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![Cooperative Extension's National Framework for Health and Wellness. Note: This framework uses an adapted social-ecological model to present the interplay between outcome, goal, environments, priorities and partnerships. Reprinted with permission from Ref. [7]. Copyright 2015 Extension Journal, Inc.](publication/362633891/figure/fig1/AS:11431281081000368@1661464103486/Cooperative-Extensions-National-Framework-for-Health-and-Wellness-Note-This-framework.png)
Cooperative Extension's National Framework for Health and Wellness. Note: This framework uses an adapted social-ecological model to present the interplay between outcome, goal, environments, priorities and partnerships. Reprinted with permission from Ref. [7]. Copyright 2015 Extension Journal, Inc.
Source publication
The U.S. Cooperative Extension Service (CE) has potential to deliver the National Diabetes Prevention Program (NDPP) to rural residents with prediabetes. However, the CE remains underutilized for the delivery of NDPP. We compared the feasibility/effectiveness of the NDPP (0–6 mos.) delivered by CE personnel to rural residents with prediabetes using...
Contexts in source publication
Context 1
... U.S. Cooperative Extension (CE), a partnership between the U.S Department of Agriculture, land-grant universities, and state and county government, maintains ~3200 offices across the U.S. The CE offices have the physical space and employ nutrition and consumer science professionals capable of delivering research-based interventions such as the NDPP. Such efforts would be consistent with the CE priority for chronic disease prevention and management as outlined in the 2014 Cooperative Extension's National Framework for Health and Wellness (Figure 1) [6,7]. However, the CE is underutilized for the delivery of NDPP to adults with prediabetes living in rural areas. ...
Context 2
... Public Health 2022, 19, x FOR PEER REVIEW 3 of 12 Figure 1. Cooperative Extension's National Framework for Health and Wellness. ...
Context 3
... conclusion, this pilot trial demonstrated the potential feasibility and effectiveness of the NDPP delivered by a CE family and consumer science agent in a group remote format (Zoom ® ) to adults with prediabetes living in a rural area. As described previously and shown in Figure 1, part of the national mission of CE is to improve health equity and well-being as part of their role within communities [8]. CE is well known and respected in rural communities. ...
Citations
... The findings of the study provide further support for the effectiveness of the distance learning delivery of the NDPP [23][24][25]. This study is novel in its analysis of a community based not-for-profit program serving over 2000 participants with a distance learning DPP. ...
The Centers for Disease Control and Prevention (CDC) indicates that individuals with prediabetes are significantly less likely to develop type 2 diabetes if they participate in a lifestyle change program that results in at least 5% weight loss and 150 min of physical activity per week. The CDC recognizes distance learning as an effective delivery mode for lifestyle change programs to prevent type 2 diabetes. The purpose of this study was to assess enrollment, engagement, and effectiveness of a type 2 diabetes prevention program (DPP) using synchronous distance technology. Eat Smart, Move More, Prevent Diabetes (ESMMPD) is an intensive 12-month DPP delivered using synchronous distance technology. Throughout 26 lessons, participants focused on healthy eating, physical activity, and mindfulness behaviors. Study findings showed a significant decrease in A1C (−0.24 p < 0.0001). Weight loss averaged 5.66% for those who completed the program. Based on the Wilcoxon signed-rank test, participants demonstrated statistically significant changes in self-reported confidence in their ability to perform all 18 health-promoting behaviors assessed (p < 0.0001). Participation in the program also resulted in the adoption of health promoting behaviors. A DPP using synchronous distance technology is an effective delivery mode to help participants adopt healthy behaviors, increase physical activity, and achieve the weight loss necessary to prevent or delay the onset of type 2 diabetes.
... The findings of the study provide further support for the effectiveness of the distance learning delivery of the NDPP [23][24][25]. This study is novel in its analysis of a community based not-for-profit program serving over 2,000 participants with a distance learning DPP. ...
The Centers for Disease Control and Prevention (CDC) indicates that individuals with prediabetes are significantly less likely to develop type 2 diabetes if they participate in a lifestyle change program that results in at least 5% weight loss and 150 minutes of physical activity per week. The CDC recognizes distance learning as an effective delivery mode for lifestyle change programs to prevent type 2 diabetes. The purpose of this study was to assess enrollment, engagement, and effectiveness of a type 2 diabetes prevention program (DPP) using synchronous distance technology. Eat Smart, Move More, Prevent Diabetes (ESMMPD) is an intensive 12-month DPP delivered using synchronous distance technology. Throughout 26 lessons, participants focused on healthy eating, physical activity, and mindfulness behaviors. Study findings showed a significant decrease in A1C (-0.24 p<.0001). Weight loss averaged 5.66% for those who completed the program. Based on the Wilcoxon signed-rank test, participants demonstrated statistically significant changes in self-reported confidence in their ability to perform all 18 health-promoting behaviors assessed (p<.0001). Participation in the program also resulted in the adoption of health promoting behaviors. A DPP using synchronous distance technology is an effective delivery mode to help participants adopt healthy behaviors, increase physical activity, and achieve the weight loss necessary to prevent or delay the onset of type 2 diabetes.
... Heterogeneous characteristics make a difference in both the motivation of farmers to join and their factor inputs, resulting in differences in the impact of cooperatives on farmers' incomes (Gorczyca et al., 2022). It has been generally agreed that farmers with better resource endowments and more factor inputs are more likely to seek more control over their surplus. ...
Introduction
Poverty eradication is one of the global challenges, and rural cooperatives provide an effective path to address smallholder households’ poverty. However, the effect of poverty reduction can show heterogeneity depending on the economic capital, human capital, and social capital of households.
Methods
Based on comprehensive research data on the poverty status of 1,622 smallholder households in four provinces in the less developed regions of western China, using OLS and PSM models, this paper empirically analyzes the impact and heterogeneous characteristics of rural cooperatives on the poverty vulnerability of smallholder households.
Results/Discussion
The results show that rural cooperatives have a significant dampening effect on the poverty vulnerability of smallholder farmers, and the findings hold true after robustness tests using multiple methods. The impact of rural cooperatives on the poverty vulnerability of farming households differed significantly across smallholder households with different characteristics. Specifically, participation in cooperatives had a more pronounced effect on reducing poverty vulnerability among non-poor, higher human capital and higher income farm households compared to poor, lower human capital and lower income farm households. The results of the study can provide a useful reference for policy-making on rural mutual assistance and poverty reduction among farmers.
... Effectiveness, adoption, implementation, and maintenance were respectable. Effectiveness measured by average weight loss and physical activity exceeded program goals and were similar to results of other research (Damschroder et al., 2017a, b;Ely et al., 2017;Gorczyca et al., 2022). All Extension professionals trained to implement the DPP eventually adopted the program, and a majority began another (and in some cases, multiple) DPP cohorts following conclusion of this study. ...
Increased dissemination of the CDC's Diabetes Prevention Program (DPP) is imperative to reduce type 2 diabetes. Due to its nationwide reach and mission to improve health, Cooperative Extension (Extension) is poised to be a sustainable DPP delivery system. However, research evaluating DPP implementation in Extension remains scant. Extension professionals delivered the DPP in a single-arm hybrid type II effectiveness-implementation study. Semi-structured interviews with Extension professionals were conducted at three time points. The Consolidated Framework for Implementation Research (CFIR) guided interview coding and analysis. Constructs were rated for magnitude and valence and evaluated as facilitators or barriers of RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) outcomes. The program reached 119 participants, was adopted by 92% (n = 12/13) of trained Extension professionals and was implemented according to CDC standards: all programs exceeded the minimum 22-session requirement (26 ± 2 sessions). The program was effective in achieving weight loss (5.0 ± 5.2%) and physical activity (179 ± 122 min/week) goals. At post-intervention, eight professionals (67%) had begun or planned to maintain the intervention within the next 6 months. Several facilitators were identified, including Extension leadership structure, organizational compatibility, and technical assistance calls. Limited time to recruit participants was the primary barrier. Positive RE-AIM outcomes, facilitated by contextual factors, indicate Extension is an effective and sustainable DPP delivery system. Extension and other DPP implementers should plan strategies that promote communication, the program's evidence-base, recruitment time, and resource access. Researchers should explore DPP implementation in real-world settings to determine overall and setting-specific best practices, promote intervention uptake, and reduce diabetes.
Objective:
The effectiveness of the National Diabetes Prevention Program (DPP) in improving diet quality (DQ) in community settings is largely unknown. This study aimed to evaluate the DQ changes of Extension DPP participants.
Methods:
A single-group, repeated-measures design was used to evaluate an Extension-implemented DPP using the PreventT2 curriculum. Participants were overweight adults with or at high risk for prediabetes (n = 88). Weight and DQ (Healthy Eating Index-2015, Dietary Screener Questionnaire) were evaluated using mixed-effects regression.
Results:
There was no change in the Healthy Eating Index-2015 total score. Predicted fiber, fruit, and vegetable intake increased (P < 0.05) but remained below recommendations.
Conclusions and implications:
Clinically meaningful DQ changes of Extension DPP participants were limited. The effect of the DPP on DQ in Extension and other implementation settings should be evaluated through randomized controlled trials. Diabetes Prevention Program curriculum revisions that include more specific dietary goals and educational tools may promote greater DQ changes in DPP participants.
