Bourbon County CES

Title:

Healthy Adults and Youth

MAP:

Improve Physical and Mental Health

Agents Involved:

Carter, Denniston, Tackett, Arthur

MAJOR PROGRAM 1:

Health & Wellbeing

MAJOR PROGRAM 2:

Substance Use Recovery - FCS

MAJOR PROGRAM 3:

Active Living and Health Promotions General

MAJOR PROGRAM 4:

Nutrition and Food Systems General

Situation:

Healthy living is one of three 4-H mission mandates and encompasses: physical activity, personal safety, mental health, addiction prevention, and diversity and inclusion.  In Kentucky 37% of youth 10-17 are overweight or obese, and 51% report not exercising regularly. 25% of youth report some form of emotional or behavioral condition and suicide rates are at record high (KY suicides per 100,000 people: 15.3, 10th highest in nation). Substance Use Disorder and Mental Health disease can affect anyone, with 1,160 reported opioid-involved deaths (a rate of 27.9 deaths per 100,000 persons) in Kentucky and Vaping nearly doubled among middle and high school students — with 27% of high school seniors reporting they had tried the product in 2018.

The recent statewide needs assessment identified substance use prevention and recovery as the most urgent priority for Cooperative Extension.  In this assessment Bourbon County identified "availability of substance use prevention programs" as an urgency following only, affordable health care insurance and chronic health diseases.  Taken together, youth KIP survey data and data from the CES needs assessment demonstrate the need to address substance use prevention, recovery, stigma and impact on families and communities.

A foundation of nutrition knowledge, skills and competencies in topics such as food safety, handling and preparation, cooking methods and techniques, feeding practices, food science, and food systems are essential to changing dietary behaviors. With the increased trend of chronic disease and obesity in Kentucky, individuals, families, and communities need tools and environments that support healthful dietary decisions. CES agents are encouraged to reach diverse audiences to help combat chronic disease and obesity in Kentucky communities.  Focusing on a foundation of overall direct health education to increase health literacy and ability to make healthy lifestyle choices.  Including, creating spaces or opportunities for active living and health behaviors.

Long-Term Outcomes:

• Reduced fatalities
• Reduced number of children in foster care
• Reduced incarceration
• Increased number of youth maintaining positive health habits;
• Increased number of youth at a lower risk for serious disease and illness;
• Increased number of youth at a lower risk for physical and emotional distress
• Reduce the number of youth reporting drug, alcohol, and tobacco use
• Reduction of substance use and its related consequences
• Routinely meeting physical activity and dietary recommendations that promote health and wellness
• Community environment promotes healthy behaviors where people live, learn, work and play
• Reduce the rate of chronic disease and obesity
• Routinely employ healthy dietary practices that promote health and wellness (e.g. consume recommended daily fruits and vegetables and improve food management skills)

Intermediate Outcomes:

• Increased adoption and mastery of healthy behaviors that lead to a healthy lifestyle
• New coalitions developed to address SUC and MH
• Improved access and utilization of resources
• Improved perceived stress and ability to cope
• Youth will contribute to their communities
• Youth will practice refusal skills, 
• Youth will intervene to prevent use/abuse  
• All agents trained in YMHFA
• Reduced stigma from local community members
• Increased Opioid Stewardship (less Rx'ing by doctors, appropriate Rd disposal, drug take-backs, etc.
• Generate positive attitudes toward changing lifestyle choices to be more healthy
• Increase intake of fruits, vegetables, and other nutrient-dense foods
• Improve self-efficacy in physical activity, movement, and active routes to destinations 
• Decrease tobacco/ substance use
• Generate positive attitudes toward changing dietary decisions to be more healthful.
• Increase intake of fruits, vegetables, and other nutrient-dense foods
• Decrease intake of solid fats, added sugars, and sodium
• Employ healthful cooking methods, feeding practices, and food preservation techniques
• Increased access to healthy food via local farmers markets, food retailers, and/or home gardens

Initial Outcomes:

• Improved in awareness of health concerns for youth
• Improved education about SUD and MH disease
• Improved education about diversity and Inclusion
• Reduced stigma of individuals with SUD and MH disease
• Improved understanding of the consequences of risk behaviors
• Promote optimal physical, social and emotional health habits
• Increased knowledge of substance use prevention, addiction, and recovery
• Increased ability to identify and use destigmatized language
• Improved social skills and/or self-efficacy in youth
• Increase awareness about lifestyle choices and chronic disease (e.g. tobacco use, poor nutrition, & lack of physical activity) 
• Increase confidence in ability to employ healthy practices 
• Improve food and nutrition-related skills (e.g. preparation techniques, safe food handling)
• Increase motivation to be active
• Increase awareness of accessible safe places for activity
• Increase awareness about relationships between food and nutrition practices and chronic disease.
• Improve food and nutrition-related skills (e.g. gardening, preparation and preservation techniques, safe food handling, food resource management)
• Increase confidence in ability to employ healthy eating practices
• Increase motivation to access and prepare healthier foods 

Evaluation:

Outcome:  Increased knowledge of substance use

Indicator  :  Number of individuals attending programs

Method:  Retroactive pre-post

Timeline:  Following every Substance Abuse Education/Prevention program

Outcome:  Increased ability to identify and use destigmatized language

Indicator:  Number of individuals plan to make effort to change behavior

Method:  Retroactive pre-post

Timeline:  Following any program that includes language training

Outcome:  Improved social skills and/or self-efficacy in Bourbon County youth

Indicator:  Number of students participating in programming

Method:  Retroactive pre-post 

Timeline:  Following programming

Outcome:  Nutrition knowledge and dietary intake

Indicator:  Number of individuals who reported: eating 4-6 servings of fruits and/or vegetables daily; utilize the food label to make healthy food choices; choosing smaller portions

Method: Self-report surveys

Timeline:  Pre-post implementing curricula or program

Outcome: Physical Activity knowledge, skills, and competencies 

Indicator:  Number of individuals who reported: knowledge and skills gained about the benefits of physical activity; adoption of physical activity practices; increase in physical activity levels

Method: Self-report survey

Timeline:  Pre-post implementing curricula or program

Outcome: Chronic Disease Prevention

Indicator:  Number of individuals who reported: participants who had one or more health indicator (cholesterol, blood pressure, body mass index, blood glucose) improved.

Method: Self-report survey

Timeline:  Pre-post implementing curricula or program

Outcome:  Availability / Access to healthy lifestyle choices 

Indicator:  Number of communities, health coalitions, or organizations who reported: implemented policy, system, and/or environmental changes to promote healthy eating and active living

Method: Self-report survey

Timeline:  Pre-post implementing curricula or program

Outcome:  Nutrition knowledge, skills, and competencies

Indicator:  Number of individuals who reported: use knowledge and skills to improve food-shopping management; utilize the food label to make healthy food choices; choosing smaller portions; increased food preservation knowledge; demonstrated recommended food preservation practices

Method: Self-report surveys; specific curricula or program evaluations

Timeline:  Pre-post implementing curricula or program

Outcome: Preparing and preserving food 

Indicator:  Number of individuals who reported: preparing more home-cooked meals; modifying ingredients and/or preparation techniques to improve nutrition

Method: Self-report survey; specific curricula or program evaluations

Timeline:  Pre-post implementing curricula or program

Outcome:  Dietary intake 

Indicator:  Number of individuals who reported: eating 4-6 servings of fruits and/or vegetables daily

Method: Self-report surveys about fruit and vegetable intake or other dietary improvements; specific curricula or program evaluations

Timeline: Pre-post implementing curricula or program

Outcome:  Availability and access to healthy food 

Indicator:  Number of individuals who reported: utilizing delivery systems/access points (e.g., farmers’ markets, CSAs, WIC, food pantries) that offer healthy foods; supplementing diets with healthy foods grown or preserved (e.g., community or backyard gardens, fishing, hunting, farmers markets); dollar value of vendor-reported sales or EBT, WIC, or Senior benefits redeemed at farmers’ markets; number of pints of foods preserved through water bath canning, pressure canning, freezing, or drying. 

Method: Self-report survey

Timeline:  Pre-post implementing curricula or program

Learning Opportunities:

Audience: High School Age Youth

Project or Activity: Truth and Consequences Drug Education Program

Content or Curriculum:  State Curriculum" T&C:  The Choice is Yours"

Inputs:  Agents, Community Agencies, Local School Systems

Date:  2023 - 2024

Audience: 4th and 5th Grade Students

Activity: Healthy Snack Choices School Enrichment

Content or Curriculum: Nutrition Curriculum

Inputs: agents

Date: March 2024

Audience: 4th & 5th Grade Students

Activity:4-H Foods Workshops

Content or Curriculum: 4-H Core Curriculum

Inputs: agents

Date: year round

Audience: 4th Grade Students

Activity: County Wide 4th grade Safety Day

Content or Curriculum: various safety presentations

Date: April  2024

Audience:  Bourbon Youth

Project or Activity:  Life Skills - Decision Making

Content or Curriculum:  Life Skills

Inputs:  Bourbon Juvenile Court

Date:  September - December

Audience:  Families Impacted By Addiction

Project or Activity:  Substance Use/Prevention

Content or Curriculum:  Addiction 101

Inputs:  Local School FRYSC directors; Outreach Bourbon County

Date:  January 2024

Audience:  5th grade students

Project or Activity:  Recipe for Life

Content or Curriculum: Recipe for Life

Inputs:  Snap Ed Assistant, Agents, FRYSC directors, Bourbon County Extension Homemakers

Date:  August 2023

Audience:  Recovery Centers

Project or Activity:  Recovery Gardening

Content or Curriculum: Recovery Garden

Inputs:  Snap Ed Assistant, Director of Shane Wallin House, Outreach Bourbon County

Date: May 2024

Audience: Communities

Project or Activity:  Policy, Systems, and Environmental Approaches

Content or Curriculum: Health Coalitions, Story Walk, , 

Inputs: Volunteers,  community partners, key stakeholders, elected officials, Health Coalitions, Employee Health and Wellness, SNAP-Ed Toolkit 

Date:Spring-Summer 2024-2025

Audience: Families and Individuals

Project or Activity:  Chronic Disease Prevention

Content or Curriculum: Publications, Health Bulletins, Cook Together Eat Together,  Dining with Diabetes, Fit Blue, Plate It Up! Kentucky Proud Resources, Health Partners,  Keys to Embracing Aging

Inputs: Programmatic materials, paid staff, community partners, health coalitions, Healthcare Providers, Health Department, Non-profits, Schools, Company Health & Wellness, Homemakers, Community Centers, etc. 

Date: Ongoing projects throughout the year

Project or Activity:  Physical Activity

Content or Curriculum: Publications, Story Walk, Health Coalitions, Be More, Fit Blue, WIN, Health Partners,  Keys to Embracing Aging

Inputs: Paid staff, volunteers, facilities, health coalitions, Healthcare Providers, Health Department, Non-profits, Schools, Company Health & Wellness, FBOs, Homemakers, Community Centers

Date: Periodically each year

Audience: Kentucky Extension Homemakers Association/Volunteers

Project or Activity:  Promoting Healthy Lifestyle Choices 

Content or Curriculum:Health Bulletins, Monthly Leader Lessons

Inputs: Volunteers, paid staff, community partners

Date: Monthly

Audience: Communities

Project or Activity:  Farmers Market Outreach

Content or Curriculum: Cooking programs, marketing, increased access (e.g. location, hours, EBT), Plate It Up! Kentucky Proud resources, Farmers Market Toolkit

Inputs: Nutrition Education Program (NEP), paid staff, facilities, Kentucky Department of Agriculture

Date: April – May-October 2024

Audience: Families and Individuals

Project or Activity:  Food Preparation for Better Health

Content or Curriculum: Cook Together Eat Together, Dining with Diabetes, Super Star Chef,Plate It Up! Kentucky Proud Resources

Inputs: Programmatic materials, paid staff, community partners, faith-based organizations, health coalitions

Date: Ongoing projects throughout the year

Project or Activity:  Food Preservation

Content or Curriculum: Publications, Trainings, Home-Based Micro-Processing Training

Inputs: Paid staff, volunteers, facilities, programmatic materials, NEP

Date: July – September for adults and youth 2024

Audience: Kentucky Extension Homemakers Association/Volunteers

Project or Activity:  Promoting Nutrition with Volunteers

Content or Curriculum:  Food preservation workshops, Monthly Leader Lessons

Inputs: Volunteers, paid staff, community partners

Success Stories