Degree Type


Date of Award


Degree Name

Master of Science


Food Science and Human Nutrition


Nutritional Science ( H u man Nutrition)

First Advisor

Sarah L Francis


Social determinants of health (SDOH) are linked to health disparities and impact quality-of-life and wellbeing. In addition, adverse health behaviors (e.g. sedentary time, poor diet quality, etc.) contribute to chronic disease risk. In response, Extension is well-positioned to address health disparities by creating and delivering relevant programming to underserved audiences. Understanding the needs and preferences of the target audience and key stakeholders is crucial for accomplishing this goal.

Study One assessed the health and Extension programming needs and preferences of Iowans (n=452). Respondents were primarily female (70.6%), non-Hispanic (89.6%), White (79.2%), and 47.6% were 35 years or younger. Respondents were split evenly between rural/urban, and food secure/insecure populations. General descriptive statistics assessed respondent sociodemographics and programming preferences. Binomial logistic regression analyses predicted the influence of SDOH variables on Extension program use, and interest in participating in a health-related programs. Respondents preferred short (< 1 hour duration and 3 weeks length), low-cost, online programs. Most (76.8%) have not knowingly used Extension programs or materials previously. Those who were persons of color (p < 0.001), Hispanic/Latino (p= 0.030), and food insecure (p < 0.001) were more likely to use Extension programs and materials. Many (47.6%) were interested in health-related programming. Those not interested were less educated (p= 0.011) and had a chronic disease condition (p= 0.036). These results provide valuable information that informs future directions for Extension program recruitment, content, and format.

Study Two gathered Supplemental Nutrition Assistance Program (SNAP) food retailers’ perspectives on the most feasible and effective strategies to improve food choices of SNAP participants. Two corporate and six local-level food retailer managers from five counties participated in interviews; each had high SNAP participation. The stores included six grocery, one convenience store, and one supermarket. Thematic analysis was performed and themes were identified via consensus. SNAP marketing, incentive, and disincentive program models, as well as simple programs with easy implementation and educational components were viewed positively. Driving sales and program alignment with corporate and social responsibility goals were important factors related to willingness to participate in SNAP pilot programs. Insights from this present study can inform future SNAP pilot programs and promote food retailer buy-in.


Copyright Owner

Morgan Michelle Bahl



File Format


File Size

134 pages