Extension Evaluation Specialist UGA, United States
Abstract Information: Rural communities face challenges accessing behavioral health resources due to limited to a lack of readily available services. There are structural barriers and stigmas related to seeking the appropriate behavioral health assistance within rural communities. Accessibility to reliable transportation and external environmental perceptions’ of receiving behavioral health services. University of Georgia’s Cooperative Extension received a grant to prevent opioid use and misuse, and other behavioral health issues in rural Georgia communities. The team sought to understand the importance of leveraging existing relationships with trusted organizations, such as Cooperative Extension, to expand resources in rural communities. In order to understand the unique social and cultural influences impacting behavioral health, the team applied a culturally responsive lens to conducting focus groups to identify community needs, with an emphasis on how Extension could serve as a “hub” for equitable and inclusive services. Cultural responsiveness acknowledges growth for social-cultural components within the evaluation process to be expressed through an equitable context. By providing this lens, the goal is to create a space for each participant to contribute their unique perspective of their community without a preconceived bias of the purpose of the research team’s intent. The team was able to establish common themes reflecting the participants’ perceived cultural and social stance on the rural communities. Results showed the positive reputation and reach Extension has in the counties. For example, the participants identified Extension’s existing relationship with a variety of community empowerment programs. Many counties felt Extension had a role in addressing gaps in current, available resources. Ideas included using offices for telehealth visits, hosting support groups, and serving as a conduit to link stakeholders. Using this feedback, hubs are being launched statewide. Preliminary results show that while some improvements are needed, the community is supportive of the effort.
Relevance Statement: The United States has a high prevalence of systemic mental health and substance abuse challenges within rural communities; impacting residents’ quality of behavioral health due to limited resources (Lundeen et al., 2018). Such disparities in rural communities contribute to the constant rise in U.S. adult and youth behavioral health divergence (MacNab & Francis, 2015). Thus, Cooperative Extension has increased its role in creating programming to assist in behavioral health awareness for its rural clients. Extension has acknowledged developing programs in these rural communities could be considered difficult compared to the urban communities due to a lack of readily available services (Benke et al., 2013). However, Extension has a long-standing relationship as a stakeholder in many rural communities and could be seen as an asset to leverage assistance to provide appropriate behavioral health programs. Extensions’ mission is to improve community members’ overall quality of life by integrating scientific interdisciplinary approaches to solving issues within a community-based context (Braun et al., 2014; Linnell et al., 2021). Furthermore, developing and enhancing community public health initiatives for individuals and families is a foundation for behavioral health promotion, a familiar strategy used by Extension to increase behavioral health practices within communities (Barnes et al., 2020; Morgan & Fitzgerald, 2014; Walsh et al., 2018). The social structure within the participants’ community would require behavioral changes in their perception of Extension to conceptualize a new behavior toward the organization (Rogers, 2003; Warner et al., 2019). Therefore, Extension professionals must fully understand the effectiveness of their programs by properly identifying the behavioral health needs within rural communities.
Addressing behavioral health issues of rural community members could be more effective when these residents see themselves reflected in the process of improving their environment. Culturally responsive evaluation serves both the researcher and the participant by engaging and comprehending the best strategies to equate the most efficient results through social; cultural, equitable, and inclusive practices (Hood, 2015). Extension evaluation practitioners should use culturally responsive evaluation to continue building relationships to instill trust amongst rural communities to be able to create Extension Behavioral Health Hubs (EBHH) throughout Georgia. In addition, implementing culturally responsive evaluation methods will token community leaders to collaborate with Extension to assist in developing innovative recruitment strategies for residents to participate in Extension programs. As the demand for mental health and substance abuse resources increases, Extension will be able to promote each division’s (4-H, ANR, FACS) programs through the rural community empowerment intiatives. Thus, ensuring these community members with a safe inclusive space to seek behavioral health resources.
