Overall, the results indicate initial struggles to translating and evaluating the program in a large, rural state. Implications for practice include making system-level changes to increase physical activity program adoption rates among Extension health educators and improve data collection and program evaluation through this community-based organization. More work is needed to identify infrastructure support and capacity to scale-out EBIs.
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    Dissemination in Extension: Health Specialists' Information Sources and Channels for Health Promotion Programming
    Strayer, Thomas E.; Balis, Laura E.; Ramalingam, NithyaPriya S.; Harden, Samantha M. (MDPI, 2022-12-12)
    In the National Cooperative Extension System (herein: Extension), state-level specialists serve as key intermediaries between research, educators, and the community members they serve. There is a need to understand information seeking and sharing practices (i.e., dissemination) among specialists to increase the adoption of evidence-based health promotion programs. Specialists (N = 94) across 47 states were identified and invited to participate in this mixed methods study. A one-way ANOVA with Bonferroni corrections was used to analyze survey data. Data collected through semi-structured interviews were analyzed using an immersion crystallization approach. Forty-seven health specialists completed the survey representing 31 eligible states (65%) and were predominately female (89%), Caucasian (70%), had a doctorate (62%), and were employed within Extension for 10.2 + 9.7 years. The information sources used most frequently were academic journals and other specialists, and most used email and online meetings to communicate. Qualitative findings support the use of other specialists as a primary source of information and indicate specialists’ desire for an on-demand, bi-directional, online national repository of Extension programs. This repository would facilitate the dissemination of evidence-based programming across the system and reduce program duplication as well as information burden on county-based educators.
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    Informing the development and uptake of a weight management intervention for preconception: a mixed-methods investigation of patient and provider perceptions
    Harden, Samantha M.; Ramalingam, NithyaPriya S.; Wilson, Kathryn E.; Evans-Hoeker, Emily (2017-02-06)
    Background It is recommended for women to have a healthy body mass index before conception. However, there is limited research on appropriate preconception interventions for weight loss. Furthermore, there is a lack of knowledge on providers’ willingness to refer to particular behavioral interventions and the degree to which patients would attend those interventions. Methods A cross-section of 67 patients and 21 providers completed surveys related to their demographics and willingness to refer/attend a number of interventions for weight loss. A case study of three patients from the target audience was used to elicit detailed feedback on preconception weight status and weight loss intervention. Results Overall, patients were willing to attend a variety of interventions, regardless of BMI category. Focus group participants shared that weight loss prior to conception would be beneficial for them and their child, but cited barriers such as time, location, and the way providers encourage weight loss. Providers were willing to refer to a number of behavioral interventions, and were less willing to prescribe weight loss medications than other intervention options. Conclusions A number of intervention strategies may be well received by both patients and providers in preconception care to assist with weight loss prior to conception. Future research is needed on intervention effects and sustainability.