Performing Department
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Non Technical Summary
To stabilize and increase intake of routine immunizations, Cooperative Extension, a trusted messenger in rural communities, can help reduce barriers and increase access to vaccines as well as strengthen vaccine confidence. This includes being able to assess adult immunization education needs and provide routine vaccination messages and resources with health partners in the community. It also incorporates an integrative model of sustainable health decision-making that combines the influence of emotions and reason on behavior change communication. Through Extension's EXCITE (Extension Collaboration on Immunization Teaching & Engagement) Program, we will achieve the following objectives:1. At the community level, EXCITE Immunization Educators in collaboration with local partners, will increase the public's confidence in vaccinations for adults.2. Extension professionals across program areas will increase their knowledge of and ability to educate communities using a model for making sustainable health decisions.3. EXCITE Immunization Educators will expand and strengthen community partnerships with health departments, healthcare providers, and community-based organizations, depending on their communities' needs.4. EXCITE will integrate vaccine education across program areas with their Extension colleagues, community health workers, and volunteers as a core part of Cooperative Extension's ongoing outreach.The impact of efforts by the EXCITE national team, Immunization Educators, and other Extension staff engaged in immunization education will be measured through a variety of means, including evaluations based on:CDC's Vaccine Confidence Survey Question Bank, Retrospective pre- and post-surveys, National Network for Collaboration's Continuum, The Systematic Screening and Assessment Method
Animal Health Component
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Research Effort Categories
Basic
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Applied
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Developmental
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Goals / Objectives
At the community level, EXCITE Immunization Educators, in collaboration with local partners, will increase the public's confidence in vaccinations for adults.Extension professionals across program areas will increase their knowledge of and ability to educate communities using a model for making sustainable health decisions.EXCITE Immunization Educators will expand and strengthen community partnerships with health departments, healthcare providers, and community-based organizations depending on the needs of their communities.EXCITE will integrate vaccine education across program areas with their Extension colleagues, community health workers, and volunteers as a core part of Cooperative Extension's ongoing outreach.
Project Methods
MethodologyMonths 1-6Each LGU region's Extension Director or Administrator will participate in a Design Collaborative facilitated by the Extension Foundation's EXCITE National Program Team. The EXCITE team will provide the job description for the positions, the funding available, and various staffing models at the beginning of the Collaborative effort. The EXCITE team will then lead the Directors and Administrators from each region through a design strategy session to facilitate the initial regional approaches to selecting the positions.A design team made up of appointed program leaders and associate directors, as well as directors representing each institution, and again facilitated by the EXCITE team, will then meet virtually to develop and finalize the regional plans. These plans will be due within six months of the start of the project. The EXCITE team will aid in these efforts by providing existing data by region, including current EXCITE programming teams and vaccine efforts, reach and methodology used, existing partners, and evaluations. The assigned regional coaches will also be a part of this process.The EXCITE National Program Team will also identify and put in place a professional development schedule, cohort meetings, evaluation tools, data collection tools, and website resources.Each final regional proposal will include a needs assessment of the priority audience, an immunization focus, and a staffing model as well as programmatic coverage across the region.Months 6-12Once Institutions have submitted a final proposal following the design collaborative, the Extension Foundation with complete the contracting process. Institutions will then begin the hiring process with the goal of having staff in place as soon as possible.After the new staff onboarding process is complete, the Immunization Educators will establish an evaluation plan and reporting tool. Planned data collection should include:Number of educational events provided and methodology (one-time or sequential learning experience)Number of vaccination clinics/events hosted with collaborators and the number of persons vaccinated at these eventsUse of existing CDC RISE materials, EXCITE prepared modules or other materials from national partnersName and number of partnersTarget population reached by each effortYears 2-3During the next two years of the program, Immunization Educators will:Solidify community partnershipsImplement educational programsComplete development and implementation of Train the Trainer curriculum for volunteersRoutinely share lessons learned and best practices among institutionsMeet quarterly with all institutions for professional development. Professional development will focus on an Integrative Model of Sustainable Health Decision Making as developed by Washington State University's Murrow College of Communication. The model integrates motivational interviewing in group settings, science media literacy skills development, and neuromarketing communication science designed to work with cognitive/emotional processes embodied in the brain. The model provides a framework for vaccine education and public health, enabling educators to address vaccine hesitancy, foster sustainable behavior change, and facilitate healthier communities.Establish partnerships with national organizations to explore collaborative effortsDevelop national programmatic resources and curriculumDevelop a sustainability plan for ongoing funding for immunization at the end of the projectProduce scholarly presentations and publicationsEvaluationObjective 1 Evaluation:The public's confidence in immunization will be assessed at the local level and reported to the EXCITE evaluation team. Specific items to be reported include:Types of program delivery and type/number of audienceAssessment of increased knowledge, confidenceNumbers of eventsIntention to be vaccinatedNumber and person vaccinated by type of event/clinicIndividual sites will be instructed on the items to be reported, but the methods for collecting this information will be determined locally or regionally. The EXCITE evaluation team will monitor these items regularly. Outcomes (Items d and e above) should be assessed locally or regionally using questions adapted from the CDC Vaccine Confidence Survey Question Bank. The EXCITE evaluation team will provide these questions and support their modification by local or regional Extension professionals.Objective 2 Evaluation:A retrospective pre-survey-post-survey approach will be used to assess Extension professionals knowledge, confidence, and readiness to deliver immunization education. Post-training, a follow-up survey will be implemented with trained Extension professionals to assess their engagement or participation in adult immunization education. The EXCITE evaluation team will develop the pre-survey, post-survey, and follow-up surveys for standardization across sites. Training "sign-in" sheets will document the number and nature of Extension professionals who attend training. Training assets will be uploaded by EXCITE Extension educators as part of the regular reporting process.Objective 3 Evaluation:The nature of the working relationship between CES and public health and/or healthcare partners, internal and external to LGUs will be assessed annually through an online survey. To assess the working relationship between CES and partners, the EXCITE evaluation team will work directly with the 20 EXCITE immunization educators to identify state and/or regional public health and/or healthcare partners and participating Extension professionals to participate in the annual assessment. These Extension professionals and their respective identified partners will provide their perception of the working relationship along the National Network for Collaboration Continuum (Bergstrom et al., 1995). Categories along that continuum include None, Networking, Cooperation, Coordination, Coalition, and Collaboration. The EXCITE evaluation team will use the annual partnership survey data to conduct a network analysis.Perceived access barriers to adult immunizations will be assessed by local or regional teams as part of their regularly reporting to the EXCITE evaluation team. These perceived barriers will be assessed by participating Extension professionals and select public health or healthcare partners.Objective 4 Evaluation:Using the Systematic Screening and Assessment Method, the EXCITE evaluation team will identify Extension programs across the nation that have successfully integrated adult immunization education. In general, the Systematic Screening and Assessment Method include the following steps.Scan for Extension programs that include adult immunization education.Review the identified content using predetermined criteria to assess program quality.Conduct an evaluability assessment of those programs that meet the criteria.Classify the programs based on documentation of outcomes.Report the information to inform future programmatic efforts.