Progress 05/01/23 to 04/30/24
Outputs
Target Audience:EXCITE Implementation teams worked with individuals, including agricultural workers; college students; Extension personnel; faith-based communities; medical, professional, or healthcare workers; low-resource individuals, families, or communities; older adults; patients of community health centers and other high-risk populations; people with chronic conditions; people with disabilities; pregnant people; racial/ethnic minority groups; refugee, immigrant, and migrant populations; rural populations; and tribal communities. About 59% of the projects worked with individuals of Hispanic, Latino, or Spanish origin. About 16% of projects worked with Native American reservations. Changes/Problems:Internal challenges include hiring new staff and internal processes (IRB, OSP, financial reports). In some cases, meetings with partners were slow but eventually came together.Translation of materials is sometimes an issue when multiple languages are involved. Some teams continue to be concerned about what they are to evaluate and how they can report successes beyond outputs. Coaches and the EXCITE Program Team are helping address these challenges. As previously stated, a primary risk to this work is the political climate in many states. Early in this year of funding, challenges continue to be around the availability of vaccines.For example, teams reported that vaccination events were canceled due to a lack of vaccines, some were less effective because they couldn't provide COVID-19 vaccines in addition to flu vaccines, and some were less effective because of insurance-related issues (lack of insurance or lack of ability to process insurance). For example, NC State had an event for 40 farm workers who had expressed interest in flu and COVID vaccination, but their health partners had an insufficient supply of vaccines, so the event did not happen. In rural areas with few pharmacies, it can be difficult to get to a site where the appropriate vaccine is available. For example, the RSV vaccine was not available at some sites.The Illinois EXCITE team has also heard from pharmacies in high-risk communities that they hesitate to order COVID-19 vaccines. They can't predict which vaccine the individuals will ask for and don't want to order too much of any one vaccine because they don't want to waste it. Kentucky has reported that there are rural areas with no Bridge providers for COVID-19 vaccinations.This team is exploring using a mobile vaccine clinic in partnership with the School of Pharmacy to provide vaccinations to the uninsured and underinsured.Utah State reports that people must travel extended distances to find locations that will provide the Bridge Access vaccinations. We anticipate that the Bridge Access Program may address some of these barriers, but that program will end in August 2024. What opportunities for training and professional development has the project provided?Each of the LGU project teams has a coach assigned to them. The coach meets with the team and/or the PI once a month. Additionally, the coach meets with a cohort of the PIs from the 5-6 teams they are coaching monthly. The teams report that the cohort has been a very helpful group for providing updates, sharing experiences, and getting insights and support from one another. Each team is contracted to meet quarterly via Zoom for a professional development session scheduled for 1.5 hours on the second Thursday of each quarter. Planned by the EXCITE program team, the quarterly meetings of the land grant universities involved in EXCITE have become exciting opportunities when program ideas are shared in 10-minute settings and then open question, answer, and discussion times. The result has been wonderful sharing and disbursement of best practices, adaptation of ideas into other programs, and encouragement for the work being accomplished. The sharing has also been of great value as extension educators struggle with the negativity around immunization education by some communities, community leaders, and some legislators at the local, state, and national levels. Some educators feel that they need to "hide" their immunization education efforts by integrating immunization information into other programs so that it is possible to provide it. They don't want to be recognized for their work in this area for fear of funding retaliation or negativity of the extension organization. Thus, sharing among others doing this work with similar experiences is also helpful in boosting morale and underscoring the value of their work and the sense of comradery, not feeling alone.in this effort. Washington State University (WSU) provided significant professional development during the 2023-24 program year. During the June launch of this implementation phase, the newly revised Getting to the Heart and Mind of the Matter Tool Kit and Zoom Learning Modules were presented, and recorded YouTube sessions were made available. The modules included several sessions: Motivational Interviewing, Science Media Literacy and Neuromarketing. During the spring, WSU pilot-tested the learning modules, evaluated them, and modified the content. The revised modules were then presented early in June at the launch of the Implementation phase. All LGUs were encouraged to have their entire EXCITE team attend the Zoom training and any other interested educators from any LGU. Various members of the WSU team presented sessions with expertise in specific areas. Motivational Interviewing was led by Dr. Anja Sheftel and was attended by 118 educators. Science Media Literacy was led by Dr. Erica Austin and Dr. Nicole McDonnell and was attended by 98 educators. Neuromarketing was led by Dr. Paul Bolls and was attended by 68 educators. Over 31 views of the recorded video modules on YouTube occurred. The Public Health Foundation Director also attended the workshops and requested that these learning modules be placed on the Public Health Foundation TRAIN Learning Network. TRAIN is the Public Health Foundation's Immunization Program that supports disseminating resources and training for immunization professionals nationwide. The Director commented, "These modules are widely useful and tangible for our audiences. I have read through other resources on motivational interviewing for immunization, but this was far more comprehensive and skill-building than the information sharing I have experienced thus far." In the fall, EXCITE coaches indicated that our LGU teams still desired more hands-on training with motivational interviewing techniques; they understood it conceptually but lacked confidence in the actual practice of the technique, especially in group settings. Motivational interviewing has traditionally occurred in clinical settings, and some adaptations were necessary to make this feel more comfortable in group teaching settings that are normal to Extension. During five cohort sessions, these concerns were addressed with additional practice professional development opportunities in the spring of 2024. The cohort sessions provided smaller groups in which the educators developed peer relationships and could feel more comfortable practicing motivational interviewing with each other. Some members had much more experience than others and were able to serve as mentors or role models. All team members were encouraged to participate in these motivational interviewing practice sessions. The LGU teams provided a very positive response to these training courses. A fall 2024 survey will provide more feedback on the toolkit, the additional professional development opportunities, and individual educators' use of motivational interviewing and other toolkit techniques during the implementation period. WSU continues to update the tool kit based on feedback and experiences with the teams as they use the materials. A summary of each quarterly development workshop is provided below. Title: Implementation Phase Grant Awardee Kick-off Date: June 22, 2023 Attendance: 83 Topics: Professional Development for project team leader, members, and other team personnel. Healthcare partners were optional but welcome. Value of partners Key partners from the current project Videos of partnerships from previous projects Data on partnerships Hear from our partners at the CDC + NIFA Evaluation and reporting Reporting deadlines Process and data collected Overview of evaluation metrics and reporting requirements for the grant Role of coaching and professional development Review resources available Contracts and finances Guidance on working with sponsored programs office Review How to make PI changesand the process of getting budget change approved Financial reports Role of the PI- the expectation is to be monitoring the project's finances Title: Implementation Phase quarterly professional development session Date: August 3, 2023 Attendance: 77 Topics: Meeting with awarded projects for professional development and project sharing Reviewed new resource- EXCITE project Asset Library Financial reporting- reviewed template and rationale for reports Overall evaluation rationale and project evaluation reminders review evaluation questions Review of reporting portal- Wizehive Leadership and Team development- communication Systems process evaluation with WSU Toolkit evaluation and Neurotesting evaluation for community Title: Implementation Phase quarterly professional development session Date: November 2, 2023 Attendance: 85 Topics: Meeting with awarded projects for professional development and project sharing Intro new resource- EXCITE Team Discussion Board Reviewed Bridge funding opportunity Discussion of evolving Language and Health Equity Team Sharing- UF, Purdue, Clemson, Utah, Georgia Title: Implementation Phase quarterly professional development session Date: February 1, 2024 Attendance: 73 Topics: Meeting with awarded projects for professional development and project sharing Sharing from NC A&T State, Mississippi State,University of MN Follow-up discussion on evolving language of health equity Review of financial reporting, invoicing, and how to use Wizehive Questions for project evaluation and discussion Title: Implementation Phase quarterly professional development session Date: May 2, 2024 Attendance: 66 Topics: Meeting with awarded projects for professional development and project sharing Project sharing from Aaniiih Nakoda "Train the trainer"project sharing from Arkansas, Virginia State, and Ohio State, where they discussed audience and need, topic focus (vaccine 101, Motivational interviewing, etc.), what teams have created so far, and what they are still planning. Breakout rooms with Train the Trainer teams to share and answer questions about their projects How have the results been disseminated to communities of interest?The EXCITE program team attended many conferences this last year to disseminate findings to communities of interest. These conferences include: Various components of EXCITE have been highlighted at peer reviewed national meetings or at the request of organizers of national meetings. These have included the following: · NEAFCS FCS Program Leaders Meeting Providence, RI, September 13, 2023 · ECOP Health Program Action online, September 26, 2023 · National Outreach and Engagement Conference East Lansing, MI, October 10, 2023 · National Extension Directors & Administrators Conference Tucson, AZ October 10, 2023 · National Assoc. Immunization and Influenza Summit Equity Group online, January 24, 2024 · EFNEP Annual Conference Washington, D.C., February 21, 2024 · St. Jude HPV Project online, February 23, 2024 Several other groups that were met with for consideration of potential collaborative efforts included: · Beginning Farmers · Cancer Moon Shot · Heartland Forward · CDC Collaborative Initiatives What do you plan to do during the next reporting period to accomplish the goals?Specific opportunities in the coming year include the following: Focus on coaching the implementation of current project efforts of over 120 contracts that include the implementation teams, Bridge EFNEP teams, and New Partner Projects and the projects selected for the RFA's. Specific professional development efforts will focus on the transition for EFNEP from Bridge awareness efforts to immunization education efforts. Bring to successful completion and expenditure in March 2025 the completion of the implementation and Bridge projects. Selection of the Integration RFA projects. Coaching approximately 20 projects through implementation and evaluation phases of development, including compiling the curriculum and related resources in the immunization resource library. Planning and conducting a Preconference at the National Health Outreach Conference on April 27 in Omaha, Nebraska. This pre-conference will showcase the work of the RFA projects as they are developed now. As projects are completed in August and curriculum and resources are placed in the resource library, attendees will be encouraged to replicate the curriculum in their states and communities across the country. We would hope to set up a system to track both the use and evaluation impact date of this curriculum. In early November, hold a first-ever face-to-face meeting of all EXCITE program team members, NIFA, and CDC partners to Celebrate, Evaluate, and Strategize for the future. This will be a pivotal opportunity for all three items and enable some evaluation work to occur and planning with all partners in a face-to-face environment, which has never happened in this project. It should be a very dynamic setting, Sustainability will be pursued programmatically through the integration of RFA projects. Additionally, funding for sustainability will be pursued through contacts with seven immunization pharmaceutical companies, pharmacies, foundations, and other federal partners. Consideration will be given to establishing a new inter-agency agreement with CDC that will lead to a new five-year plan. Additionally, discussions and partnerships that should be established that are relevant to H5N1 will be pursued for further development. The pursuit of scholarship through presentations and journal articles will continue. Specific efforts by WSU and states they have partnered with, as well as by the program team, CDC, and NRHA, are natural starting points. Design the final evaluation data needs and a plan for the final report to be completed in the project's final year.
Impacts
What was accomplished under these goals?
In year three of the EXCITE initiative, funded projects accomplished the following in pursuit of the project goals (in italics) listed below. Decrease vaccine hesitancy among rural and medically underserved audiences. EXCITE projects were encouraged to use questions adapted from the Centers for Disease Control and Prevention's (CDC) Vaccine Confidence Survey Question Bank to aid in assessing and evaluating results. From these questions, ten projects reported "Improved perceived importance of vaccines for preventive health and disease prevention," and eight reported "Improved trust in vaccinations." Cooperative Extension professionals use the CDC Rapid Community Assessment and other methods to address barriers and concerns and increase the acceptability of COVID-19 and other adult vaccinations among priority populations. EXCITE projects reported 1,975 engagement activities, including direct communication, in-person events, mass media, print materials, social media, vaccination clinics, virtual events, and billboards. EXCITE projects reported 2,791,603 contacts having been reached through the above engagement activities. Increase knowledge about and acceptability of COVID-19, flu, and other adult immunizations among priority populations. • Projects reported hosting 64 vaccination clinics and administering 482 adult immunizations. • During the year, teams began sharing information about the CDC's Bridge Access Program, a limited-term effort to improve COVID-19 vaccine confidence, demand, availability, and access among adults without health insurance and adults whose health insurance does not cover all COVID-19 costs through outreach, education campaigns, and community events. Over the last year, teams reported delivering this information. Quarter 2 - 16 teams, Quarter 3 - 13 teams, and Quarter 4 - 16 teams. These institutions provided information on the Bridge Access Program at virtual-live events, in-person events, standard events, and other events, on social media, during direct communication activities, and through print media distribution. Document barriers to vaccine confidence and vaccine access and effective interventions to eliminate these barriers. • No data reported Increase connection and communication between priority populations and healthcare systems. 16 EXCITE teams have identified public health departments as partners. Additionally, other partners include medical clinics (9 teams), pharmacies (3 teams), and senior citizens (3 teams). Cooperative Extension professionals partner with local health professionals and engage target priority populations in programs that increase the connection between communities and healthcare systems. 16 EXCITE teams have identified public health departments as partners, and 28 state and local public health departments have been identified as team partners. Increase accessibility of vaccination clinics to priority populations and Cooperative Extension professionals in partnership with health professionals increase access to local vaccination clinics. EXCITE-funded projects reported hosting 64 vaccination clinics in collaboration with partners. Most events were standard vaccination events (n=53). Ten were mobile vaccination events, and one was classified as "other." Inform CDC, USDA-NIFA, Cooperative Extension, and health partners to implement public health programs to reduce health disparities. Project team shares reports, guidance and recommendations using evidence of EXCITE to inform stakeholders about effective investments and actions to reduce healthcare disparities and increase vaccination rates among rural and medically underserved populations. While the project does not collect quantitative data on these points, all of the programmatic efforts are designed to reduce healthcare disparities and increase vaccination rates among rural and medically underserved populations. We are measuring these items by asking the projects to evaluate using the CDC Vaccine Confidence Survey Question Bank. Projects we will be receiving those evaluation responses for this report next year.
Publications
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Progress 05/01/22 to 04/30/23
Outputs
Target Audience:The Activity 2 projects continued to work with individuals who live in a large city, a suburb near a large city, a small city or town, and rural areas. These individuals included agricultural workers, college students, Extension personnel, faith-based communities, healthcare professionals, low-resource individuals, families or communities, tribal communities, rural communities, and communities of color. About 66% of the projects worked with individuals of Hispanic, Latino, or Spanish origin and one Native American reservation. The 24 Activity 2 projects serve individuals who identify as White (n=20), Black or African American (n=18), American Indian or Alaska Native (n=5), Asian (n=3), and Native Hawaiian or other Pacific Islander (n=3). Other groups included BIPOC adults, recent immigrants, migrant farmworkers, and youth. ? Changes/Problems:In quarter 1 of year 2, Washington State University (WSU)Murrow College of Communications, EXCITE A2 project 25, completed data collection with Extension professionals to gain insights for supporting vaccination communication efforts. Data collection approaches included an online survey with Extension professionals (N=1009), focus groups with "frontline" Extension professionals (N=31), neuromarketing testing with Extension professionals (N=31), and interviews with Extension directors/administrators (N=10) from all five Extension regions. The WSU team provided recommendations based on the needs assessment, and the recommendations were: Tailor training based on Extension roles Prioritize preserving community trust and professional credibility Establish connections with medical experts Strengthen science media literacy skills to counter misinformation and communicate emerging science. ? In quarter 2, EXCITE teams expanded their programming efforts to focus on other adult immunizations. Moving into other adult immunizations required finding partners familiar with the subject matter and the primary populations of interest. Relationship building related to creating effective partnerships takes time. In these situations, finding multiple partners to support various adult immunizations of interest was sometimes necessary. An example was a project forging a new relationship with a mass media organization focusing on rural communities to assist with disseminating educational information and community events. While building new partnerships, original COVID-specific partnerships are sometimes weakened. Partner burnout and staffing issues remained challenges for some EXCITE teams. Staffing issues hindered project partnership efforts. High employee turnover created challenges with moving work forward and workload distribution. Another area for improvement was supporting teams that were experiencing partner burnout. Unexpected partnerships were also occurring to increase and expand reach. For example, the University of Idaho partnered with a food bank at an event to support underserved audiences. Developing new partnerships are positive, but these efforts take time. In quarter 3, teams reported having institutional issues related to limited human resources have caused challenges due to employee turnover, retirement, and general changes in staff positions and responsibilities. Relationships between various departments across campuses were being strengthened, and they saw an increased value in partnering with Extension. They also reported that discoveries about priority changes were determined as partnerships evolved. With a shift in priorities came the understanding that the once-mutual goals no longer existed. These discoveries created opportunities to connect with local community-based organizations or health departments. This shift also helped as teams transitioned from COVID to focus on more broad immunization efforts. Also in quarter 3, using an iterative process the Washington State University team developed a tool kit built around the recommendations shared in the first quarter that focused on 3 primary areas: Ucience based communication, motivational interviewing, and neuromarketing analysis. A2 teams participated in the training on the toolkit, provided feedback and the toolkit was redesigned to incorporate the feedback suggestions. The final toolkit product was provided to the Extension System in June 2023. In quarter four, at the EXCITE Strategy Session, EXCITE program team members facilitated a discussion with funded teams to reflect on the implementation and evaluation of EXCITE Activity 2 projects. The insight the EXCITE team gained from these conversations informed future implementation strategies in EXCITE Implementation Phase. Many teams discussed that recognition and support from Extension and university leadership would move adult immunization education forward in Extension. Other suggestions from the conversation included: training around partnerships--what partners need, how to be a good partner, communicating with partners, and connecting with other partners. Many teams also were interested in finding interpreter materials and resources and evaluation tools in different languages to communicate with non-English speaking populations. Teams also said they would benefit from training around strategies for capturing reach and data in general. This might include capturing social media reach, more standardized evaluation tools, and measuring outcomes. Finally, teams reported that unrestricted funding would help them to do more in the communities in which they work. Examples of other uses for funding included incentives for events to combat survey fatigue, funding to purchase vaccines, and the ability to work towards "whole health" education with immunization as a component of health.? Next Steps Analysis of data and reporting of Activity 1 and 2 data Implementation of WizeHive grant management software within Extension Foundation and with institutions sponsored programs and principle investigators. Budgeting update based on completion of Activity 1 and 2 and new invoicing procedure for Implementation phase Coaching EXCITE Implementation Projects Planning for Sustainability What opportunities for training and professional development has the project provided?EXCITE efforts equipped Extension professionals to carry out this work through professional development opportunities and support/resources. Key resources include the EXCITE newsletter and website. Additionally, one or more monthly virtual professional development sessions were held last year. Recurring topics for these professional development sessions included: sharing lessons learned, communication and collaboration strategies, sharing updated immunization guidance, sharing project experience, introducing a new funding opportunity and holding virtual "office hours" to help teams prepare for EXCITE continued (competitive) funding. ? In addition to the previously mentioned efforts, each Activity 2 team was assigned an EXCITE program team member as a coach throughout the project. Eight national program team members personally coached three teams with similar target populations. Program team coaches helped their Activity 2 teams in various ways, from being a personal link to the national program team, cheering the successes of each Activity 2 team, and troubleshooting any challenges that came up. To achieve this, coaches met with each team at least once monthly on average. Coaches then reported progress and needs during program team meetings which aided in determining the focus for process clarity, professional development needs, and additional support for the Activity 2 teams. Co-sharing project experiences and lessons learned as part of these professional development opportunities have been identified as beneficial to EXCITE grantees. In some cases, information shared by one grantee has resulted in the redirection of another grantee's activities. Through EXCITE professional development sessions, the EXCITE project team had 785 Extension contacts. How have the results been disseminated to communities of interest?The EXCITE program team attended many conferences this last year to disseminate findings to communities of interest. These conferences include: National Association of County and City Health Officials (NACCHO) Innovative Partnerships Between Cooperative Extension Services and Health Departments to Reduce Vaccine Hesitancy National Extension Association Family & Consumer Science (NEAFCS) Opportunities, Lessons Learned, and Challenges among Extension Professionals Engaged in Adult Immunization Education During the Pandemic - Insights from the EXCITE Initiative National Health Outreach Conference A Systems-Based Approach between Federal Health Agencies and Cooperative Extension to Promote Adult Vaccinations National Urban Extension Leaders EXCITE, Urban Perspectives: CDC-Extension Collaboration Sparked by the Pandemic EXCITE program team members developed videos to highlight teams in different regions. These assets (videos) capture the experiences of EXCITE Activity 2 teams and their public health or clinical partners. These videos can be accessed at the links below. North Carolina State Extension and the North Carolina Department of Health and Human Services: https://use.vg/zfErGa Delaware Extension and Delaware Department of Health and Human Services: https://use.vg/0F7P0F the University of Arkansas Extension and Arcare: https://use.vg/H4lio5 What do you plan to do during the next reporting period to accomplish the goals? Launched EXCITE Implementation Phase in June, which includes awards and contracts, coaching, and professional development from Washington State University. Secure a new grants management system to manage relations with grantees and data collection from teams. (Wize Hive) Disseminate Washington State University's toolkit "Getting to the Heart and Mind of the Matter" video series and related resources on the EXCITE Resource Page. Launch EXCITE 3 reporting form to collect demographic, partnership, engagement activity--events and direct communications, results, and assets data from the Implementation Phase Establish 3 pilot projects with Extension and National Rural Health Association as partners Develop a sustainability plan for EXCITE
Impacts
What was accomplished under these goals?
In year two of the EXCITE initiative, funded projects accomplished the following in pursuit of the project goals (in italics) as listed below. Decrease vaccine hesitancy among rural and medically underserved audiences. EXCITE projects were encouraged to use questions adapted from the Centers for Disease Control and Prevention's (CDC) Vaccine Confidence Survey Question Bank to aid in the assessment and evaluation of results. From these questions, 19 projects reported "Improved perceived importance of vaccines for preventive health and disease prevention", 12 projects reported "Improved vaccination rate", and 9 projects reported "Improved trust in vaccinations." Cooperative Extension professionals use the CDC Rapid Community Assessment and other methods to address barriers and concerns and increase the acceptability of COVID-19 and other adult vaccinations among priority populations through Activity 1 and Activity 2 EXCITE projects reported 173,417 engagement activities. Engagement activities included direct communication, in-person events, mass media, print materials, social media, vaccination clinics, virtual events, and billboards. EXCITE projects reported 18,068,730 contacts having been reached through the above engagement activities. Activity 1 and Activity 2 increase knowledge about and acceptability of COVID-19, flu, and other adult immunizations among priority populations. 6 EXCITE projects reported "Improved social norms emphasizing importance of vaccinations" through their use of adapted CDC Confidence Survey Question Bank. In addition, projects reported administering 26,023 adult immunizations. Activity 1 and Activity 2 document barriers to vaccine confidence and vaccine access and effective interventions to eliminate these barriers. 9 EXCITE projects reported "Decreased barriers to vaccinations" as collected through their use of adapted CDC Confidence Survey Question Bank. Cooperative Extension professionals partner with local health professionals and engage target priority populations in programs that increase the connection between communities and healthcare systems through Activity 1 and Activity 2 Partnerships are a critical component of EXCITE. The Activity 1 project report 410 partners and Activity 2 reported 254 partners. The largest amount of partners were health departments or Health Care providers as they were critical to providing the vaccination. Other key partners were Institutions internal departments, community organizations and faith based communities. Increase accessibility of vaccination clinics to priority populations and Cooperative Extension professionals in partnership with health professionals increase access to local vaccination clinics through Activity 1 and Activity 2. EXCITE funded projects reported hosting 1,024 vaccination clinics in collaboration with partners.
Publications
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Progress 05/01/21 to 04/30/22
Outputs
Target Audience:The priority population of the Activity 1 projects includes individuals from 15 to 100 years of age who live in a large city, a suburb near a large city, a small city or town, and rural areas. About 65% of projects (n=48) serve individuals of Hispanic, Latino, or Spanish origin including migrant farm workers. Other projects serve individuals who identify as White (n=46), Black or African American (n=44), American Indian or Alaska Native (n=23), Asian (n=16), and Native Hawaiian or other Pacific Islander (n=11). Other demographics include agricultural workers, college students, Extension personnel, faith-based communities, healthcare professionals, low-resource individuals, families or communities, tribal communities, rural communities, and communities of color. Thirteen projects also work with communities located on 17 different Native American reservations. The Activity 2 projects also work with individuals who live in a large city, a suburb near a large city, small city or town, and rural areas. These individuals include agricultural workers, college students, Extension personnel, faith-based communities, healthcare professionals, low-resource individuals, families or communities, tribal communities, rural communities, and communities of color. About 66% of the projects work with individuals of Hispanic, Latino, or Spanish origin and one Native American reservation. The 24 Activity 2 projects serve individuals who identify as White (n=20), Black or African American (n=18), American Indian or Alaska Native (n=5), Asian (n=3), and Native Hawaiian or other Pacific Islander (n=3). Other groups include BIPOC adults, recent immigrants, migrant farmworkers, and youth. Changes/Problems:The national EXCITE program team expected there would be hesitancy among the land-grant institutions regarding adult immunization education; however, the level and intensity of hesitancy were underestimated. Some Extension professionals lack confidence regarding implementing programming and/or educational sessions around immunizations. This lack of confidence could be due to internal and/or external pressures to focus on work that LGUs have historically conducted (e.g., food and nutrition, gardening, community development, etc.). Additionally, while LGUs often work on health programming, when it came to COVID-19, there were local and regional perceptions that Extension should not be involved in this work - which had upstream influences on some decisions to not apply for EXCITE funding. Some institutions were strongly committed to initiating work on this topic and realigned resources to do so. Other institutions were already involved in vaccination education and had strong partnerships in place. Not all institutions were operating at the same place for a system-wide approach. In response to this issue, the EXCITE project team released an RFA inviting another EXCITE project focused on vaccine hesitancy among Cooperative Extension professionals. This need for a research-based project responded to the widespread vaccine hesitancy our teams reported among their colleagues. Washington State University's project called Getting to the Heart of the Matter: Extension Professional Vaccination Education Willingness, Confidence and Beliefs was selected for this special project. The purpose of this new project is to assess vaccine hesitancy of Extension field educators, specialists, and administrators, and to create and implement a strategy to reduce vaccine hesitancy for COVID-19 and other adult immunizations, and increase confidence and willingness to become immunization educators in their community. This project aims to reduce hesitancy around vaccination and increase willingness to serve in educational roles around adult vaccination among Cooperative Extension personnel at all three types of land-grant institutions (1862, 1890, 1994). Similarly, in early 2022, a new project focused exclusively on supporting the involvement of 1994 LGUs in vaccine education was launched in response to the limited pursuit of EXCITE A2 funding by 1994 land-grant institutions. The EXCITE team designated funds to support an effort aimed solely at the 1994 institutions. Because many 1994 institutions stated their inability to be involved in the EXCITE effort was due to a lack of available personnel to work on the effort, the funds include staffing for a coordinator to lead the collaborative immunization effort among participating 1994 institutions. What opportunities for training and professional development has the project provided?EXCITE equips influential messengers by providing professional development opportunities and support/resources through the EXCITE newsletter and EXCITE website. Key performance indicators related to equipping influential messengers include: Number of professional development opportunities provided to funded project personnel and partners, Number of Extension professionals who attend each professional development opportunity, and Number of funded institutions represented as participants in professional development opportunities This professional development is primarily offered through Spotlight and Insight sessions. Spotlight sessions are held on the first Thursday of every month for any EXCITE team, and Insight sessions are held on the third Thursday of each month for EXCITE Activity 2 teams. A quarterly strategy session is held for EXCITE Activity 2 teams. Strategy sessions combine professional development skills sessions and coaching with reflection time to help teams implement the strategy session's learning into their projects. Co-sharing as part of these professional development opportunities has been identified as beneficial to EXCITE grantees. In some cases, information shared by one grantee has resulted in the redirection of another grantee's activities. For example, at the November Spotlight session, one team presented their experiences using online radio, specifically Pandora, to disseminate vaccine education. Another grantee redirected their activities to include Pandora to reach their priority population from that presentation. Details about these sessions are provided below. September Spotlight (Activity 1/Activity 2 teams): Topic: LGU Hesitancy Attendance*: 99 September Insight (Activity 2 teams only): Topic: Brief resources updates/team coaching Attendance: 52 October Spotlight (Activity 1/ Activity 2 teams): Topic: CDC updates on boosters and flu, breakout rooms by programming format (social media, radio, etc.) Attendance: 86 October Insight (Activity 2 teams only): Topic: Team Coaching Attendance: 42 October 6-month Strategy Session (Activity 2 teams only): Topics: High-level overview of the importance of EXCITE from CDC and Extension; Crucial Conversations; Choice of Market Research, Evaluation, or Diversity/Equity/Inclusion Attendance: 93 November Spotlight (Activity 1/ Activity 2 teams): Topic: 6-month reflection on Activity 1/ Activity, breakouts by audience type Attendance: 81 November Insight (Activity 2 teams only): Topic: Market Research Attendance: 57 January Spotlight (Activity 1/Activity 2 teams) Topics: Success Sharing featuring nine EXCITE projects presentations addressing two questions regarding successes and lessons learned. Attendance: 96 February Spotlight (Activity 1/Activity 2 teams) Topics: - CDC update from Alexi Piasecki on isolation, quarantine, and Omicron variant - Qualtrics poll was conducted to ask interest to address additional immunization - priorities if the opportunity presented itself - Washington State University project Getting to the Heart of the Matter was introduced. - In four breakout rooms, attendees discuss survey question design and means of - assessing Cooperative Extension employees regarding vaccine knowledge and behaviors - and science literacy. - Why collecting stories of project impact matters and how to use the online tool Impact - Bullet Generator with examples from Iowa State University EXCITE project. Attendance: 92 March Spotlight (Activity 1/Activity 2 teams) Topics: No Cost Extensions and early project close-out processes, poll on program registry use, and Spotlight lightning rounds Attendance: 81 March Insight (Activity 2 teams) Topics: Intro to Washington State University's LGU Vaccine Hesitancy project objectives and timeline, sharing from teams who have shifted their focus to other adult immunizations Attendance: 64 April Spotlight (Activity 1/Activity 2 teams) Topics: CDC Thank you- presentation from Alexi, Spotlight lightning rounds Attendance: 77 April Insight (Activity 2 teams) Topics: EXCITE Year 1 trend data from project reports, discussion on partnership and institutional issues Attendance: 56 May Spotlight (Activity 1/Activity 2 teams) Topic: Spotlight lightning rounds Attendance: 37 May Insight (Activity 2 teams) Topics: Vermont's additional funding social media contractor presentation and discussion/ Q&A on social media use in projects Attendance: 48 May 6-month Strategy Session Topics: Medical Perspective on the transition out of Covid-19, other adult immunizations, and the use of iteration of EXCITE engagement efforts Attendance: 66 Additionally, shortly after being awarded their competitive grant, each Activity 2 team was assigned an EXCITE program team member as a coach. Eight national program team members are personally coaching three teams with similar target populations for the most part. Program team coaches help their Activity 2 teams in various ways, from being a personal link to the national program team, cheering the successes of each Activity 2 team, and troubleshooting any challenges that come up. To achieve this, coaches meet with each team at least once per month on average. This quarter, most of the meetings took place during monthly Insight sessions where coaches learned about project progress, challenges, and needs. Sometimes, coaching took place outside of the Insight sessions because of availability or needs. Coaches then reported progress and needs during program team meetings which aided in determining the focus for process clarity, professional development needs, and additional support for the Activity 2 teams. In the second quarter of year one, it became apparent that some teams needed additional support that the Program Team coach couldn't provide alone. This led to the hiring of Linda Kirk Fox as an EXCITE Catalyst coach to co-coach with the program team coach as needed. How have the results been disseminated to communities of interest?A presentation by the EXCITE program team at the National Health Outreach Conference was well received by attendees, and an additional six EXCITE-funded projects were shared with participants as oral presentations or poster sessions at the Conference. The National Health Outreach Conference is a leading conference for Extension professionals involved in work related to health and well-being. What do you plan to do during the next reporting period to accomplish the goals?EXCITE projects with no-cost extensions (Activity 1) will wrap up by October 2022. Individual coaching has been assigned and is now occurring with all Activity 1 projects with a no-cost extension. Ongoing Activity 2 EXCITE projects will continue through May 2022. Insight sessions and coaching sessions for Activity 2 teams will continue until May 2022. Results will continue to be disseminated to communities of interest. Two presentations have been affirmed for the next quarter at the following events, the National Association of City-County Health Officials and the Association of Extension Administrators (1890 Institutions) will occur in July and August, respectively.
Impacts
What was accomplished under these goals?
In year one of the EXCITE initiative, 11,572,481 contacts have been reached through 137, 431 engagement activities. Engagement activities include direct communication, in-person events, mass media, print materials, social media, vaccination clinics, virtual events, and billboards. The number of vaccination clinics held and vaccines administered is of particular importance to this grant. Funded projects reported hosting 837 vaccination clinics, in collaboration with partners, and administering 26,248 vaccines. Partnership development or enhancement has occurred through EXCITE projects, especially partnerships with local and state health departments or organizations. EXCITE projects (n=54) from 41 unique states partnered with local and state health departments or public health organizations to reach their target audiences through a variety of engagement activities. About half of these partnerships were "existing" and half were "new" partnerships created for EXCITE work. These public health organizations include city health departments, county health departments, Tribal health including Indian Health Service clinics and departments, and state health departments.
Publications
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