Challenges, Alternatives, and Educational Strategies in Reaching Limited Income Audiences

Introduction

The number of people who are limited in income is growing. According to the U.S. Census, there were 37.3 million people living in poverty in 2007 compared to 36.5 million in 2006. This population is in need of help to improve their quality of life. Cooperative Extension is a source of research-based educational information and programming designed to help limited resource families and considers this population to be an important audience.

Reaching this audience with Extension programs is a challenging task due to barriers such as their low education levels, limited available time, lack of transportation, and childcare issues (Richardson, Williams & Mustian, 2003). Understanding these challenges and possible alternatives in educating limited income audiences is helpful in designing effective Extension strategies to reach them. Generally, it might take years for someone to learn about these challenges and alternatives through job experience alone. Learning from successful Extension educators is effective and efficient because of their proven success in outreach strategies and delivering quality educational programs.

For more than 40 years, the Expanded Food and Nutrition Education Program (EFNEP) has helped many families who have limited incomes improve their lives through research-based food and nutrition education. Literature indicates that EFNEP participants prefer simple and practical information about nutrition. They enjoy learning by doing and sharing experiences with other limited resource families. Lectures are not an effective educational method for this group (Hartman, McCarthy, Park, Schuster, & Kushi, 1994). Goal setting is an effective strategy in promoting positive behavior changes in nutrition education (Shilts, Horowitz, & Townsend, 2004).

The review of literature indicates that still there are lessons to learn from experienced EFNEP program assistants in reaching limited income audiences effectively. They know by experience what works for this audience. Exploring EFNEP program assistants' experiences to identify challenges and best practices in reaching limited income populations effectively was the focus of the study reported here.

Purpose

The purpose of the study was to identify the challenges and alternatives in reaching limited income audiences with nutrition education programs. More specifically the study aimed to accomplish the following objectives:

1. Identify challenges in reaching people with limited incomes;
2. Identify alternatives in reaching people with limited incomes; and
3. Identify effective educational strategies for people with limited incomes.

Method

A focus group, a "fundamental way of listening to people and learning from them" was used to thoroughly investigate the research objectives (Morgan, 1998, p. 9). A selected group of EFNEP program assistants (PAs) in North Carolina were invited to participate in the focus group.

Program assistants (PAs) invited to participate in the focus group were considered "champions" or "the best of the best" of EFNEP. They were selected because of their high client enrollment and graduation rate and the high level of impact on behavior change among their clientele. Seven PAs from different counties around the state were selected for the focus group. The group consisted of PAs who work with adult audiences and deliver EFNEP in both urban and rural counties. At the time of the interview, one PA had recently retired with 28 years of service to EFNEP.

Before the focus group interview, researchers developed a questionnaire to facilitate the discussion for achieving the research objectives. There were four main questions to guide the focus group interview.

1. What are the challenges in reaching limited income audiences?
2. How are these challenges being addressed?
3. What are the most effective ways to reach limited income audiences?
4. What are the effective educational delivery strategies for limited income audiences?

The focus group interview lasted about 1.5 hours. It was audiotaped and transcribed. The transcription was analyzed to find common themes related to the research objectives.

Findings

The findings have been summarized under each of the research objectives.

Challenges in Reaching People with Limited Incomes

The focus group interview revealed the following challenges in reaching people with limited incomes:

• Difficulties in marketing and recruiting people with limited income individually
• Lack of interest in learning about nutrition
• Low literacy levels
• Lack of transportation and childcare assistance
• Lack of time to participate in educational programs due to work and family obligations
• Attitude concerning the value of nutrition education at the beginning
• Development and retention of audiences' interest in the nutrition education program
• Unexpected loss of program participants
• Delivery of education in larger groups

Alternatives for Reaching People with Limited Incomes

The focus group identified the following alternatives for reaching the people with limited incomes:

• Using pre-formed groups available in the community
• Developing good relationships with pre-formed group partners in order to share resources
• Treating each participant as an individual; knowing their names and about them
• Being personable, humorous, and flexible
• Gaining community exposure through mass media and community events

Effective Educational Strategies for People with Limited Incomes

The focus group identified the following educational strategies effective in teaching this audience:

• Using fun and interactive hands-on lessons
• Limiting the use of lectures
• Listening to clients and getting to know them personally
• Involving clients in the lesson
• Creating a non-threatening and welcoming learning environment
• Using information sharing sessions to create a dialogue with the participants
• Using quick and easy hands-on food preparations (food preparation less than 30 minutes)
• Using lessons that encourage small changes that are practical
• Splitting large groups into small (10 or less) working groups for delivering the training session
• Using music when teaching physical activity
• Distribution of useful kitchen tools or certificates as incentives for participants to practice what they learn at home

Discussion

Challenges and Alternatives

Findings revealed that recruiting limited income audiences into nutrition education programs is very challenging due to their initial lack of interest in learning about nutrition. This situation generally demands much time and effort to recruit them individually. However, it was found that the use of pre-formed groups such as Women, Infants, and Children (WIC) and Head Start parents is the best alternative for the challenge in reaching this client group with nutrition education programs.

These are pre-formed groups already in the community, and the target audience is coming to these local community resources for their needed services. By collaborating with the members of these local organizations, EFNEP PAs can very efficiently market nutrition education programs to this client group. This has been the trend nationally as a result of decreasing program funds and safety of educators (Dollahite & Scott-Pierce, 2003).

The strong partnership between EFNEP and other agencies has resulted in the successful sharing of resources and clientele. This can be achieved only by developing a good working relationship with the partners. For instance, one focus group member stated that cooperation from social service referrals "was not as good until they got to know us." One common theme brought up by the focus group is the idea of setting a good first impression with partner agencies and potential clients.

Findings revealed that transportation is a considerable limitation for low-income audiences to attend training programs. Therefore, it is important to find pre-formed groups close to the homes of the target audience to avoid transportation barriers. The focus group participants mentioned that they hold classes in convenient and central locations, making them easily accessible.

Focus group participants indicated that the educational level of the target audience is often low. For instance one focus group member said that "some of them have very little education and can hardly read." Thus it is a significant challenge reaching this group with written materials. Demonstrations and discussions were identified as effective educational strategies for them. Some of the participants do not have child care assistance and come to training programs with their children. This makes it challenging to manage the learning environment during the training program.

Most of the low-income clients are busy with their work and family obligations and lack the free time to attend training programs. Finding a time frame during which most participants are available for educational sessions is often difficult for the EFNEP PA. Even though this client group is in need of nutrition education to address health related issues such as obesity and chronic diseases, it is somewhat difficult to convince them about the value of nutrition education at the beginning of a training program.

Gaining and retaining the interests of this audience in the nutrition education program is not easy due to their busy schedules. Sometimes, these clients may leave the educational program due to reasons such as lack of transportation or having changed their work schedule. When the client groups are large, it is very challenging to individualize the instruction for low-literacy clients.

Focus group participants indicated one of the best alternatives for these challenges is treating all clients as individuals in order to win their hearts and minds and retain them in the nutrition education program. For this purpose, it is important to know about them personally and create a welcoming environment. Also, it is necessary to be flexible and humorous to make the program enjoyable and interesting to the audience. According to one PA, "sharing life experiences with each other and hearing personal stories make it more intimate." Relationship building is critical to a successful program (Baristow, Berry, & Driscoll, 2002).

Occasionally, participants leave the program unexpectedly due to external factors such as new employment rather than a program issue. As a result, PAs must be committed to go the extra step of following up with former clients so they can complete the program.

In addition to these pre-formed groups, mass media and community events such as health fairs are used by the focus group members to market the program to this client group.

Educational Strategies

Findings indicated that the instruction should be fun and interactive in order to retain participants' active involvement in the program. Lectures are not as effective as hands-on, experiential learning methods. Lectures are strongly discouraged because clients do not like long and boring nutrition lessons (Woelfel, Abusabha, Pruzek, Stratton, Chen, & Edmunds, 2004). Understanding the individual training needs of participants is helpful in personalizing instruction and involving them in the program.

The findings indicate that creating a non-threatening and welcoming learning environment is the best training strategy in order to get active participation in the educational program. One technique used by the PAs is a sharing session at the beginning of each lesson. Each client is given the opportunity to share a story of how the lessons have affected his or her life. These information-sharing sessions are helpful in initiating a discussion with clients.

Some encouragement is helpful in building program participants' self-confidence. For instance, a focus group member said that "Sometimes if I have one that doesn't get involved too much I try to find the time to do some one-on-one with that person and encourage or talk to that person and emphasize the positive things that I've seen her doing that encourages her to participate."

One of the basic principles of a learner-centered approach is that learning is best achieved when positive relationships are established (Kasier, McMurdo, & Joy, 2007). In light of this notion, a focus group member mentioned that clients have to "feel like they're being treated as an individual person." In addition, when the atmosphere is safe and comfortable, clients may reveal valuable information (Baristow, Berry, & Driscoll, 2002) that may aid learning.

There was a consensus among PAs that a humble, non-judgmental attitude also helps the learning process. When clients are not worried about being perfect, they are more comfortable in participating. PAs emphasized the significance of this, especially in helping the audience manage low self-esteem. Part of a learner-centered approach is to ensure a safe learning environment (Kaiser, McMurdo, & Joy, 2007).

Hands-on activities, demonstrations, and taste testing are effective strategies commonly used in EFNEP. The key is to have recipes that are simple and take no more than 30 minutes to prepare. One PA said that her clients are enthusiastic about preparing the meals when they see it takes less than 30 minutes.

Quick and easy recipes for family meals are very appropriate to include in the nutrition education sessions for the limited income clients because they fit with their limited resources and busy daily schedules. The recipes in EFNEP are easy for participants to understand and practice. The findings indicate the lessons that encourage small changes are realistic in achieving desirable practice changes with this target audience.

The PAs also felt that small groups of 10 or fewer people are better for making an impact on behavior compared to larger groups. It is easier to conduct an engaging lesson when groups are small and all clients can participate. According to one PA, larger groups of people are harder to maintain and impacts are difficult to achieve.

Small groups also make it affordable to provide skill builders during some lessons so that participants can practice at home what they have learned during the training. The skill builders selected aid the participants in learning and practicing a new food preparation or food safety skills. North Carolina EFNEP provides items such as measuring cups or spoons for participants to use in preparing the recipes they have learned in the class at home. This has helped reinforce the lesson because many participants share that they try the class recipes at home with their families.

The focus group indicated that if the target client group is bigger than 10 members, it is important to divide the clients into small groups for keeping them involved in the lesson activities.

Findings indicate that introducing physical activities with music they like is an effective strategy for this audience.

Because there are so many demands on time, and barriers to participation are high, retaining this audience in the program is a challenge that educators must plan to address. Strategies that have worked for EFNEP PAs include providing simple recipes that can be prepared in under 30 minutes for family meals; skill builders to practice what is learned in class at home; and making classes interactive, engaging, and fun. Additionally, PAs stressed that receiving a certificate of completion is a significant achievement for many limited income participants who have never received a certificate of any kind.

Conclusions and Recommendations

Reaching audiences who have limited incomes can be a difficult task due to their lack of transportation, time, educational level, experiences, and initial interest in nutrition educational programs. The best alternative to overcoming these challenges and recruiting limited income audiences into Extension programs is through partnering with pre-formed groups such as WIC and Head Start.

First, Extension needs to develop a relationship with these organizations and identify common interests. It is important to align the goals of the organization with the goals of Extension, be prepared to discuss individual organizational roles, and state how the partnership will help each organization achieve its mission of serving the needs of limited resource populations more effectively by working together.

Retaining the limited income audiences in the program and holding their interests are challenging because of their busy work schedules, family obligations, and low literacy. Creating a non-threatening and welcoming learning environment is essential to retain and motivate limited income audiences to participate actively in extension programs.

The use of appropriate educational strategies targeting limited resource populations is necessary for gaining their interest and active participation in Extension programs. These educational strategies include use of fun and interactive hands-on lessons, creating and facilitating discussions, personalizing instructions, and encouraging and rewarding participants with incentives. Engaging participants in discussions and sharing personal experiences aids the learning process. Lecturing is not an effective teaching method for this audience.

When behavior change is emphasized, it is effective to use lessons that focus on realistic small changes that are easy for limited resource families to make. Quick and easy food recipes and involving participants in hands-on food preparations are very practical options in bringing about desired nutrition behavior changes.

Skill building activities and tools encourage participants to practice what they have learned at home. Opening each session by asking participants to share their home practice is important for achieving high impacts. Participation in physical activity during sessions is encouraged by incorporating music in class. Increasing physical activity is accomplished through continual encouragement and personal challenges to participants throughout the program.

The study reported here was conducted with one focus group of EFNEP Pas, and this could be a limitation of the study. Further research is needed to conduct focus group interviews with EFNEP PAs and program participants to overcome this limitation and generalize findings.

References

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