The Journal of Extension -

December 2014 // Volume 52 // Number 6 // Ideas at Work // v52-6iw6

Sugar Free with Justin T.: Diabetes Education Through Community Partnerships

This article describes the design, development, and delivery of an Extension community cable television program, Sugar Free with Justin T., in Roane County, Tennessee. The program targets diabetics, pre-diabetics, and those who care for them, with practical information and demonstrations to improve dietary quality. In addition to television, program videos are posted to the county Extension Facebook page for greater exposure. This innovative approach is the result of extensive Extension and community partnerships, and the article highlights the roles of these varied partners, including the local community college that films, edits, and produces Sugar Free with Justin T.

Justin B. Thomas
Extension Agent
University of Tennessee Extension, Roane County

Joseph L. Donaldson
Extension Evaluation Specialist
Department of Extension Evaluation and Staff Development

The University of Tennessee
Knoxville, Tennessee


Diabetes is an epidemic, and the effects of the disease are far-reaching. The Centers for Disease Control and Prevention (2011) state that 25.8 million people in the United States are affected by diabetes (8.3% of the population), and the annual direct medical costs are 2.3 times higher for a person with diabetes than a person without the disease. Extension programs in diabetes education include Diabetes Conversation Maps® (Grenci, 2010), Take Care of Your Health (Kaiser, et al., 2009), Diabetes Cooking Schools (Archuleta, VanLeeuwen, Halderson, Wells, & Bock, 2012), and Preventing Diabetes: You Have the Power (Corbin, Kiernan, & Gettings, 2007).

To share information with diabetics, pre-diabetics, and caregivers, a diabetes education program was produced and broadcasted on the Roane County, Tennessee community cable outlet. The program was targeted at improving dietary quality. The production was named Sugar Free with Justin T. to add local flavor and to emphasize the show's host, who serves as the University of Tennessee (UT) Extension Family and Consumer Sciences agent in the community where the show is broadcast. Numerous studies have identified television as a valuable medium for delivery of Extension family and consumer sciences programs over the past five decades (Medved, 1966; Sunnarborg, Bradley, & Haynes, 1988; Kristiansson, 1981).

Partnerships, Design, and Development

Initially, the Extension agent was looking for effective ways to distribute diabetic-friendly recipes to the target audiences. As the Extension agent made contacts with representatives of the local Health Department and Coordinated School Health, the concept quickly evolved into a cooking show.

Sugar Free with Justin T. is a result of partnerships among representatives of the Roane County Health Department, Roane State Community College, Channel 15, Coordinated School Health, and TENNderCARE. Roane County Health Department provided all food demonstration needs through a diabetes education grant. Roane State Community College Communications department, which oversees Channel 15, filmed, edited, and produced all video segments. Students were responsible for all parts of production. Filming, editing, and production were all included as parts of the student syllabus, including creation of the program's logo (Figure 1) and video introduction. The program is filmed on the college campus (Figure 2). Every episode includes high-quality production elements such as varied views (Figure 3).

Figure 1.
Sugar Free with Justin T. Logo

Figure 2.
A View of the Set During Taping

Figure 3.
Close-Up of an Apple Crisp Recipe

The Tennessee Department of Education implements Coordinated School Health in all public school districts in the state; one or more system-level educators are tasked with addressing school health priorities by coordinating student nutrition, health services, and community partnerships (Tennessee Department of Education, 2014).

The TENNderCARE representative worked in directing parents to sources that video segments were shared (e.g., Facebook, Channel 15, etc.) TENNderCARE is a health program composed of preventive check-ups and screenings for Tennessee children in the state's Medicaid program.

Program Delivery

Sugar Free with Justin T. provides versatility with programming and can be used in multiple communication channels far beyond the initial broadcast, including cable broadcasts, Facebook promotion of diabetes programs, and exhibits at health fairs and professional meetings. The recorded videos are used in conjunction with many programs in Roane County such as Dining with Diabetes, Take Charge of Your Diabetes, and SNAP education.

Sugar Free with Justin T. episodes can be seen at the following Facebook link:

This communication is particularly important in light of the Cooper, Cox, and Corbin (2012) study of 185 Dining with Diabetes participants in 14 Pennsylvania counties for social media awareness. They posited that diabetes education through social media was an important tool to remind "young adults of the importance of physical activity, a healthy diet, and regular visits to their healthcare providers."


One result of the program has been increased visibility for Extension Family and Consumer Sciences programs in Roane County. Calls have increased in regards to diabetes education classes and food safety. Many clients who call or visit make mention of seeing the show on television or another medium. In one instance, the father of a 4-Her, who has no interaction with FCS programming, reported watching the video and preparing the recipe. The project also resulted in the increase of multi-county diabetes education programming with other Extension agents.

Facebook metrics show that the Sugar Free with Justin T. video posting results in increased visitors to the UT Extension Roane County page. A random week was selected for promotion of American Diabetes Month in November 2013 for posting of video segments. Three segments were posted in one week that resulted in 1,656 viewers. The previous five posts on the UT Extension Roane County Facebook page had a total of 970 views, and the five posts after the week of Sugar Free with Justin T. had 1,075 views. From the five preceding posts, there was a 71% increase during the week when videos were shown. The week videos were posted also drew 54% more viewers than the next five posts in the following weeks (Figure 4).

Figure 4.
Facebook Views (November, 2013)


In working with the educational television production channel, the assumption was that some data regarding overall viewership would be available for Extension reporting purposes. The channel is educational in function and therefore has no tracking capabilities, which limits reach calculation to viewer feedback only.

The program partners have met to informally evaluate the program, and a new concept has emerged to produce a tailgate party version of Sugar Free with Justin T. This version is intended to target a larger male population because diabetes education has not reached males in Roane County effectively.

The Sugar Free with Justin T. program is a promising strategy to complement a portfolio of diabetes education programs and demonstrates the value of pursuing simultaneous educational delivery through mass media and social media.


The authors wish to express appreciation to the individuals and institutions that made Sugar Free with Justin T. possible: Roane County (Tennessee) Health Department, Roane State Community College, Channel 15 (, Coordinated School Health of Roane County, TENNderCARE representative, Amy Treadway, and Kingston Parks and Recreation.


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