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Accessible, online courses provide critical training to nutrition and health professionals across the globe

Thousands of nutrition and public health professionals across the globe have expanded their skills and knowledge base thanks to free or low-cost, online continuing education courses developed by faculty in the Division of Nutritional Sciences (DNS).

Two separate courses – one about infant and young child feeding for a global audience, and another about policy, systems and environmental (PSE) approaches to improving nutrition in the U.S. – address critical topics including undernutrition, maternal and child health, and childhood obesity.

“These online courses are an efficient and effective way to deliver training,” said Christina Stark, a retired senior extension associate in DNS who had a key role in the development of both courses. “The goal has always been to provide nutrition practitioners with the knowledge and skills they need to build their capacity to work with the public.”

Two recently published studies related to the courses provide evidence of the importance of this type of education for nutrition and health professionals working in communities.

One study about the international course, published in the winter 2021 issue of the Journal of Continuing Education in the Health Professions, found health professionals working in low- and middle-income countries have an unmet need for up-to-date information and skills on infant and child nutrition, and that this type of online training is effective at filling that need.

The other study, published in the Journal of Nutrition Education and Behavior in December 2020, found the online course on using PSE approaches to improve nutrition in the U.S. helps to introduce these concepts to nutrition educators and demonstrates practical ways they can be implemented.

Enrollment for both courses has exceeded expectations. The international course – created in partnership with UNICEF and offered at no cost – had more than 5,500 enrollees in its first year, multitudes more than the 200 that were expected. Some 14,500 from 181 countries have enrolled over time. In addition, more than 30 percent have completed the entire 14-module course. (Completion rates for free online classes are typically 7 or 8 percent.)

Total enrollment in the U.S.-based course, which charges a modest fee, is approaching 1,000. Participants represent a variety of community nutrition programs, from almost all 50 states and Guam. Course completion over the last 3 years has exceeded 45 percent. In the year starting March 2020, enrollment jumped 70 percent over the previous 12-month period, providing evidence for the need and importance of distance-learning during the COVID-19 pandemic.

“It’s a testament to the value of the training overall,” said Joan Doyle Paddock, state coordinator for the Expanded Food and Nutrition Education Program and a senior extension associate in DNS.

One of the keys to the success of both courses: DNS researchers evaluated the needs of their target audiences before launching either course. “We were trying to find an affordable, accessible and effective way to deliver the content,” Stark said. “We have some previous research showing that online professional development is effective, and we know our audiences would be difficult to reach with in-person training alone.”

“Programming for Infant and Young Child Feeding”

The training on recommended breastfeeding and child feeding practices launched in 2012 as a free online course available to public health practitioners across the globe.

The class was first delivered on the Cornell NutritionWorks online platform and is now offered through UNICEF’s continuing education platform - AGORA. It teaches the latest information on breastfeeding, complementary feeding and women’s nutrition, plus how to implement programming to share this information with mothers and children and monitor improvements.

Feedback from course participants has been very positive. Patricia Adoch is a nutrition educator with Food for the Hungry, a non-governmental organization that works in a refugee settlement in northern Uganda. She completed the course in 2018. After taking the course, she wrote and recorded a song to promote breastfeeding to the refugee population.

“I would like to give my appreciation to [Cornell and UNICEF] for having offered to me a free online study,” she wrote in an unsolicited email to Cornell in 2021. “I am now promoting breastfeeding right from early initiation, exclusive breastfeeding and continue up to two years.”

“Making the Healthy Choice the Easy Choice”

The Division of Nutritional Sciences launched “Making the Healthy Choice the Easy Choice: Online Training in Policy, Systems and Environmental Approaches” in July 2018 with the goal of helping nutrition educators across the U.S. develop the skills needed to address the policies, systems and environments (PSEs) that influence our ability to make heathy food and activity choices.

The focus of the course centers around this dilemma: even when people know the recommended nutrition advice, they often have a difficult time making healthy choices because of their environments or the policies in place surrounding food and nutrition. Accessibility to affordable healthy choices can be particularly challenging.

“Say you tell students to avoid sugary drinks, but they go to the vending machine at their after-school program and it’s full of soda,” Stark explained. “That makes it tough. If a nutrition educator can collaborate with the after-school program staff to help them implement a policy of limiting sugary beverages in the vending machines, it makes it easier for students to change their behavior.” Similarly, encouraging people to buy more fresh fruits and vegetables at their local farmers’ market is not practical advice if they do not have transportation to reach the market, she said.

The six-module training teaches nutrition educators how to initiate PSE changes that will improve the nutrition and overall wellness in a community, particularly for low-income individuals and families. That process involves identifying community interest and goals, engaging partners, developing an intervention, and then evaluating and revising that intervention.

The course is available on eCornell to anyone, but was primarily designed for nutrition educators involved in two federal programs: the Expanded Food and Nutrition Education Program, or EFNEP, and the Supplemental Nutrition Assistance Program Education, or SNAP-Ed. People can enroll at any time and have a year to complete the course.

Abigail Rose is a SNAP-Ed educator with University of Illinois Extension who was new to her job when she completed the course in 2020. “The course was very informative, and I liked how we got to apply what we were learning in the workbook,” she said. “Overall, I found the course to be very beneficial and helped to finally make PSE work start to click in my brain!”

“The course was ground-breaking when it was launched because there wasn’t much continuing education available on this topic,” Paddock said. “It’s a mind shift for nutrition educators and a way of looking at community health through a new lens. The educators have to invest a lot of time to change policies, systems or environments, but the hope is that they are making lasting changes that benefit the people in their communities.”

For more information or to enroll in “Programming for Infant and Young Child Feeding,” go to https://agora.unicef.org/. For more information or to enroll in “Making the Healthy Choice the Easy Choice,” go to https://ecornell.com/pse.

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