226284 Health extension in rural New Mexico: Where the rubber hits the dirt road

Monday, November 8, 2010

Juliana Anastasoff, MS , Health Extension Rural Office, University of New Mexico, Ranchos de Taos, NM
Betsy Van Leit, OT, PhD , Health Sciences Center, University of New Mexico, Albuquerque, NM
Wayne Powell, MA , Associate Director, Office of the Vice President for Community Health, University of New Mexico Health Sciences Center, Albuquerque, NM
Arthur Kaufman, MD , Vice President for Community Health, University of New Mexico, Albuquerque, NM
James Gilroy, MEd , Dean of Instruction, Univeristy of New Mexico - Taos Branch Campus, Taos, NM
Kelley Schull, MA, CFRE , Holy Cross Hospital, Taos Health Systems, Taos, NM
Just as the Cooperative Extension Service (CES) developed out of the nation's land grant universities as a strategy for agricultural reform in the early 20th century, models of “health extension” are now emerging from academic health centers aimed at improving community health. Incubated within schools of medicine, these models mirror the CES template of situating extension agents in communities with a focus on developing technical solutions to rural health challenges.

In the meantime, community development (CD) models have evolved from disciplines as diverse as education, architecture/design, and social work. CD practitioners within underserved communities facilitate locally-driven determination of values, assets, and priorities, and support local action. CD theory and practice have the potential to add depth and dimension to the translation of extension from agriculture to the health sector. Through a CD lens, health extension becomes multidisciplinary, views social ecologies as complex systems, and emphasizes cultivation of community capacity equally with technical assistance.

This presentation examines the evolving practice of CD-informed health extension in one New Mexico county. As a link to university resources who is also a member of the community, the rural health extension agent focuses on building local capacity, developing infrastructure, and leveraging social capital across systems through engagement in knowledge networks, systems of care, and communities of practice in order to address the interdependent triad of priority health conditions, social determinants, and health professions pipeline. Thus, extension is transformed from its technical and expert roots to collaboration that is truly meaningful to and shaped by communities.

Learning Areas:
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
1. Discuss health extension as a model of academic health center engagement in rural communities to reduce disparities and improve health. 2. Explain the community development model as applied to the activities of health extension. 3. Describe the role of the health extension agent as a community member and linkage to the academic health center in building bridges and partnerships, providing practical assistance, and leveraging resources to address community-defined health needs and priorities.

Keywords: Rural Communities, Community Development

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I implement the activities of a rural health extension office, as a member of the community who is also duly trained in community development and public health education.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.