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Browsing by Author "Strayer, Thomas Edward III"

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    Dissemination of Health Promotion Information in Cooperative Extension:  A multi-study exploration of channels, sources, and characteristics that influence intervention uptake
    Strayer, Thomas Edward III (Virginia Tech, 2019-05-09)
    A translational gap exists between the development of an evidence-based health promotion intervention and its eventual implementation in the intended setting. This lack of translation impacts the uptake of health promotion interventions within delivery systems such as the Cooperative Extension Service (Extension). Within this system, Extension educators serve as the intermediaries addressing needs in the communities in which they are employed with support from Extension health specialists. Previous research has shown that educators utilize other peer educators and specialists to learn and adopt health promotion programming, but these studies are over two decades old (e.g., missing technological advances such as Internet and social media) and often focused on a single state Extension system. The purpose of this research was to understand how evidence-based health promotion intervention information is shared within Cooperative Extension by 1) identifying information sources and channels of Extension specialists and educators while 2) identifying the characteristics of an intervention that aid in the adoption and uptake of these health promotion interventions. The first mixed-methods study aimed to identify information sources and channels used by Extension educators from a national sample and learn their preferences for information delivery. Results of this study (Manuscript 1), identified specialists as the key information source Therefore, the second study (Manuscript 2) focused on Extension health specialists' preferences for information sources and channels while also 1) determine how specialists communicate with educators 2) preliminary thoughts on a dissemination intervention. The final study (Manuscript 3) explored the intervention characteristics that are both educator and specialists deemed most important to their adoption decision-making process. The results of this dissertation inform the development of a dissemination intervention to bridge the translational gap across Extension. The information sources and channels used and trusted by both Extension educators and specialists are highlighted in this work. Additionally, specialists have given insight for consideration for an online repository that can be used on demand to both facilitate the adoption and uptake of health promotion interventions as needed by Extension Educators.
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    An Examination of Virginia's Adult SNAP-Ed Program by Cost-Effectiveness Using Program Cost and Participant Self-Evaluations
    Strayer, Thomas Edward III (Virginia Tech, 2015-08-31)
    The Supplemental Nutrition Assistance Program Education (SNAP-Ed) is an extension of the Supplemental Nutrition Assistance Program (SNAP) that aims to promote living healthier lifestyles for low-income participants of SNAP with limited resources. This thesis aims to investigate the effectiveness of Virginia's adult SNAP-Ed program through a cost-effective analysis (CEA) for fiscal year 2013 which requires the separation of the into the costs and the effects of the program. The costs for the program are categories as the labor, capital, material, and utility costs that are required to implement the adult SNAP-Ed program. The effects are measured as the number of participants who start, graduate, and improve from the start to the end of the program. The effects were measured on a retrospective self-assessment that measured both if a participant graduated and their magnitude of improvement. The analysis showed that as the state of Virginia the adult SNAP-Ed program incurred a cost of $2,488,170.07 with 6,759 participants starting the program and 3,704 of those that graduated in fiscal year 2013. Participants that improved on at least one of the questions by a score of one were 3,609 of the 3,704 that graduated. For the state of Virginia the cost effective ratio (CER) for starting a participant was $368 and CER of $672 for each graduated participant. An improvement on at least one question saw a CER value of $689. These findings show patterns that can be used for future policy implementation and the focus of the program.