Partnership for Equitable Family Wellness: Implementation and Program Evaluation of a Family-Inclusive Healthy Lifestyle Program in Rural Southwest Colorado

College of Health and Human Sciences

Human Development and Family Studies

La Plata 

County 

(Montezuma)

Primary Topic:

Health & Wellbeing

Other Topics:

FCS, Nutrition, & Food Safety

Lead Mentor:  

Lauren Shomaker

Associate Professor

Internship Overview:

Over the past 5 years, Dr. Shomaker (Colorado State University main campus faculty) and Ms. Clark (La Plata County Family and Consumer Science instructor) have forged a robust, collaborative community-academic partnership: “Partnership for Equitable Family Wellness,” as titled by stakeholders. This work, guided by community-based participatory research principles and community-engaged scholarship, has been supported by over $1 million in funding, to date, from sponsors including the Colorado Health Foundation and the Children, Youth and Families At-Risk Sustainability Community Project program of the U.S. Department of Agriculture/National Institute of Food and Agriculture. A main outcome that the work has produced is “Health Without Barriers (HWB)-Southwest Colorado.” HWB-Southwest is an empirically-supported, whole family-inclusive, community-delivered lifestyle intervention that offers youth and family physical activity, parent/caregiver nutrition information and parenting skills, family hands-on cooking and goal setting. HWB-Southwest: (a) meets clinical guidelines for adolescent obesity/chronic disease prevention (e.g., ~26 contact hours), (b) includes mental health support for adolescents and parents/caregivers through mindfulness training, AND (c) was tailored for rural Colorado. Tailoring was carried by collecting and incorporating intensive, iterative feedback from racially and ethnically diverse, Southwest Colorado-area stakeholders via the combination of a community research translation process (“Boot Camp Translation”), a qualitative parent-child interview study, and post-program focus-group feedback from parents/caregivers, youth, and intervention facilitators over four successive program deliveries, with adaptations after each iteration. A community advisory board provides ongoing guidance and input.

Delivery and program evaluation of HWB-Southwest are ongoing and serve as the context for the proposed Extension Summer Internship. There is a strong team in place in Fort Collins-Durango to mentor an intern and to support a robust training environment on campus at Colorado State University AND in the field in La Plata County. With co-leadership from Dr. Shomaker and Ms. Clark, we are a team comprised of a multi-site lead research associate coordinator (Additional Mentor: Vicky Jimenez, Fort Collins), two full-time research associates in the field in La Plata County and neighboring Montezuma/Archuleta Counties, four part-time trained community workers who deliver HWB programming in the Southwest Colorado region, a faculty co-investigator (Dr. Ana Gutierrez-Colina) who has expertise in health behavior change and Hispanic/Latino health, a faculty co-investigator (Dr. Talia Thompson) with expertise in qualitative and mixed-methods, a technology/media communication specialist (Lauren Brigandi), a graduate research assistant working on her doctorate (Megan Moran), and an undergraduate research assistant (Clarissa Hernandez Jeppessen), plus consultation from two physicians with expertise in community medicine (Dr. Matthew Haemer) and pediatric endocrinology (Dr. Elizabeth Vargas), a consultant with expertise in healthcare delivery in marginalized communities (Laura Schwartz, MSW), a psychologist consultant with expertise in multi-cultural considerations in design and delivery of health and behavior interventions (Dr. Jesse Owen), and a psychologist consultant with expertise in Native American health and culture (Dr. Chesleigh Keene). The majority of individuals on the program team identify as underrepresented minorities and ~half speak Spanish as a first language.

Collectively, we have worked with many graduate and undergraduate students, including summer program students (e.g., National Science Foundation Bench-to-Baccalaureate program), as well as students from minoritized backgrounds (e.g., National Institutes of Health Diversity Supplements, American Psychological Association/National Institutes of Health LEAP mentor program for Diverse Scholars, etc.). We have not yet participated in the Summer Extension Internship program. Yet, we are excited to submit this application to that end. With a strong engaged scholarship program in place, an exceptional team, and a well thought out plan for individualized professional development for a Summer Intern, we are delighted to incorporate an intern as part of this team.

Goals, Scope and Objectives:

The proposed internship is called, “Partnership for Equitable Family Wellness: Implementation and Program Evaluation of a Family-Inclusive Healthy Lifestyle Program in Rural Southwest Colorado.” The *overall goal* of the internship is to optimize a collection of multi-modal training materials that are necessary for new program facilitators who will be trained to deliver the program to Southern Ute Indian Tribe families. The *scope* of this work will involve engagement with Southern Ute Tribe health providers and families, curriculum/technology experts, and HWB-Southwest current program staff in La Plata County and neighboring Montezuma County. The *specific objectives* are to (1) collect information from program curriculum experts, Southern Ute Tribe stakeholders, and current program staff/facilitators in order to determine additional didactic/training content that is necessary for optimizing facilitators’ preparedness for delivering HWB to Southern Ute Tribe families; (2) develop a trainee user manual to progress through the three phases of facilitator training–(a) foundational pre-work, (b) intensive practice/feedback, and (c) supervised co-facilitation; and (3) collect qualitative feedback from users on the acceptability, feasibility, and perceived utility of the user manual and training content/process. Completion of these objectives will result in an enhanced, multi-modal training curriculum with particular attention to cultural humility, cultural opportunities, and cultural comfort with families who identify with the Southern Ute Tribe. An optimized training curriculum is a critical, capacity building block for future scaling up and grant applications for larger dissemination and implementation studies.

With which stakeholder group(s) will the intern work?

The intern will work with the entire Partnership for Equitable Family Wellness team as previously described, plus current program facilitators. The intern will also work with newly hired facilitators responsible for program delivery in Southwest Colorado, which may include working with members of the Southern Ute Indian Tribe in Ignacio, Colorado. Additional stakeholders specific to the program in Ignacio may include the Southern Ute Indian Tribe Public Health Department, administrators of the Community Recreation Center, and/or program participants.

What student learning outcomes do you anticipate and what are the opportunities for professional development?

1. The intern will practice cultural competency while working with diverse populations.
2. The intern will design a research strategy using focus groups and surveys to evaluate the strengths and gaps of the Health Without Barriers (HWB)-Southwest facilitator training program at two intervals; before and after (co)facilitating a program.
3. The intern will examine survey and focus group feedback from program participants to assess facilitation quality.
4. The intern will evaluate all data and collaborate with the Partners for Equitable Family Wellness team to improve the facilitator training program.

Professional development opportunities will include attending mentorship meetings with Dr. Shomaker and Ms. Clark, attending weekly Partnership for Equitable Family Wellness whole-team meetings, and two field site visits to La Plata County. Professional development opportunities also will include a selection of attending talks on main campus, integrated meetings with larger Extension network-main campus faculty, community events in La Plata County during site visits, as well as opportunities to shadow and observe at a range of our community partner sites (e.g., hospitals, healthcare practices, community gardens, and so on). Students will be encouraged to disseminate their findings as part of the planned Extension intern program in addition to dissemination directly to other stakeholders.
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