Can a large-scale public nutrition program sustain the motivation of front-line workers?

A negative response to this question is often presumed to account for failures of large public nutrition programs to meet expectations, domestically and internationally. Low motivation limits front-line workers' (FLW) success in inspiring dietary change among clientele, yet we lack understanding of influences on their work attitudes. To address this gap, we studied the Expanded Food and Nutrition Education Program in NY State, first interviewing FLWs on work context, motivation and empowerment. A survey then assessed the influence of work context (supervision, job traits, workload, etc.) on FLW attitudes and on program outcomes (completion rate, behavior change), 78% of FLWs reported high work satisfaction, which was related to congruent program and personal values, team support, management styles that gave autonomy and voice to paraprofessional FLWs, and ethnicity (r=.82). Motivation has been sustained, often for decades and despite low pay. Results suggest new ways to increase program effectiveness worldwide via management and job design strategies that attract and retain FLWs with the values and skills needed to transform nutrition knowledge into meaningful behavior change.