December 2015 // Volume 53 // Number 6 // Feature // v53-6a1
Extension Professionals and Community Coalitions: Professional Development Opportunities Related to Leadership and Policy, System, and Environment Change
Community coalitions play an important role in communitywide strategies to promote health and wellbeing, and Extension professionals may provide leadership, technical assistance, and other support to coalitions. Extension professionals across a Midwestern state were invited to participate in an online survey about their coalition involvement and related training needs. The results of the study reported here describe the nature of Extension professionals' work within community coalitions; identify gaps in knowledge particularly related to policy, system, and environment change (PSEC) strategies; and point to professional development opportunities that will improve Extension's ability to work effectively within community coalitions.
In the 100 years that Cooperative Extension has been in existence, Extension professionals nationwide have worked to "extend" university resources to their communities in a multitude of ways. Community coalitions, defined as formal alliances of individuals and organizations that come together to work for common goals, may support Extension professionals in their efforts to reach out to their communities. Furthermore, Extension professionals may be able to maximize their community impact by working with and through community coalitions on certain projects and goals. Conone and Smith (1996) suggest that community coalitions enable Extension professionals and other community members to pool resources, share information, coordinate efforts, and reach larger audiences than any one individual or organization can reach on its own. This type of collaboration can result in efficient, effective, and sustainable community change.
Community coalitions play an important role in communitywide strategies to promote health and wellbeing. Coalitions often use policy, system and environmental change (PSEC) strategies to improve the health of individuals and communities (Herman et al., 2011). In the past two decades, many communities across the nation have formed coalitions to advance PSEC efforts with support from the Centers for Disease Control and Prevention (CDC) and large organizations such as the Robert Wood Johnson Foundation, Nemours, the W.K. Kellogg Foundation, and the California Endowment (Bunnell et al., 2012). Grounded in the Health Impact Pyramid (Frieden, 2010), PSEC involves examining the policies, systems, and environments that affect individual behavior and modifying them as necessary to make healthy choices the easy choices for individuals and communities (Bunnell et al., 2012). In short, PSEC is a way of modifying the environment to make healthy choices feasible and available to community members. It is based on the idea that people cannot make healthy decisions unless presented with realistic, healthful options from which to choose.
Coalitions accomplish PSEC by mobilizing communities and engaging a wide variety of people in issues that affect health (Roussos & Fawcett, 2000). Community mobilization efforts occur at multiple levels and in multiple sectors of the community involving individuals, families, organizations, businesses, and institutions with an interest in the wellbeing of the community. Extension professionals are prospective coalition members, as they are often involved in issues that affect community health and wellbeing, including education, agriculture, and economic development. Additionally, many Extension professionals have resources, knowledge, and skills that are beneficial to community coalitions. Extension professionals may provide technical assistance and support to coalitions in a variety of ways that assist them in accomplishing PSEC.
The University of California Cooperative Extension (UCCE), for example, fostered PSEC strategies among 13 community coalitions formed between 2001-2005 to advance UCCE's childhood obesity prevention efforts. A survey of these coalitions indicated they had implemented activities using PSEC strategies to address childhood obesity, including advocating for access to healthier foods and safer ways for children to walk or bike to school (Espinosa-Hall et al., 2007). UCCE professionals' community-level activities have also included efforts by nutrition education staff to help change practices at local organizations and cross-program, multi-component interventions involving education, youth empowerment and outreach to local business and policy leaders (Crawford et al., 2013).
The University of Maine Cooperative Extension participated in the Healthy Maine Partnerships (HMP), a network of coalitions established by the Maine Department of Health and Human Services in 2001 to reduce tobacco use and tobacco-related chronic disease through community mobilization and PSEC efforts (Martin et al., 2009). More than 4,600 policy and environment changes were documented by this network between 2002-2005, addressing tobacco use, physical activity, and nutrition in municipalities, schools, and worksites. The work of HMP resulted in the first smoke-free housing policy in Maine, the declaration of certain public parks and various other buildings as smoke-free establishments, the introduction of healthy vending guidelines in certain schools, and the creation of new trails for biking and walking (Martin et al., 2009).
As research continues to support the value of working within community coalitions and funders encourage community engagement and environmental change strategies, it is necessary to assess the involvement of Extension professionals in coalitions across program areas and determine what types of professional development can best support this kind of work. The purpose of the present study was to assess the extent of Extension's involvement with community coalitions across Ohio and describe the PSEC that the Ohio State University Extension (OSUE) is targeting through coalitions. The results of the study can be used to describe the experiences of Extension professionals in their work with community coalitions, identify gaps in knowledge, and plan professional development opportunities that will improve Extension's ability to work within coalitions.
In October 2014, all OSUE professionals were invited to participate in an online survey designed by the research team based on a review of coalition best practices. The survey consisted of questions related to coalition involvement, the role of Extension professionals in coalitions, and the use of Extension resource materials to support PSEC. The assistant directors of each of OSUE's four program areas emailed a letter introducing the survey to the professionals working in their areas, and the research team followed up this letter with an invitation email containing a link to the online survey. The research team sent weekly reminders to all eligible survey participants for the 3 weeks that the survey was open. Extension professionals were encouraged to participate in the survey regardless of whether they were involved with a coalition.
Survey responses were analyzed using frequency statistics at the group level. The design and content of the survey were approved by the Institutional Review Board (IRB) at The Ohio State University in September 2014.
Extension professionals representing all four program areas (n=175) completed the survey for an overall response rate of 23%. The response rate among Extension professionals working in Community Development (CD) was 55%, followed by 26% for Family and Consumer Sciences (FCS), 22% for 4-H Youth Development (4-H), and 16% for Agriculture and Natural Resources (ANR). Responses were received from Extension professionals based in the state office and in 76 of OSUE's 88 county offices.
Respondents by Program Area
Counties were classified as either urban or rural using the definitions provided by the Office of Management and Budget in which all counties that are not designated as parts of Metropolitan Areas are considered rural (Office of Rural Health Policy, 2010). Just over one-third (39%) of survey respondents represent rural counties, while the remaining respondents represent urban counties or the state as a whole. Survey responses did not differ significantly between rural and urban counties.
Two-thirds of the survey respondents indicated involvement in community coalitions, either as active participants (44%) or support/resource people (22%). Among the four program areas, FCS had the highest number of active coalition participants; however, as a percentage of total respondents, 71% of CD professionals reported active coalition participation compared to 52% for FCS, 35% for ANR, and 34% for 4-H (Figure 2).
Coalition Involvement by Program Area
Among those not involved in coalitions:
- 4% indicated that "there are no coalitions in my county,"
- 12% indicated that "coalition work does not apply to me,"
- 14% indicated that "I do not have time/am not interested in coalition work,"
- 27% indicated that "others in Extension are involved,"
- 45% provided other reasons for their lack of involvement, such as "I am new to my position."
Of those involved with coalitions, respondents indicated that Extension provides formal leadership (51%), informal leadership (58%), resources (78%), and technical assistance (52%) to coalitions. When asked to name the top strengths that Extension professionals bring to their work with coalitions, respondents listed a variety of skills and attributes, including:
- Content knowledge and inputs from areas of expertise,
- The general experience and knowledge of Extension,
- Extension resources and programs,
- Community and statewide connections,
- Unbiased, evidence-based information,
- The willingness to partner,
- Leadership and facilitation skills,
- Many specific skills such as data analysis, program evaluation, grant writing, fundraising, coaching, project management, and strategic planning
In ranking the skills they would most benefit from in their work with coalitions, respondents chose maintaining and sustaining coalitions, coaching coalitions for success, coalition development, fundraising and grant writing for coalitions, and obtaining tax-exempt status.
While many Extension professionals are involved in coalitions as general members (44%), many also hold leadership positions (Figure 3). Most respondents (74%) believe that their work with coalitions helps them to meet their professional goals each year, regardless of program area.
The Roles of Extension Professionals in Coalitions
Over 100 unique coalitions were identified by respondents, comprised of diverse membership from the following sectors:
- Non-profit organizations (73%),
- Local public health (71%),
- Higher education (58%),
- K-12 schools (56%),
- Healthcare (50%),
- Job and Family Services (46%),
- Early childhood education (45%),
- Private businesses (43%),
- The faith community (39%),
- Public safety and the court system (36%),
- Other government agencies (76%),
- Other (14%).
Respondents reported that the primary focus areas of these coalitions pertain to health (52%), education (27%), agriculture (9%), and business (5%). The main activities of these coalitions are:
- Providing services and resources to the community (66%),
- Outreach to specific populations (50%),
- Advocacy (50%),
- Policy and environmental change (43%),
- Health promotion (38%).
Among those who claimed that their coalitions had activities and objectives related to PSEC, respondents from all four program areas identified around 25 specific projects and tasks in response to the question "As an Extension professional, what projects do you participate in at the community level?" These activities and objectives include:
- Advocating for complete streets at the municipal level,
- Creating healthy vending policies for county and local municipalities,
- Developing a statewide network to allow farmers' markets that accept SNAP (Supplemental Nutrition Assistance Program) benefits to be able to offer SNAP incentives,
- Improving storm water management best practices and installing rain gardens for storm water run off,
- Working with the juvenile court system to offer life skill training to offenders,
- Supporting community garden programs and being a model of urban agriculture.
OSUE professionals from all four program areas are involved with coalitions in both urban and rural areas of the state. Extension professionals working in Community Development, the smallest of OSUE's four program areas, appear to be more involved with coalitions than those working in the other program areas. Almost all (94%) respondents from this program area indicated current involvement in a coalition as either an active participant or a support/resource person. The CD program area had a much higher response rate (55%) than the other program areas, though, which could reflect a voluntary response bias in which Extension professionals more involved and interested in coalition work were more likely to participate in this survey than professionals not as familiar with coalitions. The overall low response rate associated with the survey could also reflect an overall response bias; thus, survey results may not be generalizable to all Extension professionals and should be interpreted with caution.
Overall, over 100 unique coalitions with diverse membership were identified by the survey, indicating that there is substantial potential for OSUE to collaborate with community groups to work toward shared goals and maximize community impact. Most (76%) of Ohio's counties were represented by survey respondents, and very few respondents indicated that there are no coalitions in their counties. Among respondents not involved in coalitions, only 4% cited the lack of coalitions as their reason for no coalition involvement. The most common reason given for lack of involvement was the involvement of others from Extension. This finding indicates that survey respondents recognize the importance of having someone from Extension represented in their community's coalition(s) but that it is not always necessary to have multiple Extension professionals working within a single coalition.
Another reason for lack of coalition involvement offered by a few respondents was the fact that they were new to Extension at the time of the survey and were still getting acclimated to their positions. This finding highlights the opportunity to introduce the idea of working within community coalitions to new Extension professionals as they learn their roles within their communities. The majority of Extension professionals involved in coalitions believe that their work with coalitions helps them to meet professional goals, so working within community coalitions from the beginning of one's career with Extension may be beneficial to both Extension and to the communities served.
Survey respondents recognize strengths that they bring to coalitions due to their affiliation with Extension, including content knowledge, university research and resources, access to a large professional network, and leadership skills. Survey respondents involved with coalitions acknowledge that Extension provides formal leadership, informal leadership, resources, and technical assistance to coalitions, and many Extension professionals hold leadership roles within their groups. Among those involved in coalitions, nearly half report serving as a coalition chair or co-chair, a committee or task force chair, or a steering committee or leadership board member. Thus, there are a number of Extension professionals serving as leaders in their communities, despite the potential response bias present in the study. Depending on their experience, Extension professionals may benefit from introductory or advanced training in leadership strategies specifically related to community coalitions. Extension professionals working within coalitions could also benefit from training in strategic planning, program evaluation, obtaining and maintaining tax-exempt status, and logic model development related specifically to coalition functions. Other topics that survey respondents indicated interest in learning more about include coalition development, maintaining and sustaining coalitions, coaching coalitions for success, and fundraising and grant writing for coalitions.
The four stages of coalition development outlined in the Community Coalition Action Theory—formation, implementation, maintenance and outcome—could be used to structure professional development opportunities for Extension professionals (Butterfoss & Francisco, 2004). A recent study involving focus groups with leaders from coalitions in different stages of development revealed the importance of providing targeted training resources to community coalitions in their formation and midlevel stages (Nichols et al., 2014). Another recent study of coalitions found that community impact increases as coalitions increase in longevity and size (Burgus, Schwab, & Shelley, 2012), so providing resources and support to coalitions during the formation stage may pay off in the long run. Thus, there may be a role for Extension to provide technical assistance related to coalition start-up and advising through the formation stage for new coalitions.
Professional development opportunities related to PSEC strategies are also needed for Extension professionals, especially those who work within community coalitions to achieve Extension objectives in their counties. Survey respondents involved in coalitions indicated that almost half (43%) of their coalitions have activities and objectives related to PSEC. Furthermore, respondents from all four program areas identified around 25 specific projects and tasks they participate in at the community level.
At the same time, however, some respondents indicated that they were not sure what was meant by related questions and/or gave inappropriate answers, demonstrating that a basic understanding of PSEC is lacking among many Extension professionals. While attending meetings, connecting people, promoting resources, and generating awareness around specific issues are common functions of both Extension professionals and coalition members, they do not qualify as PSEC strategies. Thus, there is much potential for professional development in this area, as Extension professionals who understand PSEC can 1) offer training and technical assistance related to PSEC to the coalitions that they work within and 2) use multi-level strategies to better achieve Extension objectives in their counties. Examples of the kind of technical assistance, materials, and resources that Extension professionals can provide to community groups include guidelines, fact sheets, manuals, and more on topics such as developing healthy meeting and event guidelines, changing the built environment, or implementing policy at the municipal level.
Understanding PSEC is imperative for Extension professionals, as both the CDC and the Institute of Medicine recommend policy change as a chronic disease prevention strategy, endorsing PSEC strategies as more sustainable and impactful than individual behavior change efforts (Bunnell et al., 2012). Additionally, the 2014 SNAP-Ed guidance requires SNAP-Ed administrative and implementing agencies to identify evidence-based obesity prevention PSEC strategies to include in their SNAP-Ed plans (USDA, 2014). Thus, Extension professionals working within community coalitions need to be familiar with the process of critically assessing the policies, systems, and environments that affect individual behaviors and modifying them as necessary to make healthy choices the easy choices for individuals and communities. Familiarity with this process will help Extension professionals to obtain funding for community work, as well as to most effectively and efficiently use available resources to better the health and wellbeing of their communities. Over half of the coalitions represented in this survey consider health to be their primary focus area, suggesting that a focus on PSEC is relevant for most Extension professionals involved in coalition work.
Working within community coalitions can help Extension professionals to achieve their professional goals while simultaneously improving the health of individuals and communities. The research study reported here found that many OSUE professionals are involved with community coalitions across the state by offering resources, expertise, and various types of support. Survey respondents indicated interest in learning more about maintaining and sustaining coalitions, coaching coalitions for success, and offering other types of technical assistance to coalitions. There are numerous possibilities for professional development opportunities that will support Extension professionals in their work with community coalitions, especially in relation to PSEC. Of the over 100 coalitions represented in the study, almost half have activities or objectives related to PSEC, and over half are involved in issues related to health. At the same time, however, many Extension professionals did not seem to understand PSEC and were unable to give appropriate examples of PSEC efforts taking place in their communities, even when they claimed to be involved in such work. If professional development opportunities are designed to enhance Extension's understanding of PSEC, Extension professionals could potentially use their program area expertise as they work within coalitions to promote PSEC and create healthier communities while simultaneously achieving Extension objectives.
Bunnell, R., O'Neil, D., Soler, R., Payne, R., Giles, W. H., Collins, J., & Bauer, U. (2012). Fifty communities putting prevention to work: Accelerating chronic disease prevention through policy, systems and environmental change. Journal of Community Health. DOI 10.1007/s10900-012-9542-3.
Burgus, S., Schwab, C., & Shelley, M. (2012). Assessing rural coalitions that address safety and health issues. Journal of Extension [On-line], 50(2) Article 2FEA7. Available at: http://www.joe.org/joe/2012april/a7.php
Butterfoss, F. D., & Francisco, V. T. (2004). Evaluating community partnerships and coalitions with practitioners in mind. Health Promotion Practice, 5, 108-114.
Conone, R. M., & Smith, P. L. (1996). Coalitions addressing problems. Journal of Extension [On-line], 34(2), Article 2TOT2. Available at: http://www.joe.org/joe/1996april/tt2.php
Crawford, P. B., Schneider, C. L., Martin, A. C., Spezzano, T., Algert, S., Ganthavorn, C. G., … Donohue, S. (2013). Communitywide strategies key to preventing childhood obesity. California Agriculture, 67(1), 13-20.
Espinosa-Hall, G. B., Metz, D., Johns, M., Smith, D., Crawford, P. B., Siemering, K., & Ikeda, J. (2007). UCCE helps community coalitions reduce childhood overweight. California Agriculture, 61(3), 124-130.
Frieden, T. R. (2010). A framework for public health action: the health impact period. American Journal of Public Health, 100(4), 590–595.
Herman, E. J., Keller, A., Davis, A., Ehrensberger, R., Telleen, S., Kurz, R., … Fierro, L. (2011). A model-driven approach to qualitatively assessing the added value of community coalitions. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 88(S1), S130-S143.
Martin, S. L., Maines, D., Martin, M. W., MacDonald, P.B ., Polacsek, M., Wigand, D. … Dufresne, R. (2009). Healthy Maine partnerships: Policy and environmental changes. Prevention of Chronic Disease [On-line], 6(2):A63. Retrieved from: http://www.cdc.gov/pcd/issues/2009/apr/08_0123.htm.
Nichols, A., Riffe, J., Peck, T., Kaczor, C., Nix, K., & Faulkner-Van Deysen, A. (2014). Developmental stages and work capacities of community coalitions: How Extension educators address and evaluate changing coalition needs. Journal of Extension [On-line], 52(1) Article 1FEA3. Available at: http://www.joe.org/joe/2014february/a3.php
Office of Rural Health Policy (2010). List of rural counties and designated eligible census tracts in metropolitan counties. Retrieved from: ftp://ftp.hrsa.gov/ruralhealth/Eligibility2005.pdf
Roussos, S. T., & Fawcett, S. B. (2000). A review of collaborative partnerships as a strategy for improving community health. Annual Review of Public Health, 21, 369-402.
USDA (2014). SNAP-Ed strategies and interventions: An obesity prevention toolkit for states. Retrieved from: http://snap.nal.usda.gov/snap/SNAP-EdInterventionsToolkit.pdf