Everett Rogers’ diffusion of innovation (DOI) theory (Rogers, 1962) is the foundation of many dissemination and implementation theories, models, and frameworks (Estabrooks et al., 2018; Tabak et al., 2012). It was developed to characterize the spread of information and knowledge through social systems, and much of the early work was conducted within the National Cooperative Extension System (herein: Extension).
Extension is associated with land grant universities in every state and territory in the U.S. (Franz & Townson, 2008). This system’s infrastructure employs university-based specialists who work with county-based field professionals (herein: agents), staff, or volunteers who, in turn, provide services to communities (Franz & Townson, 2008). The Extension model has the potential to facilitate broad reach into populations that may benefit most from the application of evidence-based interventions, has credibility within the community, and aligns evidence-based services with community needs (Balis, Strayer, et al., 2019; Dunifon et al., 2004; Fetsch et al., 2012; Wilson et al., 2018). Many successes of this model have been noted over the last 100 years (Blair et al., 2013; Block et al., 2004; Bull et al., 2004; Buscemi et al., 2014; Cases et al., 2016; Dunn et al., 2006; Dwyer et al., 2017; Estabrooks et al., 2008; Folta et al., 2015; Freedman et al., 2014; Janicke et al., 2013; Kaiser et al., 2015; Kaufman et al., 2017; MacKenzie Whetstone et al., 2011; McNamara & Gunter, 2012; Phillips et al., 2013; Reed et al., 2016). Much of this success has been noted in agriculture (which is unsurprising as Extension is funded through the United States Department of Agriculture [USDA]), but new attention has been paid to the health promotion initiatives within the system (Balis & Harden, 2019; Ball et al., 2013; Dzewaltowski et al., 2004; Harden et al., 2018; Manore et al., 2017; Peña-Purcell et al., 2012).
This attention is, in part, due to the release of the Extension National Framework for Health and Wellness in 2014, which stated that “the same system of Extension can do for the nation’s health what it did for American agriculture” (Braun et al., 2014), including ‘physical activity’ as part of the NIFA strategic plan for the first time (Farm Service Agency, 2014). This has provided opportunities for specialists to foster partnerships with healthcare, other public health entities, or academic researchers to promote physical activity (Braun et al., 2014; Harden et al., 2018).
As with most new initiatives, physical activity has been a less prominent focus within the system (Braun et al., 2014; Harden et al., 2016, 2018). In this report, we provide our perspectives of working within the system; specific state-based successes and challenges encountered when applying the current Extension model to physical activity promotion; and suggestions for improved dissemination within the system that was the birthplace of DOI. While our shared experiences are not comprehensive of all physical activity promotion in Extension, we strategically teamed together to ensure that these examples span the nation and over 20 years of work as physical activity scholarly practitioners.
