a b s t r a c tThis analysis reports on the projected cost of Alaska's public infrastructure at risk from rapid climate change. Specifically, we coupled projections of future climate with engineering rules of thumb to estimate how thawing permafrost, increased flooding, and increased coastal erosion affect annualized replacement costs for nearly 16,000 structures. We conclude that climate change could add $3.6-$6.1 billion (+10% to +20% above normal wear and tear) to future costs for public infrastructure from now to 2030 and $5.6-$7.6 billion (+10% to +12%) from now to 2080. These estimates take into account different possible levels of climate change and assume agencies strategically adapt infrastructure to changing conditions. In addition to implementing a risk-based economic analysis of climate change impacts, this research effort demonstrates that implementing plausible adaptation strategies could offset impacts by up to 45% over the long-run.

Purpose: The Cooperative Extension System (Extension) has implemented concerted efforts toward health promotion in communities across the nation by acting as an intermediary between communities and universities. Little is known about how these intermediaries communicate and learn about existing evidence-based programming. This study serves to explore this gap by learning about information sources and channels used within Extension. Design: Sequential explanatory mixed methods approach. Setting: National Cooperative Extension System. Participants: Extension community-based health educators. Methods: A nationally distributed survey with follow-up semistructured interviews. Survey results were analyzed using a Kruskal-Wallis 1-way analysis of variance test paired with Bonferroni post hoc. Transcripts were analyzed by conventional content analysis. Results: One hundred twenty-one Extension educators from 33 states responded to the survey, and 18 of 20 invited participants completed the interviews. Educators’ information seeking existed in 2 forms: (1) information sources for learning about programming and (2) channels by which this information is communicated. Extension educators reported contacting health specialists and other educators. Extension educators also reported using technological means of communication such as e-mail and Internet to reach information sources such as peers, specialists, academic journals, and so on. Conclusion: Extension state specialists were preferred as primary sources for intervention information, and technology was acknowledged as an easy contact channel. This study identifies county-based health educators’ information structures and justifies the need for future research on the role of specialists in communication efforts for educators.

The results indicate notable differences between peer-reviewed literature and Extension programs and present an opportunity for Extension programs to more effectively use evidence-based program characteristics, including behavioral theories and group dynamics, a combination of physical activity components, and educator/agent-trained delivery agents.

Only 17% of older adults meet the recommendations for two days of full body strength training that is associated with improved functional fitness; reduced risk of falls; and reduced morbidity and mortality rates. Community-based interventions are recommended as they provide supportive infrastructure to reach older adults and impact strength training behaviors. Scalability and sustainability of these interventions is directly linked with setting-level buy-in. Adapting an intervention through an integrated research–practice partnership may improve individual and setting-level outcomes. The purpose of this study was to evaluate the initial reach and effect of a locally adapted, health educator-led strength-training intervention; Lifelong Improvements through Fitness Together (LIFT). LIFT was compared to an evidence-based exercise program, Stay Strong; Stay Healthy (SSSH). Intervention dose and mode were the same for LIFT and SSSH, but LIFT included behavioral change strategies. Older adult functional fitness was assessed before and after the 8-week strength training intervention. Health educators who delivered LIFT and SSSH were able to reach 80 and 33 participants, respectively. Participants in LIFT were able to significantly improve in all functional fitness measures whereas SSSH participants were only able to significantly improve in 5 of the 7 functional fitness measures. In conclusion, this study provides preliminary evidence that the locally adapted program reached more individuals and had improvements in functional fitness.

Efficacy and effectiveness data for strength-training programs targeting older adults have been well established, but it is evident that they are not translated within practice-based settings to have a public health impact, as most (~90%) older adults are not meeting strength-training recommendations. Strength-training interventions developed, delivered, and evaluated in highly controlled settings (e.g., eligibility requirements, certified instructor, etc.) may not reflect real-world needs. One strategy to improve these outcomes is to work through an integrated research–practice partnership (IRPP) to plan and evaluate an intervention to better fit within the intended delivery system. The purpose of this study was to describe the IRPP method by which academic and practice representatives can partner to select and adapt a best-fit strength-training program for older adults. This work was planned and evaluated using the reach, effectiveness, adoption, implementation, and maintenance framework, applying the AIM dimensions to complement the methodology of the partnership. In this pragmatic work, members of the IRPP adapted the evidence-based program, Stay Strong, Stay Healthy (SSSH) into a new program, Lifelong Improvements through Fitness Together (LIFT). Of the health educators who agreed to be randomized to deliver LIFT or SSSH (N = 9), five were randomized to SSSH and four were randomized to deliver LIFT. Fifty percent of educators randomized to SSSH delivered the program, whereas 80% of the health educators randomized to LIFT delivered the program. The health educators deemed LIFT more suitable for delivery than SSSH, self-reported high rates of fidelity in program delivery, and intended on delivering the program in the following year. In conclusion, this study provides transparent methods for using an IRPP to adapt an intervention as well as preliminary outcomes related to adoption, implementation, and maintenance.

Uterine gland development occurs after birth in cattle and other mammals. The timeline of gland development has been described in various species, but little is known about how postnatal diet influences uterine gland development. This is especially concerning in dairy heifers, where a variety of milk replacer and whole milk nutrition options exist. Little work also exists in cattle to describe how early exposure to steroids influences reproductive tract and uterine gland development. The objective of this work was to determine the effects of early postnatal plane of nutrition and estrogen supplementation on uterine gland development in calves. In both studies, Holstein heifer calves were assigned to restricted milk replacer (R-MR) or enhanced milk replacer (EH-MR) diets. In study 1, calves (R-MR, n = 6; EH-MR, n = 5) were euthanized at 8 wk. In study 2, calves were weaned at 8 wk and administered estradiol (R-MR, n = 6; EH-MR, n = 6) or placebo (R-MR, n = 6; EH-MR, n = 5) for an additional 14 d before euthanasia. Average daily gain and final body weight was greater in both studies in heifers fed the enhanced diet. At 8 wk, EH-MR calves had a greater number of glands and a smaller average gland size, but total gland area was not different from the R-MR group. At 10 wk, uterine gland number and size were not affected by diet or estrogen. Expression profiles of several paracrine mediators of gland development were examined. Increases in transcript abundance for IGF1 and IGFBP3 and a decrease in abundance of WNT7A were detected in calves fed the enhanced diet at 8 wk of age. Plane of nutrition did not affect transcript profiles at 10 wk of age, but estradiol supplementation decreased MET and WNT7A transcript abundance. To conclude, heifer calves on a restricted diet exhibited a uterine morphology and transcript profile suggestive of delayed uterine gland development. These changes appear to be corrected by wk 10 of life. Also, this work provides evidence supporting the contention that early estradiol exposure has detrimental effects on uterine gene expression.

Purpose and Objectives Responsive methods and measures are needed to bridge research to practice and address public health issues, such as older adults’ need for multicomponent physical activity. The objective of this study was to detail the longitudinal, quasi-experimental work that spans 5 years to describe outcomes across RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) dimensions of integrating a physical activity intervention for older adults into the Cooperative Extension System through the assess, plan, do, evaluate, report (APDER) cycle. Intervention Approach The participant-level intervention is Lifelong Improvements through Fitness Together (LIFT), an 8-week, group dynamics-based, strength-training program with 16 in-person sessions. The implementation intervention applies the iterative APDER cycle based on feedback for each dimension of RE-AIM. Each year, the APDER cycle was used to embed data collection procedures at the instructor and participant level to reveal the next evolution of the program. Evaluation Methods Each evolution of LIFT was measured through a pretest and posttest quasi-experimental design. Data were collected on each RE-AIM dimension through participant surveys and functional fitness assessments, number and representativeness of trainees, and process evaluation. Results Overall, LIFT was expanded to 4 states with 275 instructors, reaching 816 older adults; consistently improved functional fitness outcome measures; demonstrated strong program adherence; and was seen as feasible and enjoyable by instructors and participants. LIFT is now undergoing adaptations for virtual delivery as well as updating the exercise protocol to introduce yoga postures that target flexibility and balance. Implications for Public Health Overall, ongoing adaptations were necessary to ensure the program continued to fit the mission, values, and resources of the delivery system. Public health implications to support the need for ongoing adaptation include embedding pragmatic measures of adaptations and RE-AIM into standard evaluation pathways and using iterative APDER cycles.

It is well known that perceptions of intervention characteristics (e.g., cost, source, evidence strength and quality) are a critical link from dissemination to implementation. What is less known is the process by which researchers understand the characteristics most valued by key intermediaries (i.e., real-world decision-makers), particularly in the federal system of Cooperative Extension. In Extension, university-based specialists are available to assist county-based agents in program selection, delivery, and evaluation. For this work, a sequential explanatory mixed-methods design was used to conduct surveys and semi-structured interviews, informed by the Diffusion of Innovations theory and Consolidated Framework for Implementation Research. Educators and specialists were recruited across 47 states to identify characteristics of health promotion interventions that facilitate the adoption decision-making process. Analysis of intervention attribute importance survey data was conducted through a one-way ANOVA with Bonferroni post hoc test to determine individual variable differences between responses. Interviews underwent a conventional content analysis. In total, 121 educators and 47 specialists from 33 states completed the survey. Eighteen educators and 10 specialists completed interviews. Educators and specialists valued components such as the community need for the intervention, and potential reach compared with other components including previous delivery settings and external funding of the intervention ( p < .05). Qualitative data indicated divergence between educators and specialists; educators valued understanding the intervention cost (time and training) and specialists valued the evidence base and external funding available. Intervention developers should communicate information valued by different stakeholders to improve the adoption of evidence-based interventions.