Dissemination of Health Promotion Information in Cooperative Extension:  A multi-study exploration of channels, sources, and characteristics that influence intervention uptake

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Virginia Tech

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.

Science-to-service gap, knowledge transfer, Cooperative Extension, preventive care, mixed-methods, health promotion, public health