Nutrition education for Navajo elders: Use of diffusion of innovation attributes

                         Cunningham-Sabo, Leslie Derry; PhD

                         THE UNIVERSITY OF NEW MEXICO, 2000
                         EDUCATION, HEALTH (0680); HEALTH SCIENCES, NUTRITION (0570); GERONTOLOGY (0351);
                         SOCIOLOGY, ETHNIC AND RACIAL STUDIES (0631)

                         This study examined the feasibility of using attributes of an innovation (Rogers, 1995) to develop a
                         nutrition education module for Navajo elders, to be presented by trained Senior Center supervisors. The
                         relationships between these attributes and the adoption and implementation of the innovative module
                         were assessed. Participatory research approaches were used to enhance the cultural and organizational
                         relevance and appropriateness of the module and training. A participatory attribute was developed and
                         its relationship to the implementation of the module was also measured. Supervisors from 19 Navajo Area
                         Agency on Aging Senior Centers served as study participants, contributing to the development of the
                         module, and receiving training to deliver the nutrition information to local elders. Data were collected from
                         trainees including: (1) post-test knowledge of module content; (2) evaluation of training
                         session (including perceptual rating of innovation and participation attributes of the module and training);
                         (3) reaction to facilitating the module with elders; and (4) focus group interviews identifying
                         factors contributing to adoption and implementation of the module. Trainees rated the experience
                         positively, especially the opportunity to practice delivering the session to their peers role-playing elders.
                         Mean scores for all attribute scales were above the neutral score, indicating positive perceptions of each
                         attribute. Twelve of 19 trainees reported presenting the module at least partially to elders within two
                         months post-training. Most reported the experience as positive for them and the elders. Supervisors
                         who perceived themselves as actively participating in the module development were more likely to
                         present it (r = .40, p = 0.09). Those who perceived a higher relative advantage of the module scored
                         significantly higher on the nutrition knowledge post-test (r = .40, 0.09). Two focus groups with seven
                         supervisors revealed enablers and barriers to module implementation. Enablers included perceived
                         expectations to deliver the module from program administrators, and personal factors relating to their
                         commitment to their job and recognition that this information could help elders. Several supervisors
                         reported being personally positively influenced by the nutrition information they had learned. Barriers to
                         implementation of the module included doubts about program administrators' commitment to this project,
                         and other work-related responsibilities.

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