Extension as a Backbone Support Organization for Physical Activity Promotion: A Collective Impact Case Study From Rural Kentucky

Click name to view affiliation

Margaret McGladrey
Search for other papers by Margaret McGladrey in
Current site
Google Scholar
PubMed
Close
,
Angela Carman
Search for other papers by Angela Carman in
Current site
Google Scholar
PubMed
Close
,
Christy Nuetzman
Search for other papers by Christy Nuetzman in
Current site
Google Scholar
PubMed
Close
, and
Nicole Peritore
Search for other papers by Nicole Peritore in
Current site
Google Scholar
PubMed
Close
Restricted access

Background: Rural counties in the United States face daunting structural issues that reduce their populations’ physical activity levels, including geographic isolation as well as deficits in infrastructure, public transportation, health care providers, and funding. Methods: Funding from the Centers for Disease Control and Prevention provided an opportunity to assess how Extension enhanced the collective impact of systems-level physical activity promotion programming through a multisectoral coalition in Clinton County, Kentucky. Results: The Extension-led coalition accomplished the 6 essential functions of a backbone support organization by identifying obesity as a critical local issue (function 1: providing overall strategic direction), developing a multisectoral coalition (function 2: facilitating dialog between partners), compiling data on the county’s physical activity infrastructure (function 3: managing data collection and analysis), creating communication channels (function 4: handling communication), organizing community awareness events (function 5: coordinating community outreach), and securing additional grants (function 6: mobilizing funding). The average rating of Extension’s leadership across multiple dimensions by 3 coalition members in a postproject survey was “excellent” on a 5-point Likert scale. Conclusions: Extension is well positioned through their mission, broad community engagement, data collection, needs assessment, community and academic relationships, and embeddedness in local communities to serve as the backbone support organizations for rural physical activity promotion coalitions.

McGladrey is with the Department of Sociology, Jonathan M. Tisch College of Civic Life, Tufts University, Medford, MA. Carman and Nuetzman are with the University of Kentucky, Lexington, KY. Peritore is with Augusta University, Augusta, GA.

McGladrey (margaret.mcgladrey@gmail.com) is corresponding author.
  • Collapse
  • Expand
  • 1.

    Befort C, Nazir N, Perri M. Prevalence of obesity among adults from rural and urban area of the United States: findings from NHANES (2005–2008). J Rural Health. 2012;28(4):392397. PubMed ID: 23083085 doi:10.1111/j.1748-0361.2012.00411.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2.

    Calancie L, Leeman J, Pitts S, et al. Nutrition-related policy and environmental strategies to prevent obesity in rural communities: a systematic review of the literature, 2002–2013. Prev Chronic Dis. 2015;12:140540. doi:10.5888/pcd12.140540

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3.

    Robert Wood Johnson Foundation. How does where we live, work, learn and play affect our health? Health Policy Snapshot: Public Health and Prevention. 2011. https://www.rwjf.org/en/library/research/2011/09/how-does-where-we-live--work--learn-and-play-affect-our-health-.html. Accessed August 9, 2018.

    • Search Google Scholar
    • Export Citation
  • 4.

    Dillon C. Rural Obesity: Strategies to Support Rural Counties in Building Capacity. Washington, DC: National Association of Counties; 2008.

    • Search Google Scholar
    • Export Citation
  • 5.

    CDC. The social-ecological model: a framework for prevention. 2015. https://www.cdc.gov/violenceprevention/overview/social-ecologicalmodel.html. Accessed August 10, 2018.

    • Search Google Scholar
    • Export Citation
  • 6.

    Wray L, Epstein P. Harnessing the power of community collaborations. Public Manage. 2012;94(2):253255.

  • 7.

    Kopell MR. Civic engagement: Bringing in the real experts—a commentary on the shaping America’s youth initiative. Pediatrics. 2010;126(S90):S90S94. doi:10.1542/peds.2010-0482D

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Beitsch L, Brooks R, Menachemi N, Libbey P. Public health at centre stage: new roles, old props. Health Aff. 2006;25(4):911922. doi:10.1377/hlthaff.25.4.911

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9.

    Joyce P, Pattison S. Public budgeting in 2020: return to equilibrium or continued mismatch between demands and resources. Public Adm Rev. 2010;70(S1):S24S32. doi:10.1111/j.1540-6210.2010.02243.x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    CDC. The public health system and the 10 essential public health services. 2013. http://cdc.gov/nphpsp/essentialservices.html. Accessed February 1, 2016.

    • Search Google Scholar
    • Export Citation
  • 11.

    Kegler M, Butterfoss F. Strategies for Building Coalitions in Rural Communities. San Francisco, CA: John Wiley & Sons; 2012.

  • 12.

    NACCHO. Mobilizing action through planning and partnership. 2012. www.naccho.org. Accessed August 15, 2018.

  • 13.

    Scutchfield FD, Ireson C, Hall L. The voice of the public in public health policy and planning: the role of public judgement. J Public Health Policy. 2004;25(2):197205. PubMed ID: 15255385 doi:10.1057/palgrave.jphp.3190018

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Mathews D. Naming and Framing Difficult Issues to Make Sound Decisions. Dayton, OH: Kettering Foundation; 2011.

  • 15.

    Downey LH, Anyaegbunam C, Scutchfield FD. Dialogue to deliberation: expanding the empowerment education model. Am J Health Behav. 2009;33(1):2636.

  • 16.

    Williams KJ, Bray PG, Shapiro-Mendoza C, Reisz I, Peranteau J. Modeling the principles of community-based participatory research in a community health assessment conducted by a health foundation. Health Promot Pract. 2009;10(1):6775. PubMed ID: 17652187 doi:10.1177/1524839906294419

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17.

    Kania J, Kramer M. Collective impact. Stanford Soc Innovation Rev. 2011;9(1):3135.

  • 18.

    Hanleybrown F, Kania J, Kramer M. Channeling change: making collective impact work [published online ahead of print January 26, 2012]. Stanford Social Innovation Review. https://ssir.org/articles/entry/channeling_change_making_collective_impact_work#.

    • Search Google Scholar
    • Export Citation
  • 19.

    Wolff T. Ten places where collective impact gets it wrong. J Community Psychol Pract. 2016;7(1):15.

  • 20.

    Flood J, Minkler M, Lavery S, Estrada J, Falbe J. The collective impact model and its potential for health promotion: overview and case study of a healthy retail initiative in San Francisco. Health Educ Behav. 2015;42(5):654668. PubMed ID: 25810470 doi:10.1177/1090198115577372

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21.

    Varda DM. Are backbone organizations eroding the norms that make networks succeed? Nonprofit Quarterly. 2018. https://nonprofitquarterly.org/2018/02/06/backbone-organizations-eroding-norms-make-networks-succeed/. Accessed August 20, 2018.

    • Search Google Scholar
    • Export Citation
  • 22.

    Gold M, McCoy K, Teutsch S, Haddix A. Assessing outcomes in population health: moving the field forward. Am J Prev Med. 1997;13:35. PubMed ID: 9037335 doi:10.1016/S0749-3797(18)30216-2

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Emmons K. Behavioral and Social Science Contributions to the Health of Adults in the United States. Washington, DC: National Academy Press; 2000.

    • Search Google Scholar
    • Export Citation
  • 24.

    American Council on Education. A brief guide to the federal budget and appropriations process. American College President Study 2017. 2017. https://www.acenet.edu/news-room/Pages/A-Brief-Guide-to-the-Federal-Budget-and-Appropriations-Process.aspx. Accessed August 8, 2018.

    • Search Google Scholar
    • Export Citation
  • 25.

    CDC. High obesity program. 2018. https://www.cdc.gov/nccdphp/dnpao/state-local-programs/hop-1809/high-obesity-program-1809.html. Accessed August 8, 2018.

    • Search Google Scholar
    • Export Citation
  • 26.

    Washburn CE, Cornell M, Phillips HF, Traywick L. Strength training in community settings: impact of lay leaders on program access and sustainability for rural older adults. J Phys Act Health. 2014;11(7):14081414. PubMed ID: 24368673 doi:10.1123/jpah.2013-0007

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    CDC. National public health performance standards—essential services. 2013. http://www.cdc.gov/nphpsp/essentialservices.html. Accessed November, 2014.

    • Search Google Scholar
    • Export Citation
  • 28.

    Smathers CA, Lobb JM. Extension professionals and community coalitions: Professional development opportunities related to leadership and policy, system, and environment change. J Extension. 2015;6:6FEA1.

    • Search Google Scholar
    • Export Citation
  • 29.

    Riley P. Collaboration for prevention of chronic disease in Kentucky: the health education through extension leaders (HEEL) program. Nurs Clin North Am. 2008;43:329340. doi:10.1016/j.cnur.2008.04.007

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Gustafson A, McGladrey M, Liu E, et al. Examining key stakeholder and community residents’ understanding of environmental influences to inform place-based interventions to reduce obesity in rural communities, Kentucky 2015. J Rural Health. 2018;34(4):388395. PubMed ID: 28685866 doi:10.1111/jrh.12254

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    US Census Bureau. American Community Survey. 2012–2016. https://www.census.gov/acs/www/data/data-tables-and-tools/data-profiles/2016/. Accessed February 12, 2018.

    • Search Google Scholar
    • Export Citation
  • 32.

    CDC. County data interactive atlas diabetes DDT. 2018. https://www.cdc.gov/diabetes/atlas/countydata/atlas.html. Accessed December 4, 2017.

    • Search Google Scholar
    • Export Citation
  • 33.

    CDC, Division for Heart Disease and Stroke Prevention. Interactive atlas of heart disease and stroke. 2018. https://www.cdc.gov/dhdsp/maps/atlas/index.htm. Accessed December 4, 2017.

    • Search Google Scholar
    • Export Citation
  • 34.

    CDC. National Center for Chronic Disease Prevention and Health Promotion. 2013. Accessed December 4, 2017.

  • 35.

    US Census Bureau. County business patterns. 2016. https://www.census.gov/programs-surveys/cbp.html. Accessed February 17, 2018.

  • 36.

    US Census Bureau. State and county quick facts. 2014. https://www.census.gov/quickfacts/fact/table/US/PST045217. Accessed February 17, 2018.

    • Search Google Scholar
    • Export Citation
  • 37.

    Kegler M, Swan D. Advancing coalition theory: the effect of coalition factors on community capacity mediated by member engagement. Health Educ Res. 2012;27(4):572584. PubMed ID: 21911845 doi:10.1093/her/cyr083

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38.

    Boyte H. Reinventing Citizenship as Public Work: Citizen-centered Democracy and the Empowerment Gap. Dayton, OH: The Kettering Foundation; 2013.

    • Search Google Scholar
    • Export Citation
  • 39.

    Peters JS. Educating the civic professional: reconfigurations and resistances. Michigan J Community Service Learning. 2004;11:4758.

  • 40.

    Schoenberg N, Howell B, Swanson M, Grosh C. Perspective of healthy eating among Appalachian residents. J Rural Health. 2013;29:2534. doi:10.1111/jrh.12009

    • Crossref
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 2743 523 19
Full Text Views 175 20 7
PDF Downloads 96 14 4