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February 2008
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Contents
Editor's PageJOE by the NumbersAs usual this time of year, I report on the previous year's submission rate and readership statistics. And I announce JOE's current acceptance rate. I also call attention to one of the most interesting features of the JOE site (and one of my favorites). Submission RateWe have yet another new all-time high in submissions. JOE received 285 submissions in 2007, two more than in 2006, when we reached our previous all-time high. Readership StatisticsIn 2007, there were 2,115,060 "visitors" to the JOE site who viewed 4,280,465 pages. Our readership rates have dipped a bit from last year's, but this comes after nine years of ever-expanding readership rates. And in 2007, JOE still had more than 500,000 visitors who viewed more than 110,000 pages compared to 2005. You can find JOE Readership Statistics from 1998 onward at <http://www.joe.org/stats-yearly.html>. Also in 2007, JOE attracted readers from 193 nations and territories. You can find these nations and territories listed at <http://www.joe.org/nations1207.html>. Acceptance RateIn 2003, we started collecting the data that would allow us to post an annual acceptance rate for JOE, but posting annual acceptance rates caused confusion. It also failed to account for submissions that were submitted in one year but reviewed in another. We now have enough reliable data from enough years to post a single rate. JOE's current acceptance rate is 36%. (This figure is the average of submission data from 2003 through 2007.) JOE is an increasingly rigorous journal in which Extension professionals and other scholars can be proud to be published. The Top 50 Most Read ArticlesYou can find the list of the Top 50 Most Read Articles in 2007 as well as those from previous years at <http://www.joe.org/stats.html>. Brian Weaver, JOE Web Developer, has added a new feature to the 2007 list, how the articles ranked the year before. It all makes for interesting reading. These lists are not a reflection on the quality of the JOE articles that "made the lists" as opposed to those that didn't. But they do say a lot about the degree of interest readers from around the world have in some of the topics discussed in JOE. February JOEIn a break from the norm, this month brings us two Commentaries, both on an increasingly important topic, Extension's response to the issue of an aging nation. "Building Extension's Capacity Through Knowledge of Global Aging Issues" puts the issue in a global context, and "USDA CSREES' Role in Broadening Support for an Aging Nation" brings the issue home. Then, the first Feature, "Meeting the Needs of Rural Caregivers: The Development and Evaluation of an Alzheimer's Caregiving Series," demonstrates that Extension is already responding. The next two Features, "Research-Based Outreach: Albert Bandura's Model" and "Now Is the Time for Change: Reframing Diversity Planning at Land-Grant Universities," both take a system-wide look at Extension, while the rest of them are more focused but no less interesting. There are also articles on meeting the needs of American Indian audiences, on health and nutrition, on evaluation and impact, and on so much more. Laura Hoelscher, Editor
Building Extension's Capacity Through Knowledge of Global Aging Issues
Debra M. Sellers Local Needs, Global AnswersExtension professionals are firmly grounded in local communities. We are proud of our ability to improve the lives of our neighbors. At times, we extend this definition of neighbor to include individuals living in our state, nearby states, or region. Sometimes we expand the definition to a national level. It can be more difficult to think of a neighbor as an individual living in another nation; this may seem too far from the Extension tradition and may be thought to occur at the expense of local needs. Incorporating a global perspective into daily Extension work is not, however, a zero-sum game. The advantages of thinking globally have been outlined by several Extension professionals (Gallagher, 2002; Lev, 2001; Ludwig, 2002; Sundermeier, 2006). A willingness to explore the global stage can improve and embellish program development, implementation, and evaluation methods. Knowledge of other countries' successes and failures builds Extension's capacity to have a positive impact in local communities. Insight into global issues thus becomes an additional resource for Extension professionals. One common global concern is the aging of the population. In 2002, those aged 65+ comprised 7% of the world's population. By 2050, that number is expected to rise to nearly 17% (U.S. Census Bureau, 2004). This trend points to serious social, political, and economic consequences around the world and is a signal that for many countries, current programs are inadequate and must be reformulated. China's Importance on the Global Aging StageFor those interested in the impact of global solutions related to aging communities, an exploration of China's alternate viewpoints and models is instructive. China has several features that demand immediate attention.
Program Development and Implementation in ChinaInsight into aging in China is outlined here through a presentation of selected observations from the Seminar in Beijing conducted by the American Society on Aging in May 2007. This event was experiential in nature, and the 24 of us who participated were provided with entrée not normally granted to foreigners. An investigation of Chinese perspective through visits to aging centers in Beijing; interaction with medical professionals, academics, and government officials; and an exploration of the culture were integral components of the seminar. China's rapid social and economic reforms, coupled with future population projections, provide openings to develop innovative aging programs on a scale never before attempted in world history. In particular, efforts in personal development, health care, and family caregiving have possible implications for programming in the United States. Personal DevelopmentPersonal development for older adults is positioned within China as a crucial central tenet in terms of quality of life. Women retire at 55; men at 60. Thus, there is a critical need to develop non-employment interests for a stage of life that could last upward of 30 years. Recreation, leisure, and sport are viewed as an important aspect of personal development. This value is evident in the approximately 47,000 recreation and activity centers for older adults. For those interested in education, individuals can attend one of more than 26,500 senior universities. Varying across communities, senior universities consist of facilities and programming. A senior university in Beijing provides classes in a variety of areas, such as dance and computer instruction. The cost to attend is minimal (about $8.00 per term). Health CareTraditional Chinese Medicine (TCM) is a comprehensive and holistic view of health and is composed of five foundational concepts: nutrition, lifestyle, emotion, exercise, and mental fitness. Prevention and wellness are viewed as critical aspects of the overall framework. Physical activity is highly encouraged in China and is a habit for many people, young and old. Exercise can occur for its own sake, but the incorporation of physical activity into daily lives is a cultural norm. Education about prevention is a primary focus in China for its potential impact upon quality of care and quality of life. As approximately 60% of all older Chinese live in rural areas (IOSCPRC), education about health-related topics is primarily disseminated through use of various media, including television and radio. Family CaregivingIn 1996, a law concerning the rights of elderly people was adopted, with one article stating explicitly that the main provision of support to old people is the family (Legislative Affairs Commission of the Standing Committee of the National People's Congress of the People's Republic of China, 1996). The Chinese presenters commented frankly concerning the breakdown in thousands-year-old traditions of familial values related to reverence for older people. Through the use of words such as "abandonment," it became evident that social attitudes are quickly changing. As part of a response to changing attitudes, the government is encouraging family support contracts: a legal document that outlines what children will provide for their parents. By 2005, approximately 13 million such contracts had been enacted (IOSCPRC, 2006). What Extension Can Learn from China's ResponseI pose the questions below as examples of initial thoughts concerning another country's responses to aging and the applicability of that response to Extension programming. Personal Development
Health Care
Family Caregiving
Consideration of China's responses and the possible applicability to the United States is worthy of reflection as we are also facing broad and comprehensive changes to our population. Thinking globally about this issue presents an opportunity to expand possible Extension programming possibilities for older adults through assessment of the relevance of global answers to local communities. By thinking of the Chinese as neighbors, Extension professionals can learn about diverse and unique solutions and incorporate the 'best of' into their own programs and services. How Extension Professionals Can Go Global Without Leaving Their OfficeAlthough Extension professionals may acknowledge the benefit of thinking globally, it can be easy to allow the active development of a global perspective to slide to the bottom of the pile. Here are some activities that can be helpful, and all of these can be completed without leaving the office!
What Does Global Aging Mean to My Neighbors and Me?The pressing problems that have and will come to the United States as the result of our aging population sweep across areas as diverse as agriculture, family relationships, finances, health, and nutrition. Taking an expanded view of the needs of an aging clientele and possible solutions is one way to serve in our local communities. Extension professionals clearly will have an important role in shaping the vision for this future old age society. We can build capacity in the role of educator through understanding global efforts and increasing our knowledge of other countries' failures and successes as they attempt to address aging populations. Engagement in active reflection and assessment of diverse answers results in the development of new perspectives. Thinking beyond the state, region, and nation powerfully influences the creation of solutions and development of programs for our neighbors. ReferencesChina National Committee on Ageing. (1999, January 9). Ageing and development. Beijing: Author. Gallagher, T. J. (2002). Going international in Extension: A done deal? Journal of Extension [On-line], 40(3). Available at: http://www.joe.org/joe/2002june/comm1.html Information Office for the State Council of the People's Republic of China. (2006, December). The development of China's undertakings for the aged (1st ed.). Beijing: Foreign Languages Press. Legislative Affairs Commission of the Standing Committee of the National People's Congress of the People's Republic of China. (1996). Law of the People's Republic of China on Protection of the Rights and Interests of the Elderly (1st ed.). China National Committee on Ageing: HuaLing Publishing House.
Lev, L. (2001). Leave home! International sabbaticals as unfreezing experiences. Journal of Extension [On-line], 39(4). Available at: http://www.joe.org/joe/2001august/comm1.html Ludwig, B. G. (2002). Global in our backyard. Journal of Extension [On-line], 40(2). Available at: http://www.joe.org/joe/2002april/comm1.html McDevitt, T. & Rowe, P. M. (2002, February). The United States in international context: 2000. Census 2000 Brief (Report No. C2KBR/01-11). Washington, DC: U.S. Census Bureau. Sundermeier, A. (2006). Become an international ambassador with People to People. Journal of Extension [On-line], 44(5) Article 5TOT6. Available at: http://www.joe.org/joe/2006october/tt6.shtml U.S. Census Bureau. (2004, March). Global population at a glance: 2002 and beyond. International Brief (Report No. WP/02-1). Washington, DC: Author. U.S. Department of State. (2007, March 19). Consular information sheet: China. Retrieved June 14, 2007 from http://travel.state.gov/travel/cis_pa_tw/cis/cis_1089.html Now it's your turn. Engage in discussion with your colleagues. Participate in the JOE Discussion Forum on "Building Extension's Capacity Through Knowledge of Global Aging Issues."
USDA CSREES' Role in Broadening Support for an Aging Nation
Shirley A. Gerrior
Caroline E. Crocoll IntroductionThe aging of America is a major public concern and has far reaching implications for the nation and for rural communities (U.S. Census Bureau, 2003). With one-quarter of Americans living in rural settings, rural communities generally have a higher proportion of older persons in their total population than urban areas. This is largely due to aging-in-place, out-migration of young adults, and in-migration of older persons from metro areas and other regions of the world (ERS, 2005; U.S. Census Bureau, 2003). Additionally, older Americans living in these communities face a greater likelihood of poverty and food insecurity, geographic isolation, inadequate housing, and often inaccessible or costly health and social services (ERS, 2005). Non-farm rural elderly account for the majority of rural elderly and suffer from a disproportionate number of chronic health conditions and health problems and have more restrictions on their lives than any other group of older people (ERS, 2005). Of particular concern is the increase in overweight and obesity, the high incidence of hypertension and diagnosed arthritis, and incidences of cancer, diabetes, and arthritis (AOA, 2006). Many rural elderly do not participate in health promotion programs and services, resulting in undiagnosed conditions and higher rates of chronic disease (Wilcox, Bopp, Oberrecht, Kammermann, & McElmurray, 2003). Although the challenges facing rural communities are formidable, opportunities for improving health and health care services of older adults do exist. For example, the recent growth of the ethanol industry in rural areas may be advantageous to some rural families through employment and increased income (ERS, 2007). Older persons as members of these families may benefit indirectly through family resources and the potential for improved community infrastructure associated with economic development. The federal government as well as states and local communities can play a critical role in providing resources and supports to rural people and communities to improve health. This role and the coordination of services and educational outreach can be effectively supported through the U.S. Department of Agriculture's Cooperative State Research, Education, and Extension Service (USDA CSREES) in partnership with the land-grant university system.
What Is the Role of USDA CSREES?USDA CSREES is strategically directed to address many of the problems faced by older populations. Two of its six strategic goals align with the needs of rural aging populations:
Within each of these two goals are specific objectives that expand on CSREES' role to achieve these goals. Working with its land-grant university and Cooperative Extension System (CES) partners, CSREES promotes the well-being of Americans through effective research, education, and Extension to better understand the socioeconomic and environmental factors affecting rural communities and the people who live there. Cross-cutting programs within these two goals effectively align and bring together a number of content areas focused on rural aging issues to include; health; nutrition; financial security; housing; rural caregiving and community development. Improving the Nation's Nutrition and HealthEnvironmental barriers, geographic isolation, lower income, and lower education levels are common to the rural elderly (Vitolins, Quandt, Bell, Arcury, & Case, 2002) and may compromise health. Limited access to a nutritious diet or a diet of poor quality has the potential for inadequate energy and essential nutrient intake leading to malnutrition and dehydration (ADA, 2000, 2005) and may be a factor in the development of a number of chronic and debilitating diseases. In addition, a sedentary lifestyle is a significant health risk to aging individuals. Regular physical activity is associated with many physical and mental health benefits (NCHS, DHHS & USDA, 2005; Stepnick, 2006), but older people are often discouraged from doing physical activity, and regular leisure physical activity decreases with advancing age. Poorer adults are less likely to engage in physical activity than those with higher incomes (NCHS, 2005). Also, older rural residents, especially women, face a number of barriers to being physically active, including lack of family support, the fear of injury, caregiving duties, and unsafe or isolated physical environments (Wilcox, Bopp, Oberrecht, Kammermann, & McElmurray, 2003). USDA uses its nutrition and assistance programs and broader nutrition education efforts to promote healthier eating and more physical activity across the nation. CSREES sponsors research to improve scientific knowledge concerning nutrition and health and supports education and Extension to promote healthy diets, ensure access to healthy food, and encourage healthy living. CES' educational and outreach efforts strive to improve nutritional well-being and quality of life of older adults using a variety of effective strategies and research-based interventions and establishing community-based healthcare partnerships. Supporting Increased Economic Opportunities and Improved Quality of Life in Rural AmericaRural areas struggle with many forces that can negatively affect health and the well-being of older adults. To help meet the economic and quality of life needs of this population in rural areas, family members, neighbors, and friends often fill the service gap, providing both direct and indirect caregiving services. Finding resources to help with caregiving can be difficult. Rural caregivers are isolated from social support, resources, financial assistance, training, respite options, community programs, and information on caregiving (Rural Assistance Center, 2005). Additionally, caregiving demands often interfere with job responsibilities and workplace productivity. Unmet family needs, including access to accurate information and support among diverse populations, leave communities and employers unprepared to meet growing caregiving responsibilities. These factors can have a significant impact on the health and wellness of older family members. Rural communities should be able to provide basic services to families, including access to clean water, adequate housing, and reliable electricity and telecommunications, and such essential needs as quality education, health care, day care, public safety services, and cultural activities. To assist with these needs and services, CSREES and its nationwide partnership promote the well-being of rural communities through research, education, and Extension to better understand the economic, demographic, and environmental forces affecting older adults and use this knowledge to develop strategies that make maximum use of local assets. What Does CSREES Need to Do to Engage Individuals and Communities on Rural Aging Issues?Enhanced educational efforts and outreach to rural communities are needed to increase public awareness and community engagement on aging issues. Over the past decade CSREES and other USDA agencies have addressed population aging both as individual agencies and through coordination and collaboration in a variety of ways. Interagency working groups, task forces, multi-state initiatives, and local, state, and national communities of educators and social service professionals have joined forces to share and exchange resources, services, and educational materials to support for interventions to promote healthy aging. Partnerships between state and community agencies, as well as with private partners, facilitate coordination and expansion of nutrition, health, and housing information and supportive services for older adults living in rural areas. The need for these services and for education and outreach at the state, regional, and community level will continue to grow as the vast Baby Boomer generation ages over the coming decades. CSREES and its land-grant partners are uniquely positioned to reach out to older adults and their families in rural communities to inform and educate them about the many issues, challenges, and opportunities related to healthy aging. In 2007, CSREES supported research on healthy aging in rural communities through the Rural Health and Food Safety Education Program, and many other research and educational efforts are underway to serve this audience, including the emerging Family Caregiving Community of Practice sponsored by the eXtension Initiative. Through higher education programs, CSREES builds and strengthens the capacity for training the next generation of scientists and educators to care about the well-being and quality of life of older adults. More information about these age-related activities can be accessed at http://www.csrees.usda.gov/nea/family/in_focus/family_if_adultdevelopment.html ConclusionCES' Family and Consumer Sciences and Nutrition educators in the land-grant university system are ideal conduits to improve access for older adults, their families, and communities to high-quality educational resources and support services. However, to ensure program sustainability and effective educational programs serving rural communities, CES must document local program effectiveness and timeliness to meet current and future needs related to aging and caregiving. In particular, it is important that CES educators keep older adults and their families interested and participating in educational programming by making programs culturally and ethnically relevant and suited to an aging rural population in a safe environment with trained staff. CES can and should lead the way in the interpretation of relevant research, government policy, advocacy of nutrition programs, and promoting accurate health information to rural communities to strengthen families and improve quality of life for generations to come. ReferencesAdministration on Aging. (2006). A profile of older Americans: 2005. Retrieved June 7, 2006, from http://www.aoa.gov/PROF/Statistics/profile/2005/2005profile.pdf American Dietetic Association. (2000). Position of the American Dietetic Association: Nutrition aging and the continuum care. Journal of the American Dietetic Association, 100, 580-595. American Dietetic Association. (2005). Position of the American Dietetic Association: Nutrition across the spectrum of aging. Journal of the American Dietetic Association, 105, 616-633. Center for Health Workforce Studies. School of Public Health, University at Albany. (2006). The impact of the aging population on the health workforce in the United States. Rensselaer, NY. Economic Research Service. (2005). Briefing Room: Rural population and migration: rural older population. Retrieved September 6, 2005, from http://www.ers.usda.gov/briefing/population/older/ Economic Research Service. (2007). Rural America at a glance 2007 edition. Retrieved October 9, 2007 http://www.ers.usda.gov/Publications/EIB31/ National Center for Health Statistics. (2005). Health United States, 2005 with chartbook on trends in the health of Americans. (Library of Congress Catalog Number 76-641496) Washington, DC: U.S. Government Printing Office. Rural Assistance Center. (2005). Informal caregiving. Retrieved June 4, 2006, from http://www.raconline.org/info_guides/caregiving/ Stepnick, L. (2006). A new vision of aging: Helping older adults make healthier choices. Washington, D.C. U. S. Census Bureau. (2003). Internal migration of the older population: 1995 to 2000. (Census 2000 Special Reports. CENSR-10). Washington, DC: U.S. Government Printing Office. U.S. Department of Health and Human Services and Department of Agriculture. (2005). Dietary guidelines for Americans 2005. (Home and Garden Bulletin No 232). Washington, DC. Vitolins, M. X., Quandt, S. A., Bell, R. A., Arcury, T. A., & Case, L. D. (2002). Quality of diets consumed by older adults. Journal of Rural Health, 18, 49-55. Wilcox, S., Bopp, M., Oberrecht, L., Kammermann, S. K., & McElmurray, C.T. (2003). Psychosocial and perceived environmental correlates of physical activity in rural and older African American and white women. Journal of Gerontology: Psychological Sciences, 58B, 329-337. Now it's your turn. Engage in discussion with your colleagues. Participate in the JOE Discussion Forum on "USDA CSREES' Role in Broadening Support for an Aging Nation."
Meeting the Needs of Rural Caregivers: The Development and Evaluation of an Alzheimer's Caregiving Series
Sandra Bailey
Lynn Paul
Department of Health & Human Development IntroductionCaregiving for a chronically ill person is a challenging task. Chronic illness is characterized by its long-term nature and uncertainty of prognosis. On a daily basis, managing chronic illness requires balancing illness needs with tasks. There is difficulty in controlling emotions, such as pain, anxiety, grief, and depression, and physical problems, such as weight loss and reduced strength in the chronically ill person. Yet informal caregivers often do not define themselves as such, thus making it difficult for them to see the toll caregiving takes on their own health. The disruption of the lives of individuals and families along with financial drains, added stresses from efforts to normalize relationships, social isolation, and stigma affect all involved (Miller, 1993).
Trends indicate a continued increase in the number of adults who provide caregiving to family and friends (Berg-Weger & Tebb, 2004; Marks, Lambert, & Choi, 2002). It is estimated that one in four households have at least one person providing informal caregiving, defined as care provided by family, friends, and neighbors as opposed to paid or volunteer formal caregivers (U.S. Department of Health and Human Services Administration on Aging [AOA], 2004). Caregivers assume a wide variety of responsibilities for which they have not been trained (Marks et al., 2002). The most common caregiver responsibilities can be categorized as personal care, emotional support, financial assistance, and linking with formal care providers, with each category representing an array of time-consuming tasks (Stone, Cafferata, & Sangl, 1987). Caregivers often suffer greatly from the demands of caregiving, with greater caregiver burden for those caring for people with complex chronic illnesses (Levine, Reinhard, Feinberg, Albert, & Heart, 2004). These demands result in poorer physical and psychosocial health for the caregiver (AOA, 2004). A recent study documented that older, burdened caregivers of spouses have 63% higher mortality risks than their non-caregiving peers (Schultz & Beach, 1999). One particularly stressful caregiving situation is that of caring for a loved one with Alzheimer's disease. Alzheimer's disease is the leading cause of dementia. It is a progressive disease that affects the individual physically and psychologically (Alzheimer's Association, 2005). The disease currently has no cure. Due to the progression of the disease and the lack of a cure, caregivers of Alzheimer's patients experience increasing burdens that can affect their own physical and psychological well-being. There are an estimated 16,843 people in Montana diagnosed with Alzheimer's disease (Alzheimer's Association, 2005). More than 70% of Alzheimer's patients live at home and are primarily cared for by family members or friends (Alzheimer's Association, 2005). Because of the rural nature of the state, Alzheimer's patients and their families are often isolated, with few resources and supports, which creates greater challenges for caregiving. Extension professionals in the state became aware of the situation from the Alzheimer's Association state chapter and Extension constituents in the state. To address this unmet need, Extension county agents and specialists developed the Alzheimer's Caregiver Series for informal caregivers. This article discusses the development of the series and evaluation of the project and provides information for replication in other states. Family CaregivingEighty percent of home care services are provided by family members who may live close to or in the same house as the ill person (U.S. Agency for Health Care Research and Quality [AHCRQ], 2000). It is estimated that almost one out of every four U.S. households contains a caregiver for a relative or friend at least 50 years old (AOA, 2004). The likelihood of an adult becoming a family caregiver is increasing (Marks et al., 2002). In Montana, there are an estimated 88,154 family caregivers who annually provide 94,000,000 caregiving hours with a market value of $832,000,000 (National Family Caregiver Association [NFCA], 2003). A typical caregiver is a married woman who works outside the home; however, more men are assuming caregiver responsibilities (NFCA, 2003). Most caregivers receive great satisfaction from providing support to the chronically ill person, but it is common for caregivers to experience significant physical and psychosocial problems (Schultz & Beach, 1999; Marks et al., 2000). Common psychosocial problems include depression and lowered self-esteem (Marks et al., 2002), while physical problems include poorer nutritional status (Silver & Wellman, 2002). In addition, long-term caregiving can affect the caregiver's employment and interferes with providing for the needs of other family members and friends (AOA, 2004). Caregivers assume many roles as the physical and mental health of the ill person deteriorates (Stone et al., 1987). The primary caregiver manages all or parts of tasks the chronically ill person is no longer capable of performing. Therefore, a primary caregiver may both manage a variety of needs of a household or individual as well as provide direct care to the chronically ill (Silver & Wellman, 2002). As a result, caregivers can assume an overwhelming array of responsibilities that require the caregiver to be knowledgeable about and act upon needs such as legal, financial, medical, emotional, transportation, and home maintenance. The primary caregiver also interacts with, manages the responsibilities of, and provides updated information to a variety of other caregivers, who may include informal caregivers, such as the spouse, adult child, grandchild, relative, friend, neighbor, and formal caregivers, such as paid professionals or volunteers. Challenges of Rural CaregiversLiving in a rural setting further complicates the initiation and follow-through of a health maintenance program for caregivers of those with chronic illness. In Montana, 50 of the 56 counties are designated as frontier counties. This means that residents in the 50 counties have greater obstacles in accessing care for families. Additionally, the eastern portion of the state is experiencing a decline of population, leaving behind an aging population with fewer services. Caregivers of Alzheimer's afflicted friends and loved ones face particular challenges and obstacles. Typical obstacles include distance, terrain, climate, lack of providers, fewer available specialty services, and lack of social support (Krummel, Humphries, & Tessaro, 2002; Paul & Weinert, 1999). As the length of time for caregiving increases, overall physical health of caregivers declines (AOA, 2004). It is imperative that caregivers for rural older adults have access to effective caregiver training to assist them in maintaining their own health and well-being. Only a few published studies document the outcomes of caregiver training with even fewer published studies documenting results of comprehensive caregiver training for rural, older adults with chronic illness (Kaasalainen, Craig, & Wells, 2000). Preparation of CaregiversThe majority of caregivers transition into caregiver roles without the knowledge or skills to provide effective caregiving (Marks et al., 2002). However, caregiver training can improve well-being and health for these two at-risk populations, the chronically ill and their caregivers (AOA, 2004; Silver, 2004). For example, training in nutrition information and skills can positively affect healthy food choices of the chronically ill person and the caregiver. The goal of caregiver training is to ultimately improve the effectiveness of caregiving to the chronically ill person and reduce caregiver burden (AOA, 2004). Development of effective caregiver training addresses appropriate educational strategies for the burdened caregiver, provides comprehensive coverage of caregiver tasks, and considers an educational format and delivery system that is affordable, practical, and easily accessed. Effective caregiver training programs are formally evaluated to document that the program met training goals. Training content includes knowledge, skills, and resources for the ill person and the caregiver. Appropriate educational strategies are employed to meet the learning needs of individuals and their environmental context. The outcomes of effective caregiver training include improved indicators for health, finances, and other related categories.
Planning of the Alzheimer's Caregiver SeriesSince 2002, the MSU Extension Service has been working with the Alzheimer's Association state chapter to increase the awareness and support for caregivers in the form of in-kind assistance and monetary contributions for conferences and participation on the board of directors. Although conferences on the topic of Alzheimer's disease are held annually, the location and time away from caregiving often precludes many rural caregivers from attending. This need led to a request to hold a "conference" in the rural northeast portion of the state. Originally the state Family and Consumer Science Extension specialists planned to have a 1-day conference in northeast Montana targeting informal caregivers of Alzheimer's patients. Feedback from Extension agents and constituents suggested that a better use of time and resources would be a 5-week series. In this format, each specialist would travel to northeast Montana (approximately a 500-mile drive one way from the university) and present his or her seminar six times in the five-county area over the course of a week. The result was the development of a 5-week educational series using didactic educational strategies emphasizing: 1) an introduction to the disease presented by county agents using a video or local expert; 2) family interactions and caregiver stress; 3) nutrition; 4) financial planning and legal issues; and 5) Alzheimer's-proofing the home. Funding for the series was a collaborative effort with an MSU Extension Director's mini grant, a commitment from four Family and Consumer Science specialists' operations budgets, and county budget commitments. The total budget for the series was $4,800.00. Additionally, in-kind contributions of brochures and other materials from the Alzheimer's Association, Montana Chapter, were provided, and local in-kind contributions of space to hold the series and refreshments were provided in the counties. EvaluationMore than 80 individuals attended the 5-week series. Although the series targeted the informal caregivers such as friends and family members, a variety of other individuals attended, including home healthcare providers, nursing assistants, and long-term care facility staff. A few participants attended because they had lost a loved one due to Alzheimer's. Several of these individuals indicated they wished the series had been available when they were caregiving. This study reported here was exploratory in nature. All attendees were invited to participate in the evaluation; however, participation was voluntary. Demographic data from the evaluations revealed that the majority of participants were ages 50 years and older (75%), and most were Caucasian (98%) and female (87%). Although attendance varied somewhat from week to week, it was relatively consistent, and there was little attrition. The majority of participants resided in communities with fewer than 5,000 people. OutcomesThe evaluation of the project was based on the logic model of evaluation assessing short-term, medium-term, and longer-term outcomes. Data were gathered at three different points of time. Short-term outcomes were measured through a pencil and paper evaluation given at the end of each presentation. A telephone interview 6 weeks after the end of the series with a random sample of 14% (N = 11) of the participants assessed medium-term outcomes. A telephone interview conducted 4 months after the end of the series with another random sample of 11% (N=9) of participants assessed long-term outcomes. Short-Term OutcomesThe short-term evaluation assessed what the participants in the series learned related to financial planning issues, nutrition, home modifications, and family interactions related to caring for an Alzheimer's patient. The response rate varied depending upon the attendance at a particular class. The average response rate was approximately 69% of attendees at a particular class. Results from the short-term evaluation of the presentations revealed:
Anecdotal and observational data also provided the project with valuable information. One woman attended who thought she might have early stages of Alzheimer's and wanted to learn more. Another woman who had not been able to be out of her husband's sight due to the disease started using respite care. Her husband was resistant to going to a daycare facility but by the third session he was comfortable with it, which allowed his wife to receive much needed respite. Nurses' aides and home health care workers commented on how the information would be useful for the families of the Alzheimer's patients for whom they were caregiving. Medium-Term OutcomesThe medium-term outcomes sought to assess if the participants had followed through and used the information from the series. A random sample of participants (11) was selected for telephone interviews 6 weeks after the series was completed. Eighty-one percent of those interviewed stated that they had shared the information with a family member, coworker, or friend, thus increasing the number of participants receiving benefit from the program. Nine out of the 11 participants interviewed had already used some of the information learned in the series. A participant shared: "I am suspicious of a family member, and I have not had time yet to address any issues, but just having the information helps me look for more things and be more aware." One person stated: "I am using the nutrition information, and it has helped me to more or less recuperate from the stress of taking care of my mom because I was the sole caregiver." Ten out of the 11 participants (91%) planned to use the information with friends, family members, or co-workers. One person commented "[I am] more aware of people in the family and also at the business, here at the store. There was one lady who I think may have Alzheimer's and she was trying to write a check for more and just being aware of that and helping the family be aware of what she is doing. I think just having a general knowledge and awareness to use for everyday life." Longer-Term OutcomesThe longer-term outcome of the series was to assess if participants felt more comfortable in their caregiving role and had a greater understanding of how they can assist a loved one afflicted with Alzheimer's. Additionally, we wanted to know if participants were interested in more educational programming on caregiving. Four months after the series ended, a random sample of nine participants was selected to participate in a telephone interview. This length of time was selected due to feasibility and propriety (The Joint Committee on Standards for Educational Evaluation, 1994). Those participants who were interviewed at the mid-term evaluation were eliminated from the sample to avoid over evaluating any one participant. Eight out of the nine participants or (89%) agreed or strongly agreed that they had increased their self-confidence in caregiving. All reported that they were better prepared for their role as a caregiver since participating in the series. The evaluation of the series found that there was an interest in continuing to offer additional educational programming on caregiving. Extension professionals are now training class leaders in the Powerful Tools for Caregiving program so that county agents and others can offer the 6-week program in their communities. Another resource, Tenderhearts, (Parsons, 2004) is being adapted to our state. This is a project to assist caregivers in organizing information and keeping journals about their caregiving to assist them when working with health care professionals. These efforts along with fact sheets on topics of interest to caregivers have expanded Extension's role in caregiving educational programming. Implications for ReplicationBecause of the success of the program, a similar effort has been implement in two other areas of the state. The program is also being packaged for national dissemination. The evaluations of the series were overwhelmingly positive. The comments made for improvement were aimed at publicity for the series. Many participants commented that they knew of others who would benefit from participating in the series. We have formalized a brochure for the series with space for each county to add locally specific information. We have also scheduled conference calls with the participating county agents to discuss advertising and potential collaborators in their areas. Reaching out to community healthcare providers, registered dieticians, assisted living, and nursing home staff is important in getting the word out about the series. The program was designed for the informal caregiver, yet caregivers and staff from nursing homes, home health care agencies, and hospitals attended. We found with the series that both informal and formal caregivers gained from the program, and we will continue to offer it to both groups. With little access to continued education available in remote communities, we found that the series was also of great interest to paid caregivers. Future plans include evaluating long-term impacts and providing continuing education credit to those who desire it. The aging baby-boomers in the United States and the changing population in Montana have resulted in a need for Extension to focus on the issue of caregiving. Although our project began as a response to the needs of caregivers of Alzheimer's patients, we see that the project will grow as we enter into other areas of caregiving for our aging population. Acknowledgment We would like to thank Sheila Friedrich, Sheridan County Extension agent, for her comments on an earlier draft of this article. ReferencesAlzheimer's Association. (2005). Alzheimer's disease fact sheet. Retrieved January 10, 2005 from http://www.alz.org/Resources/FactSheets/FSADFacts.pdf. Alzheimer's Association, Montana Chapter Newsletter. (2004, Winter). Copy Editor. Berg-Weger, M., & Tebb, S. S. (2004). Conversations with researchers about family caregiving: trends and future directions. Generations 27(4), 9-16. Kaasalainen, S., Craig, D., & Wells, D. (2000). Impact of the caring for aging relatives group program: An evaluation. Public Health Nursing, 17(3), 169-177. Krummel, D. A., Humphries, D., & Tessaro, I. (2002). Focus groups on cardiovascular health in rural women: implications for practice. Journal of Nutrition Education and Behavior, 34(1), 38-46. Levine, C., Reinhard, S. C., Feinberg, L. F., Albert, S., & Hart, A. (2004). Family caregivers on the job: moving beyond ADLs and IADLs. Generations 27(4), 17-23. Marks, N. E., Lambert, J. D., & Choi, H. (2002). Transitions to caregiving, gender and psychological : A prospective U.S. national study. Journal of Marriage and Family, 64, 657-667. National Family Caregivers Association. Prevalence and economic value of caregiving: state by state analysis. Montana statistics. Retrieved January 9, 2005 from http://www.thefamilycaregiver.org/pdfs/state_stats.pdf Parsons, K. G. (2004). Tenderhearts: A helping hand for family caregivers of the elderly. Kansas State University Extension. Manhattan, KS: Department of Human Nutrition. Paul, L., & Weinert, C. (1999). Wellness profile of midlife women with a chronic illness. Public Health Nursing, 16(5), 341-350. Schulz, R., & Beach, S. R. (1999). Caregiving as a risk factor for mortality: The Caregiver Health Effects Study. Journal of the American Medical Association, 282 (23),2215-2219. Silver, H. J., & Wellman, N.S. (2002). Nutrition education may reduce burden in family caregivers of older adults. Journal of Nutrition Education and Behavior, 34 (Supplement 1), S53-S58. Stone, R., Cafferata, G.L., & Sangl, J. (1987). Caregivers of the frail elderly: a national profile. The Gerontologist, 27(5), 616-626. The Joint Committee on Standards for Educational Evaluation (1994). The program evaluation standards, (2nd Ed). Thousand Oaks, CA: Sage Publications. U.S. Agency for Healthcare Research and Quality. Long-term care users range in age and most do not live in nursing homes. Research Alert, November 8, 2000. Rockville, MD. Retrieved January 4, 2005 from http://www.ahrq.gov/news/press/pr2000/ltcpr.htm U.S. Department of Health and Human Services Administration on Aging.(2004). Compassion in action: The older Americans act national family caregiver support program. Washington, DC: Squillace, M. R. & Jackson, Y.
Research-Based Outreach: Albert Bandura's Model
Stephen F. Hamilton Universities live in tension between the isolated contemplation of the monastery and the hectic exchange of the marketplace. Universities emerged in twelfth-century European cities and towns, eventually displacing monasteries and cathedral schools as centers of learning, and expanding the curriculum to prepare future doctors, lawyers, rulers, and warriors as well as clerics (Haskins, 1923/1957). Although universities have continued to enjoy some degree of protective isolation from the "real world," they also retain obligations to the societies that charter and pay for them. Living in tension between the monastery and the marketplace gives universities their capacity to bring knowledge to bear on practical problems. Extension, outreach, and engagement manifest that creative tension. (These terms can be distinguished, but they have much in common.) When universities share some of their resources with people beyond the academic community, they simultaneously demonstrate the value of the support and protection they enjoy and give up some of that protection. Land-grant universities were founded with a mission to the marketplace, but now nearly all institutions of higher education in the United States claim to do more than teach and conduct esoteric research. They encourage students, faculty, and staff to participate in their communities, point with pride to their contributions to economic development, and issue press releases about the benefits promised by their faculty's newest research findings. Energy and expertise are two of the resources universities have to share. Person-power is found in abundance on campuses. Students especially, but also staff and faculty can pitch in to make things happen in their local communities and elsewhere; alternative spring breaks to help clean up hurricane damage along the Gulf Coast are an excellent recent example. Such high-energy activities are worthwhile, but the kind of outreach that higher education can do better than any other institutions is grounded in knowledge, the academy's stock-in-trade. Not so long ago, simply disseminating reliable research-based information was a great contribution, one in which universities excelled all other institutions. Cooperative Extension is the institutional epitome of this contribution. But as the volume of information multiplies and electronic technology makes information more easily accessible, universities are in competition with many other sources of information. The challenge has become to reach out effectively and reciprocally, to move from being the fount of knowledge toward joint participation with community partners, being responsive to pressing needs while inquiring continuously into how best to meet those needs. Outreach of this nature helps to sustain the balance-in-tension between the university as a cloister for learning and the university as an actor in the affairs of the day. (See Peters, Jordan, Adamek, & Alter, 2005, for an insightful treatment of this type of engagement.) Social Cognition in the Service of Health and WelfareDelivering the Henry Ricciuti Lecture at Cornell, Albert Bandura provided an exceptionally rigorous example of research-based outreach, which he prefers to call "translational research." Considered by many to be the world's most eminent psychologist, Stanford's Bandura is best known for his ambitious and elegant experiments and his powerful theoretical writings. The use of his research in outreach activities helps to re-define what it means to do research-based extension. (See also Dunifon, Duttweiler, Pillemer, Tobias, & Trochim, 2004). He described several programs in developing countries that are using his insights to alter attitudes and behavior toward gender equality, family planning, and health behavior. He showed brief illustrations and discussed "serial dramas" broadcast by radio or television in Brazil, China, India, Mexico, and Tanzania. These programs have been carefully designed according to his principles of social influence and behavior change and their impact has been stunning. Enrollment in literacy programs in Mexico rose from 100,000 to 1,000,000 when TV characters learned to read. Radio dramas in Tanzania led to increased condom distribution and reductions in numbers of sexual partners. As a rigorous test of their impact, broadcasts were limited initially to one half of the country. Subsequent broadcasts to the other half of the country yielded the same changes (Bandura, 2004). The Many Contributions of ResearchResearch contributed in different ways and at multiple points to these successful efforts at "fostering society-wide changes." Bandura's presentation began with data establishing the need to reduce unsustainable population growth in developing countries. Demographic and public health data directed outreach toward demonstrated needs and toward those most in need. Those data also serve as a baseline for subsequent evaluation. Bandura's scholarship on The Social Foundations of Thought and Action (1986) provided the theoretical grounding for the serial dramas. As a partial illustration, his research has found that effective modeling for behavior change entails not only a positive model but a negative contrasting model plus a transitional model, someone who is going through the change from negative to positive. Making use of this finding, script writers created characters to serve as these three types of models. A third type of research also supported the script writers' creativity. People representing the intended audiences were interviewed about the kinds of problems and issues that are important to them, revealing as well how they think and talk about these matters. A variant of market research (more specifically, social marketing), this form of inquiry aided the script writers and actors in portraying situations with which audiences could identify. As the programs aired, additional research monitored audience response, checking on which characters proved attractive and which situations challenged audience members to think and act differently. Depending on one's discipline, this can be thought of as either additional market research or as formative evaluation. No matter how well-crafted it may be, a serial drama has no impact without an audience. Research on communication and on the diffusion of innovations guided both the broadcasting of the programs and the provision of supplementary programs, such as increased availability of contraception. Research of this nature revealed, for example, that villages in which people gathered around one radio to listen to a serial drama proved to be ideal settings for post-broadcast discussions, which augmented the program's impact. It also confirmed the importance of giving audience members access to services and sources of information that would help them to follow through on intentions to change their behavior in response to the serial dramas, for example, a toll-free number to call for help in combating spouse abuse. Any enterprise of this magnitude must be carefully evaluated. The evaluation research Bandura described went well beyond the typical survey of how participants responded to a program and even beyond most attempts to assess a program's impact. Country-wide social and health statistics were used in time-series designs to track changes across entire populations. The experimental design employed in Tanzania yielded exceptionally powerful confirmation of the program's effectiveness. Everett Rogers, who originated research on the diffusion of innovations (Rogers, 2003), was responsible for this experiment (Rogers et al., 1999). One more kind of research contributed to the project Bandura described. It is so obvious as to remain implicit: the content conveyed in the programs is supported by research (e.g., condom use reduces the risk of HIV-AIDS infection). This brings us back to the dissemination of research-based information. Information dissemination remains a necessary element of contemporary outreach, but it is no longer sufficient. Social science research is essential to improving the design and delivery of outreach, but research in other disciplines can provide the content, and the arts and humanities can make unique contributions. Bandura was quick to praise the gifted writers who created engaging characters and plot lines and the talented actors who brought them to life, without which his theoretical concepts could not have been applied effectively. Serial dramas also required musicians, camera operators, set designers, and other creative talent. A New Yorker article credits Mexican TV director, Miguel Sabido, with developing serial dramas. Sabido, in turn, credits Bandura with the insights that guide his work (Rosin, 2006). Forms of Research That Contribute to OutreachBandura's model illustrates a rich and complex interweaving of research with outreach. The threads can be pulled apart and arrayed in rough chronological order to illustrate an ideal case of research-based outreach.
Even though this separation is somewhat artificial, it reveals how limited conventional notions of research-based outreach can be. Certainly the content of outreach programs should be valid and up-to-date and certainly programs should be carefully evaluated, but the contributions of research can be much greater. In addition to their grounding in social science, medical, and public health research, the serial dramas depended upon experts in the arts and humanities as well. It is too easy to identify scholarship with research, and research with science. Outreach should draw on multiple disciplines, even when their contribution is something other than research. Implications for Research and OutreachOutreach so thoroughly infused with research is not only better outreach, it also generates new knowledge. Findings about attitude change from large-scale experimental interventions often have greater "ecological validity" than those from contrived laboratory experiments (Bronfenbrenner, 1979). The research that informed the programs Bandura described was conducted both in laboratories and in natural settings and was published in leading psychological journals. He did not do one kind of research as an academic psychologist and another for application. Everett Rogers' role in evaluating the impact of serial dramas in Tanzania highlights an essential point about research-based outreach: one researcher is not enough, even if the researcher is Al Bandura. One discipline's research is not enough either. Outreach is inherently an interdisciplinary endeavor. Like "big" science research, outreach is increasingly conducted by multi-disciplinary teams. Each of the forms of research that contributes to the programs Bandura described has its own standards of rigor and its own peer-reviewed journals. Outreach requires theoretically refined and empirically validated research that is conducted in a range of settings using a variety of theories and methods, each appropriate to the issue at hand and the relevant discipline(s). Linking research so closely with outreach enables scholars not only to apply what they have discovered but also to test those discoveries, advancing knowledge in the process. The effectiveness of an outreach program guided by Bandura's findings provides another level of validation of those findings beyond replication in someone else's laboratory. Achieving such a vigorous hybrid of research and outreach is not always possible, or even necessary. It serves as a model that cannot always be replicated. Not every problem generates or merits the amount of resources required to mount a nation-wide campaign to change behavior. Moreover, such a campaign would be far more challenging in the United States and other media-soaked nations. The image of an entire village sitting around a radio epitomizes how different things are here. Reflecting on the six different uses of research in the work Bandura described and on the other contributions that made the serial dramas effective can help those engaged in research and outreach to identify both the strengths and the limitations of their enterprise. It should, at the least, help clarify that "research-based" outreach needs more than one kind of research. Bandura made a strong case during his visit to Cornell that the amalgam of research with outreach that he described is essential to the future of psychology, but the point applies to other academic disciplines as well. Although thrilling achievements in space exploration and fascinating discoveries in elementary particle physics continue to drive public support for research, taxpayers increasingly want to know how they can expect to benefit from their investment in research. Medicine and the life sciences have answered that question most compellingly and have flourished as a result. Social and behavioral scientists have been far less successful at demonstrating the value of their work and building broad public support. Scholars in the arts and humanities face much higher hurdles. Linking research and other forms of scholarship more closely with outreach will not only help solve important problems outside of academe but also help to renew and maintain the disciplines. Few scientists achieve Albert Bandura's level of productivity and distinction, and few outreach efforts are as ambitious and efficacious as the ones he described. Programs with different content and methods and scholars from different disciplines will all deviate substantially from this example. No single scholar can hope to approximate this ideal. Even large-scale team projects will usually fall short in some aspects. But the rich mutual reinforcement of research and practice that he described should inspire all of us to link research more tightly with outreach and to do so at multiple points rather than settling for research-based content. ReferencesBandura, A. (1986). The social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall. Bandura, A. (2004). Health promotion by social cognitive means. Health education and behavior, 31 (2): 143-164. Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Cambridge, MA: Harvard University Press. Dunifon, R., Duttweiler, M., Pillemer, K., Tobias, D., & Trochim, W.M.K. (2004). Evidence-based extension. Journal of Extension, 42(2). Available at: http://www.joe.org/joe/2004april/a2.shtml Haskins, C. H. (1923/1957) The rise of universities. Ithaca, NY: Cornell University Press (originally published by Henry Holt and Company). Peters, S. J., Jordan, N. R., Adamek, M., & Alter, T. R. (Eds.) (2005). Engaging campus and community: The practice of public scholarship in the state and land-grant university system. Dayton, OH: The Kettering Foundation Press. Rogers, E. M. (2003). Diffusion of innovations, fifth edition. New York: Free Press. Rogers, E. M., Vaughan, P. W., Swalehe, R. M. A., Rao, N., Svenkerud, P., & Sood, S., (1999). Effects of an entertainment-education radio soap opera for family planning behavior in Tanzania. Studies in Family Planning, 30: 1193-1211. Rosin, H. (2006). Life lessons: Annals of broadcasting. The New Yorker, 82: (16, June 5), 40-45.
Now Is the Time for Change: Reframing Diversity Planning at Land-Grant Universities
Susan V. Iverson Background and SignificanceCongress passed the Morrill Act in 1862, creating a new type of university. These land-grant universities were based on the ideas that U.S. higher education should be open to all, provide liberal and practical education, and prepare the citizenry for the U.S. labor market (Campbell, 1995; McDowell, 2001). Dedicated to teaching, research, and public service, these land-grant universities continue to be recognized as educational leaders and many have joined the ranks of the nation's most distinguished public research universities (Johnson, 1999). Yet the institution "with its emphasis on 'equal access'" (Johnson, 1999, p. 222) faces a challenge: not all sectors of society have benefited equally (NASULGC, 1999). For instance, historically, Black farmers have been excluded from USDA and land-grant programs (Schor, 1992); and women have been (and remain) under-represented in agricultural components of Extension (Hassanein, 1999; Hine & Cheney, 2000). Further, Ewert, and Rice (1994) observe that "Cooperative Extension's traditional, white, rural clientele is aging and the rapidly growing, ethnically diverse population remains under-represented in its programs." Academic fundamentalism may contribute to these inequities in 1862 land-grant universities; the "gate-keeping function of a 'research-based approach' . . . may have unintended consequences of excluding diversity" (Hassel, 2004). A commitment to access that is "inclusive of talented and qualified individuals of every race and ethnicity" (Now is the time, 2005), coupled with demands for the land-grant institution to increase its multicultural competence and effectiveness, has contributed to the elevation of diversity as an educational priority (Gurin, Dey, Hurtado, & Gurin, 2002). In response, land-grant universities, and their respective colleges and Extension offices, initiate diversity planning and assessment and generate diversity action plans to increase access and retention of historically underrepresented populations, improve campus climate and inter-group relations, incorporate diversity into the curriculum and program design, and utilize diversity as a resource for an enriched and engaged academic environment (Ewert & Rice, 1994; Hurtado, 1992; Ibarra, 2001; Smith & Schonfeld, 2000). These university policies codify an institution-wide commitment to influence and determine decisions to strengthen, enhance, promote, and support coordinated and integrated diversity efforts, applied to students, faculty, and staff. Despite the proliferation of recommendations, initiatives, and strategies, codified in diversity action plans, many segments of the national population continue to be grossly underrepresented on campus and under-served, and the capacity and effectiveness of land-grant universities to function inclusively in a multicultural world remains under-achieved (Ibarra, 2001; Ingram, 2005; Valverde, 1998). PurposeIn order to enhance understanding of these diversity policy documents, how they contribute to producing a particular cultural reality, and how they may compromise the achievement of their own goals, the study described here sought to identify and analyze discourses circulating in diversity action plans. These policy documents are a primary means by which land-grant universities advance recommendations regarding their professed commitment to inclusive access and an equitable climate for all members of the campus community. As Schauber and Castania (2001) observe, diversity policies provide a "vision for change" and "the language and goals that can guide our system." As such, diversity action plans not only record and reflect organizational culture (e.g., as an archival document), but also construct particular realities for members of the institution (e.g., construct power relations and re/produce dominant ideologies) (Allan, 2003). This is explicitly notable when programs and policies are designed "from a dominant cultural perspective, which does not work for most of our under-represented cultural groups" (Schauber & Castania, 2001). Thus, an analysis of the discourses circulating in diversity policies queries and illuminates "which groups or institutions have preferential access to various kinds of knowledge, which groups or institutions set the criteria for the very definition or legitimization of knowledge, and which are specially involved in the distribution of knowledge--or precisely in the limitation of knowledge in society" (van Dijk, 2002, p. 88). Well-intentioned attempts to create a more inclusive institutional culture may unwittingly reinforce practices that support exclusion and inequity. The use of assumptive concepts in diversity planning policies may limit a policy's effectiveness and actually reinscribe the very problem the policy seeks to alleviate (Allan, 2003; Bacchi, 1999; Ball, 1990; Scheurich, 1994). Defining Diversity"Diversity" is a term often used but without simple definition. In their review of diversity scholarship, Linnehan and Konrad (1999) identified four themes:
The predominant usage of diversity is often the first: defined demographically, listing multiple identity statuses (e.g., race-ethnicity, gender, sexual orientation, disability, age, religion). Yet these identity categories are typically without definition, leaving diversity to mean difference that is reflective of how those who are socially dominant define reality for themselves and others (see Jones, 1996; Yanow, 2003; West & Fenstermaker, 1995 for elaboration on the social construction of difference). Diversity is a socially constructed concept, "into which 'others' are now being added" (Ellsworth, 1999, p. 35). For this article, my use of the word "diversity" is as an all-inclusive category representing (subsuming) numerous identity groups; this is consistent with its definition in diversity action plans (differences in age, ethnicity, gender, race, culture, nationality, sexual orientation, religion, class, and physical ability). Notably, while the policies delineate multiple identity statuses, and some add that diversity can be viewed more broadly, incorporating differences in thoughts, ideas, perspectives, and personalities, the attention in the plans (e.g., their descriptions of problems and recommendations) focuses primarily on race and gender, and secondarily on sexual orientation and disability, with little to no discussion of the other identity statuses defined in the introduction to the plans. Some scholars offer a critique of the term "diversity," suggesting alternatives (e.g., Bensimon's 2005 discussion of three cognitive frames--diversity, deficit, equity--and her argument that individuals must shift from deficit and diversity toward equity thinking); however, it is beyond the scope of this article to engage this analysis. Thus, while acknowledging the limitations of the existing conception of diversity, I adopt the term as explicated in the policies. Diversity PlanningThe origins of diversity planning can be traced to institutional policies of the 1960s and 1970s on equal opportunity and affirmative action that considered race, along with other factors, in assembling a diverse student body of varying talents, backgrounds, and perspectives. These laws and policies, along with changing demographics in the U.S., have contributed to the construction of diversity as a social phenomenon requiring institutional attention. Pluralism and globalization rose to the top of the agenda in the late 1980s for numerous university presidents and system chancellors who, in addition to identity-specific commissions (i.e. women's commissions), convened Commissions on Pluralism into the 1990s (e.g., University of Maine System, 1989). Similarly, the Cooperative Extension System engaged committees in strategic diversity planning and published several reports during this time, as shown by these selected examples: 1988 Organized the Council on Diversity 1989 Established "Emphasis on Diversity" 1990 Published two reports: Valuing Diversity and Celebrating Diversity and Pathway to Diversity 1991 Released Commitment to Diversity and Pluralism In 1999, the Change Agent States for Diversity (CASD) project was initiated by Cooperative Extension. The goal of this project was to "build the capacity of land-grant universities to function inclusively and effectively in a multicultural world" and "set standards and implement a vision for supporting healthy, thriving, culturally diverse communities through Extension, research, and academic programs" (Ingram, 2005). More recently, Cooperative Extension published Pathways to Diversity Reaffirmed (2003) to intensify its commitment to diversity and codify recommendations for change. Land-grant universities continue to generate their own diversity policies--documents that serve as a plan of action, codify "an institution-wide commitment to enhancing diversity and vigorous leadership" (Green, 1989, p. 7). Chang (2005) echoes Green, more than 15 years later, when he states that "the impact [of diversity] is likely to be strongest when campuses intervene by coordinating a set of mutually supportive and reinforcing experiences" (also Ewert & Rice, 1994). MethodsThe data for this article come from a larger study investigating the questions: (a) what predominant images, problems, and solutions related to diversity are represented in diversity action plans? and (b) what discourses are employed to shape these images, problems, and solutions? I employed Allan's (2003) method of policy discourse analysis to investigate how university diversity policies discursively frame diversity and what reality is produced by diversity action plans. A hybrid methodology, policy discourse analysis focuses on written documents; it is a strategy for examining policy discourses and the ways they come together to make particular perspectives more prominent than others (Allan, 2003). According to Ball, "discourses construct certain possibilities for thought. They order and combine words in particular ways and exclude or displace other combinations" (in Bacchi, 1999, p. 41); discourses then provide "frameworks or ways of viewing issues" (Bacchi, 1999, p. 40). Thus, my use of policy discourse analysis serves to illuminate how these texts (diversity action plans) construct social relationships and re/produce dominant ideologies (and conceal alternatives) regarding inequities in higher education. For this sample, I screened 50 U.S. "1862 land-grant" universities (one per state), seeking institutions that had a diversity committee, charged by a senior administrator (e.g., president, provost), which had developed at least one university-wide diversity action plan issued within a recent 5-year period (1999-2004). This search yielded 21 diversity action plans issued at 20 U.S. land-grant universities over a 5-year period (see Appendix A). I retrieved these policies from the Internet sites of each institution (with two exceptions, from which I acquired paper copies of the policies and then scanned these to generate electronic copies). All documents were loaded into NVivo, computer software designed for qualitative data analysis, and then analyzed using line-by-line coding. The process of data analysis was informed by established methods of coding and categorizing (Marshall & Rossman, 1999; Miles & Huberman, 1994) to identify broad themes and predominant images of diversity. Initially, I conducted line-by-line analysis of each report in reply to the research questions. Once all documents were coded, I used NVivo to generate "reports" for each category--images, problems, and solutions--across all diversity action plans. These reports were then analyzed using both deductive and inductive processes, which served as the second phase of coding; in this phase, the codes assigned were both descriptive and interpretive (Miles & Huberman, 1994). Finally, an examination of the coded data for conceptual patterns and linkages illuminated how coded text reflected and shaped discourses circulating within the scripts and how these discourses produced particular identity positions. Findings and InterpretationsThe goal of the inquiry was to understand how university diversity policies frame ideas about diversity and what realities are produced by the discourses carried in these documents. The investigation of the 21 diversity action plans examined:
Analysis of 21 diversity action plans revealed a dominant discourse of access, evident in attention to and improvement of recruitment, retention, and advancement practices to enhance entrée and representation, and create a campus culture affirming of diverse individuals (Figure 1). Three distinct strands were evident within the access discourse: a discourse of entrée, clear in calls for diverse persons to be permitted to enter and participate in the university; a discourse of representation, apparent in attention to greater involvement, full participation, and increased retention and advancement; and a discourse of affirmation, visible in calls for diverse persons to be valued, welcomed, and celebrated by the campus culture. These discourses coalesce to produce the diverse individual as an outsider to the university, particular arenas within the institution, and the dominant culture.
Figure 1. Analysis also revealed descriptions of diverse individuals as at-risk for educational failure before entering institutions of higher education and remaining at-risk once a member of the university--at-risk for educational failure, non-promotion, no advancement, no tenure, attrition, discrimination, and harassment, among other things. These characterizations are made visible by a discourse of disadvantage, along with a discursive strand of discrimination that constructs the diverse individual as an at-risk victim (Figure 1). Framed in this way, differences in educational outcomes are generally attributed to lack of academic preparation, deficiencies in skills, and inadequate support. The diverse individual, constituted as at-risk before and after entering the university, is also dependent on the university--represented by an administration that is predominantly white and male--for access to and success in higher education, as well as for remediation, skill development, safety, and support. Further analysis revealed a marketplace discourse, characterized by fierce competition and rapidly changing market conditions and the need for multicultural competence in the global marketplace. Two distinct strands emerged within this discourse: a discourse of excellence, evident in a focus on success and reputation, quality and performance; and a discourse of managerialism, apparent in the emphasis on effectiveness, accountability, monitoring of costs and effects, and quality assurance (Figure 2). These discourses contribute to shaping the diverse individual as a commodity, possessing economic value that can enhance the university's status, and an object to be managed.
Figure 2. Finally, analysis of diversity action plans revealed a discourse of democracy, evident in calls for inclusion and opportunity, civic responsibility, commitment to equity and equality, and open, participatory, and deliberative dialogue (Figure 2). This discourse contributes to shaping a change-agent identity, visible in individual and collective efforts to produce social change and equality as a result. The discourse of democracy emerges as an alternative to the marketplace discourse; however, the dominance and greater weight of the marketplace discourse undermines the systemic change-making possibilities of the discourse of democracy. Instead, out of the tension evident between the discourses of democracy and the marketplace, images of the change agent give way to images of entrepreneurial endeavors: individuals encouraged and rewarded for initiative and the development of innovative programs that ensure the university a competitive edge in the marketplace. Discussion and ImplicationsVarious university personnel, including Extension leadership and managers, draft and implement diversity action plans "to build the capacity of land-grant universities to function inclusively and effectively in a multicultural world" (Ingram, 2005). Toward this end, the Change Agent States for Diversity (CASD) project was initiated by Cooperative Extension to support greater cultural diversity in land-grant universities by providing technical assistance and training to participating state. In this section, the findings reported above are discussed and some recommendations are delineated for how Extension administrators might use the findings of this research to improve their work. Become Informed About Privilege and PowerLand-grant universities, and specifically Cooperative Extension, strive to open access and increase representation of racially and culturally diverse populations; yet the ability to recruit and retain diverse persons is fraught with challenges. Inextricably linked to the problem of access are inadequate resources to invest in effective recruitment and retention efforts. Predominant solutions articulated in the plans, made visible by the commingling of a discourse of managerialism with the discourses of access and disadvantage, include the development of risk factor models and criteria for improved identification of "diverse pools" to mobilize recruitment and enhance the delivery of support services. Yet the problems of access and disadvantage remain located in the diverse individuals, namely in their deficiencies and how to compensate for these or accommodate them, on their disadvantaged status and how to support them. The policies generally fail to identify privileging conditions and practices that advantage some (namely white males) and marginalize others; they fail to question what produces a risky institution for some more than others. Thus, Extension personnel, and in particular those with responsibility for diversity efforts, could benefit from reading, training, and discussion on privilege and power. Such education and training should not divert attention from the material realities of oppression and disadvantage, but rather extend discussion to include awareness of the privileging conditions that construct both oppressive and empowering realities for individuals. As Hu-DeHart (2000) critically observes, until the university interrogates its privilege, "the diversity project as we know it on our campuses [will remain] complicit in perpetuating the racial order as historically constructed" (p. 42). Be Critical of How Documents Are ConstitutedThrough awareness, Extension personnel can consider how their work could result in discursive shifts, meaning they may call upon alternative discourses. Unfortunately, this is not as simple as rewriting policy to replace certain words with others, such as searching a document for "disadvantage" and replacing it with "equality" in order to shift from a deficit to an equity focus. However, individuals can be more informed and critical of the ways in which such documents are discursively constituted. For instance, a discussion about an institution's commitment to diversity action versus equity planning may be a useful start, for a focus on equity can shift attention away from individual differences and deficiencies to institutional practices and the production of unequal educational outcomes (Bensimon, 2005). Consider the Relationship Between Stated Problems and SolutionsExtension personnel are invited to examine the (in)congruence between diversity problems and solutions. The research described here revealed a striking lack of relationship between many problems and solutions. For instance, the problems made visible by a discourse of discrimination are harassment, bias, racism, sexism, homophobia; solutions include to offer support services to those who are victims, deliver training and education, and facilitate inter-group dialogue. These solutions are important, but they fail to sufficiently address the "source" of the problem: the individuals or systems that are discriminatory, racist, sexist, and homophobic. Consideration of the relationship between stated problems and solutions can engage a process through which practitioners can question assumptions about a problem, what Stacey (1992) refers to as "double-loop learning." Such a "cognitive shift" (Bensimon, 2005) may inspire discussions about different solutions and deploy the tactical use of discourse. Disaggregate the ProblemDiscussions about "the discrepancy between shifting demographics and current practice" (Ewert & Rice, 1994) typically lump together multiple identity-based groups under the heading of "diversity" and assign concerns to all. Solutions, in turn, are assumed to apply to everyone as well. Disaggregating the problem enables Extension leaders to see the patterns of inequalities that exist and examine unequal outcomes (Bensimon, 2005). Discussing the problem in this way, enhanced through the display and analysis of disaggregated data, "can intensify learning, confirm or refute untested hypotheses, challenge preconceived ideas, motivate further inquiry, and provide the impetus for change" (Bensimon, 2005, p. 106). Embrace Multiple PerspectivesListen to (hear) all voices; learn (tell) the whole story. Diversity action plans are authored by institutional agents (e.g., administrators, faculty, and experts such as contracted consultants), and thus these documents tell one (part of the) story. Multiple perspectives exist regarding the challenges faced when organizations build their multicultural capacity (Ewert & Rice, 1994); yet the university's narrative, disseminated through institutional policy and the university newswire, can give the impression that one perspective is universally applicable (Hassel, 2004). Additional sources of knowledge can be identified, and other voices should be heard. Extension leaders can use their positional authority to facilitate dialogue--not to help "us" learn from "them," |
