Webster County CES

County Emphasis:

Increasing Physical and Mental Health and Well Being

Concentration 1:

Health and Wellbeing

Concentration 2:

Family and Youth Development

Concentration 3:

Substance Use Prevention and Recovery

Situation:

The opportunities and resources available to support the health and well-being of adults and families in Kentucky vary widely. Disparities in health-promoting knowledge, resources, and infrastructure contribute to higher rates of chronic health conditions and lower quality of life. Prevention, early detection, and care are essential to maintain and/or improve quality of life. Yet, this burden is often placed on individuals to navigate the

healthcare system and traditional public health entities. Additionally, for decades, little attention has been given to the external factors that undoubtedly affect health such as access to care, education, nutritious foods, and safe physical spaces. These same issues and concerns were echoed throughout the 2023 UK Cooperative Extension Community Assessment. Within the top 15 priority issues identified by Kentuckians, “ensuring individuals and families have access to affordable nutritious foods” was #4 and “reducing youth obesity through nutrition education and/or exercise” was #8. Guided by the Cooperative Extension’s National Framework for Health Equity and Well-being, UK Extension aims to become a critical public health partner for addressing disparities in health-promoting knowledge, resources, and infrastructure through comprehensive health, nutrition, and wellness programming that supports adult physical health and well-being.

Family and Youth Development programming is essential for fostering healthy, supportive environments where both children and adults can thrive. By offering structured activities and educational workshops, UK Extension aims to build strong family bonds equipping young people and older adults with critical life skills. Guided by the Cooperative Extension’s National Framework for Health Equity and Well-being, our programming also addresses social and emotional needs throughout the lifespan, promoting resilience and positive relationships which are two of the key concerns identified in the top 15 needs of Kentucky’s statewide needs assessment. Investing in such programs can prevent future challenges by supporting early intervention and personal growth. Ultimately, these initiatives contribute to the well-being of individuals and the stability of communities, making them a vital component of social development. 

Though substance use and substance use disorder have been pressing social problems for decades, the public health burden and consequence associated with substance use has rapidly worsened in recent years. Drug overdoses have surpassed car accidents as the leading cause of accidental death and overdoses have contributed to a reduction in average life expectancy in the US. Much of the substance use-related morbidity and mortality is a result of a persistent treatment gap. Each year, about 90% of people who need treatment for SUD in Kentucky do not receive it. To address this gap in service provision, more community-level programming is required to meet the complex needs of Kentuckians who use drugs. Cooperative Extension is uniquely positioned, both with deep connections to each Kentucky county and with its transdisciplinary team of specialists, to address the holistic needs of Kentuckians who use drugs including mental health, fair housing, second-chance employment, nutrition and physical health, and much more.

Youth Focus

Substance use and substance use disorder are persistent public health problems in Kentucky. Kentucky youth fare worse than their US counterparts in terms of numerous indicators of drug use and drug-related harm including cigarette and smokeless tobacco use, vaping, alcohol use, and illicit drug use such as opioid and methamphetamine use. Accordingly, the recent University of Kentucky Cooperative Extension Service Needs Assessment (2023) indicated substance use prevention is the primary concern among most Kentucky counties. Nevertheless, few Kentucky communities support prevention efforts that are informed by research. Cooperative Extension is well-positioned with deep collaborative community ties to support evidence-based prevention programming. Such programs may target substance use directly or indirectly by focusing on pertinent risk and protective factors and promoting overall well-being for Kentucky youth.

It is proven that people who have access to and consume their daily dietary requirements of fresh fruits and vegetables are less likely to suffer from chronic conditions such as obesity, diabetes and cardiovascular disease and have an increased quality of life. Having the knowledge and skills to prepare or preserve fresh fruits and vegetables presents an additional barrier beyond obtaining fresh food access.

With the goal of increasing the consumption of fresh fruits and vegetables, the Kentucky Cooperative Extension Service (CES) aims to increase access to fresh food, as well as increase knowledge and awareness of how to select, store, safely prepare, process, and preserve these foods. CES prioritizes statewide partnership development that helps us meet our goals and objectives. We collaborate with statewide agencies including Kentucky Department of Agriculture, Community Farm Alliance, KY Farm to School Network, Kentucky Department of Fish & Wildlife and others to help build statewide systems that increase access and usage of fresh fruits and vegetables. These programs benefit Kentuckians because they support food access policy, systems and environmental changes in communities and across the state. They increase knowledge of how to grow, prepare, and preserve fresh fruits and vegetables.

Youth Focus

Kentucky faces significant health and economic challenges, with five of the top ten causes of death being nutrition-related. According to the Obesity Action Coalition the cost of obesity reached $36.31 billion. The rapidly changing social and economic landscape underscores the need for a healthy, productive, and engaged young people to contribute to a prepared workforce and engaged community to tackle these challenges. The University of Kentucky Cooperative Extension System's 2023 Community Needs Assessment identifies critical priorities, including access to affordable nutritious food, reducing youth obesity through improved nutrition and exercise, and enhancing youth wellbeing through effective coping strategies. Kentucky 4-H plays a crucial role in addressing these needs by equipping young people with essential skills in nutrition, culinary arts, financial education, and entrepreneurship. 69% of youth reported that they learned about healthy food choices in 4-H. 4-H youth report an increase in preparing meals together as a family, increase in meals eaten as a family, and confidence in the kitchen. These programs not only foster healthier, more resilient individuals, but also contribute to the development of engaged citizens prepared to navigate and thrive in a rapidly evolving world.

County Situation:

As of 2022, the percentage of families in Webster County living below poverty was 15.5% as well as a 14.9% food insecurity rate as of 2021. Webster County advisory council groups have identified a need for parent education materials related to budgeting/ financial planning, nutrition, and mental health to combat the stressors they are facing. Members of the advisory councils have been involved in the development of parent education classes as needs have been identified. They are able to connect the extension office with their contacts which include parents of Webster County students as well as parents involved with DCBS for educational curriculum.

From 2020-2022, there were 335 substance abuse related emergency department visits. From that number, the drug involved incidences were 66, and 11 were opioid involved. The need for educational programming for substance misuse prevention and recovery in Webster County has been identified by advisory council groups. Advisory council groups have been involved in the Truth and Consequences program in the county for many years but as it has evolved, have voted for it to take place at the county courthouse as opposed to the school for a more "real life" experience. The WC Drug Free Communities coordinator as well as many members of the ASAP board are heavily involved in the planning and execution of this prevention program.

Long-Term Outcomes:

1.

Adult

• Routinely meeting guidelines and recommendations for health behaviors that promote wellness and quality of life
• Community environments that equitably support health-promoting behaviors where people live, learn, work, and play
• Increased availability and accessibility to community-based health resources
• Reduced rate and burden of non-communicable chronic diseases and injury
• Decreased health disparity prevalence in Kentucky counties
• Improved quality of life

Youth

• Kentucky 4-H members report decreased obesity.    
• Increased number of 4-Hers who pursue employment in the health and wellbeing field. 
• Youth will increase contributions to their communities through applying critical thinking, problem-solving, and effective communication learning in the 4-H Health and Well-Being Core Content Area.

2. 

• Increased meaningful social connections
• Increased support network
• Increased kindergarten readiness rates in the county and state
• Increased caregiver preparation
• Improved quality of family life

3. 

Adult

• Increased recovery capital
• Reduced adult substance use
• Reduced adult substance use disorder
• Reduced adult overdose fatalities
• Reduced stigma related to adult substance use
• Improved quality of life

Youth

• Improved social and emotional competency
• Reduced youth substance use
• Reduced youth substance use disorder
• Reduced youth overdose fatalities
• Reduced stigma related to youth substance use
• Improved quality of life

Intermediate Outcomes:

1. 

Adult

• Increased health-promoting behaviors that support family, community, and occupational health and safety
• Increased and/or strengthened partnerships to address community health or safety issues
• Increased organizational/site/community support for health-promoting behaviors that equitably address community health or safety issues

Youth 

• 4-H members will practice general wellness habits.   
• Increased self-reflection and exploration of personal values and beliefs related to health and well-being among 4-Hers.  
• 4-H members will increase physical activity. 

2. 

• Increased healthy relationships across generations that support healthy community, nurturing behaviors, and quality time together.
• Enhanced community partnership that equitably support family health (e.g., FRISC, Health Depart., DAIL, AAA,)

3. 

Adult

• Increased availability and accessibility of evidence-based recovery capital-building programs
• Enhanced community partnerships that target recovery from substance use disorder

Youth

• Increased availability and accessibility of evidence-based prevention programs
• Enhanced community partnerships that target youth prevention

Initial Outcomes:

1. 

Adult

Health promoting behaviors include but are not to, regular physical activity, safe preparation and consumption of nutritious foods, vaccinations, moderate or no consumption of alcohol, avoiding/reducing/eliminating tobacco use, health screenings, sleep, stress management, health literacy, pest prevention/reduction/management, and occupational safety.

• Increased knowledge about health-promoting behaviors.
• Increased awareness of community resources to support health-promoting behaviors.
• Increased confidence in making decisions related to health-promoting behaviors.
• Improved skills related to health-promoting behaviors

Youth

• Increased knowledge of positive mental health practices  
• Increased knowledge and awareness of healthy habits and practices among 4-Hers.  
• Improved attitudes and beliefs towards healthy habits and practices among 4-Hers.  
• Increased knowledge of general wellness practices

2. 

Strengthening family behaviors include, but are not limited to, spending time together, creating safe environments, engaging in positive communication, building supportive networks, showing appreciation, healthy stress management, engaging in regular selfcare, and adopting a positive outlook.

• Increased knowledge about nurturing parenting and caregiving across the life span.
• Increased awareness of community resources to support healthy families.
• Increased confidence making decisions related to parenting and caregiving.
• Increased confidence and motivation to reduce loneliness and social isolation.
• Improved skills related to nurturing parenting and caregiver support
• Increased intentions to employ health-promoting behaviors (e.g., reading to your child, spending time together, self-care, caregiver preparation, active living).

3. 

Adult

Substance use prevention and recovery behaviors for adults include, but are not limited to, pro-social activity, employability, building supportive networks, healthy coping and stress management, and mental health support.

• Increased knowledge about addiction as a chronic disorder
• Increased awareness of community resources to support prevention and recovery
• Increased confidence making decision related to substance use (i.e. substance use refusal skills)
• Increased confidence and motivation to use destigmatized language
• Increased intentions to employ health-promoting behaviors (e.g., exercise, healthy nutrition, positive coping, etc.). 

Youth

Substance use prevention and recovery behaviors for youth include, but are not limited to, pro-social activity, positively relating to parents and other non-parental adults, building supportive networks, healthy coping and stress management, substance use refusal self-efficacy, and peer pressure management.

• Increased knowledge about substance use and its effects
• Increased awareness of community resources to support prevention and recovery
• Increased confidence making decisions related to substance use (i.e. substance use refusal skills)
• Increased confidence and motivation to use destigmatized language
• Increased intentions to employ health-promoting behaviors (e.g., exercise, healthy nutrition, positive coping, etc.).

Evaluation:

Adult

Outcome: Increased knowledge about health-promoting behaviors (e.g., how to prepare nutritious foods, benefits of routine vaccinations/screenings) (initial)

Indicator: Number of participants who reported/demonstrates improved knowledge, skills, opinions, or confidence regarding a health-promoting behavior as a result of a participating in a health and well-being program

Method: Observation by Agent or self-reported surveys

Timeline: Post-program/curricula survey administration 

Outcome: Increased confidence and motivation to engage in health-promoting behaviors (e.g. add physical activity, consume more nutritious foods, receive vaccination or screen) (initial)

Indicator: Number of participants who reported/demonstrates improved knowledge, skills, opinions, or confidence regarding a health-promoting behavior as a result of a participating in a health and well-being program

Method: Self-reported surveys

Timeline: Post-program/curricula survey administration or follow up evaluation

Outcome: Increased intentions to employ health-promoting behaviors (e.g. vaccinations, screenings, preparation/consumption of nutritious foods, active living, pest prevention) (initial)

Indicator: Number of participants who reported intentions to implement a behavior learned from a health and well-being program

Method: Demonstration or self-reported surveys

Timeline: Post-program/curricula survey administration

Outcome: Increased health-promoting behaviors that support family and community health (e.g., physical activity, consuming nutritious foods, routine vaccinations and screenings) (intermediate)

Indicator: 

Number of physical activity minutes recorded by a participant

Number of participants who reported consuming more nutritious foods and/or beverages

Number of participants who reported a change in a health-promoting behavior as a result of participating in a health and well-being program

Method: Self-reported surveys

Timeline: Repeated self-reported surveys and/or follow-up evaluations to capture change over time

Outcome: Short Term

Indicator: 

• Number of youth who reported that they have identified an interest in health or wellbeing initiatives in their community. 
• Number of youth who reported that they understand the importance of habits or choices that promote health and wellbeing.  
• Number of youth who reported that they learned ways to be physically active  
• Number of youth who reported that they learned how physical activity contributes to overall health 
• Number of youth who reported that they learned how food impacts their overall health. 
• Number of youth who reported that they have identified at least one job/career in health and wellbeing that fits their interest.  

Method: Standard Evaluation for 4-H Health and Wellbeing: Survey

Timeline: Immediately after program/event 

Outcome: Enhanced community partnerships that equitably support family health (e.g., FRYSC, Health Depart.,)(intermediate)

Indicator: Number of participants who reported seeking support from local community organizations and/or its individual member.

Method: Self-reported surveys

Timeline: Repeated self-reported surveys and/or follow-up evaluations to capture behavior change over time

Outcome: Increased knowledge about nurturing parenting and caregiver support across the lifespan (e.g., how often you read to your child, benefits of spending time together, identifying selfcare behaviors, enhance communication) (initial)

Indicator: Number of participants who reported increased knowledge of nurturing parenting and/or caregiver support practices.

Method: Self-reported surveys

Timeline: Post-program/curricula survey administration

Outcome: Increased awareness of community resources to support prevention and recovery (initial)

Indicator: Number of partnerships with community organizations, institutions, agencies, or individuals to address substance use/recovery in the community

Method: Program metrics agents will track, and report based on their activities and partnerships related to substance use prevention, addiction, and/or recovery)

Timeline: Post-program/curricula survey administration

Outcome: Increased intentions to employ health-promoting behaviors (e.g., exercise, healthy nutrition, positive coping, etc.). (Short-term, ST, and Intermediate, BC).

Indicator: 

Number of participants who reported that they intend to use self-care strategies to improve their recovery and/or substance refusal skills (ST)

Number of participants who used self-care strategies to improve their recovery and/or substance refusal skills.

Method: Self-reported surveys

Timeline: Post-program/curricula survey administration (ST) 

Youth

Outcome: Increased knowledge about substance use and its effects (initial)

Indicator: Number of participants who reported an increased knowledge of substance use prevention, addiction, and/or recovery (or related subject matter)

Method: Self-reported surveys

Timeline: Post-program/curricula survey administration

Learning Opportunities:

Adult

Audience: Families and Individuals

Project or Activity: Family & Community Health

Content or Curriculum: Publications, presentations, trainings, demonstrations, Health Bulletins, resources for early care and education settings, chronic disease prevention programs and materials, health fairs, hygiene education

Inputs: Programmatic materials, paid staff, volunteers, community partners, health coalitions, healthcare providers, health departments, non-profits, faith-based organizations, schools, company health & wellness, community centers, etc. 

Date: Ongoing

Audience: Families & Individuals

Project or Activity: Physical Activity

Content or Curriculum: Publications, Faithful Families, Story Walks, Health and wellness Ambassadors, Health Coalitions, Health Partners, Bingocize, County Walking Challenges, LEAP, Laugh and Learn

Inputs: Programmatic materials, paid staff, volunteers, community partners, facilities, health coalitions, healthcare providers, health department, non-profits, schools, company health & wellness, faith-based organizations, Homemakers, community centers, etc. 

Date: Ongoing/seasonal

Audience: Families & Individuals

Project or Activity: Nutrition Education

Content or Curriculum: Nutrition Education Program, SNAP-Ed toolkit, Publications, Cook Together Eat Together, Savor the Flavor,  Plate it up! Kentucky Proud,  Recovery Garden Toolkit, maternal and child health program materials, Laugh and Learn, Farmers Market

Inputs: Programmatic materials, paid staff, community partners, volunteers, faith-based organization, health coalitions, healthcare Providers and local clinics, health department, non-profits, schools, company health and wellness, Homemakers, farmers’ markets, local farms/growers/producers, commodity groups, community centers, etc. 

Date: Ongoing

Audience: Youth  

Project or Activity: Health Rocks

Content or Curriculum: 

4-H Health Rocks! Curriculum. 

Inputs: 4-H Family and Consumer Sciences programs in which youth experience a sense of belonging, and developmental relationships, explore their spark, and actively engage in meaningful opportunities.  

Accredited and certified volunteers in 4-H FCS projects. 

Four residential camping facilities.  

Cooperative Extension Educational facilities.  

Utilization of approved research-based curriculum. 

Outreach of the Cooperative Extension Land-Grant System.   

Engagement of youth and volunteers in program delivery. 

Engaging communities in identifying and implementing programming based on local needs

Date: Seasonal

Audience: Families and Individuals

Project or Activity: Kindergarten Readiness

Content or Curriculum: Laugh and Learn Playdates, Understanding Disability, Information Releases, and Publications

Inputs: Programmatic materials, paid staff, community partners, volunteers, faith-based organizations, HeadStart/daycare organizations, healthcare providers and local clinics, health department, non-profits, schools, Homemakers, community centers, etc.

Date: Ongoing

Audience: Families and Individuals

Project or Activity: Parenting Education

Content or Curriculum: Parenting A Second Time Around, Information releases and Publications, Entertaining Little Ones; Emergency Health Information Cards; Time Well Spent: Organizing Tips for Increased Productivity; In the Face of Natural Disaster Toolkit; Cook Together, Eat Together; Eating for Health; Faithful Families; Food Safety; Family Mealtime; Increasing Powerhouse Vegetables; Making Health Lifestyle Choices; Making the Most of Meals while Traveling; Maternal and Child Health; 

Inputs: Programmatic materials, paid staff, volunteers, community partners, Family Resource Youth Support Coordinators; Department of Community Based Services, health departments, non-profits, faith-based organizations, schools, company health & wellness, community centers, etc. 

Date: Ongoing

Audience: Families and Individuals

Project or Activity: Recovery Capital Building

Content or Curriculum: Healthy Choices for Your Recovering Body (HCYRB), Recovering Your Finances (RYF), Recovery Gardens, Positive Employability, Question. Persuade. Refer (QPR), Budgeting, Money Habitudes, SNAP, Plate it Up

Inputs: Programmatic materials, community partners, ASAP Boards and Community Coalitions, residential treatment centers, detention centers, healthcare providers, law enforcement, and clergy

Date: Ongoing

Audience: Families and Individuals

Project or Activity: Substance Use Prevention Programming

Content or Curriculum:  Strengthening Families, 4-H Health Rocks, Engaging People with Lived Experience (testimonies), Truth and Consequences

Inputs: Programmatic materials, paid staff, volunteers, community partners, health coalitions, schools and school staff

Date: Ongoing

Audience: Youth

Project or Activity: Food Club

Content or Curriculum: Super Start Chef, Teen Cuisine, Cupcake wars, Culinary Challenge

Inputs: Kentucky Cooperative Extension Service (CES) agents, program assistants, specialists and volunteers

Kentucky CES publications and resources

Date: Ongoing 

Evaluation:

Adult

Outcome: Increased knowledge about health-promoting behaviors (e.g., how to prepare nutritious foods, benefits of routine vaccinations/screenings) (initial)

Indicator: Number of participants who reported/demonstrates improved knowledge, skills, opinions, or confidence regarding a health-promoting behavior as a result of a participating in a health and well-being program

Method: Observation by Agent or self-reported surveys

Timeline: Post-program/curricula survey administration 

Outcome: Increased confidence and motivation to engage in health-promoting behaviors (e.g. add physical activity, consume more nutritious foods, receive vaccination or screen) (initial)

Indicator: Number of participants who reported/demonstrates improved knowledge, skills, opinions, or confidence regarding a health-promoting behavior as a result of a participating in a health and well-being program

Method: Self-reported surveys

Timeline: Post-program/curricula survey administration or follow up evaluation

Outcome: Increased intentions to employ health-promoting behaviors (e.g. vaccinations, screenings, preparation/consumption of nutritious foods, active living, pest prevention) (initial)

Indicator: Number of participants who reported intentions to implement a behavior learned from a health and well-being program

Method: Demonstration or self-reported surveys

Timeline: Post-program/curricula survey administration

Outcome: Increased health-promoting behaviors that support family and community health (e.g., physical activity, consuming nutritious foods, routine vaccinations and screenings) (intermediate)

Indicator: 

Number of physical activity minutes recorded by a participant

Number of participants who reported consuming more nutritious foods and/or beverages

Number of participants who reported a change in a health-promoting behavior as a result of participating in a health and well-being program

Method: Self-reported surveys

Timeline: Repeated self-reported surveys and/or follow-up evaluations to capture change over time

Outcome: Short Term

Indicator: 

• Number of youth who reported that they have identified an interest in health or wellbeing initiatives in their community. 
• Number of youth who reported that they understand the importance of habits or choices that promote health and wellbeing.  
• Number of youth who reported that they learned ways to be physically active  
• Number of youth who reported that they learned how physical activity contributes to overall health 
• Number of youth who reported that they learned how food impacts their overall health. 
• Number of youth who reported that they have identified at least one job/career in health and wellbeing that fits their interest.  

Method: Standard Evaluation for 4-H Health and Wellbeing: Survey

Timeline: Immediately after program/event 

Outcome: Enhanced community partnerships that equitably support family health (e.g., FRYSC, Health Depart.,)(intermediate)

Indicator: Number of participants who reported seeking support from local community organizations and/or its individual member.

Method: Self-reported surveys

Timeline: Repeated self-reported surveys and/or follow-up evaluations to capture behavior change over time

Outcome: Increased knowledge about nurturing parenting and caregiver support across the lifespan (e.g., how often you read to your child, benefits of spending time together, identifying selfcare behaviors, enhance communication) (initial)

Indicator: Number of participants who reported increased knowledge of nurturing parenting and/or caregiver support practices.

Method: Self-reported surveys

Timeline: Post-program/curricula survey administration

Outcome: Increased awareness of community resources to support prevention and recovery (initial)

Indicator: Number of partnerships with community organizations, institutions, agencies, or individuals to address substance use/recovery in the community

Method: Program metrics agents will track, and report based on their activities and partnerships related to substance use prevention, addiction, and/or recovery)

Timeline: Post-program/curricula survey administration

Outcome: Increased intentions to employ health-promoting behaviors (e.g., exercise, healthy nutrition, positive coping, etc.). (Short-term, ST, and Intermediate, BC).

Indicator: 

Number of participants who reported that they intend to use self-care strategies to improve their recovery and/or substance refusal skills (ST)

Number of participants who used self-care strategies to improve their recovery and/or substance refusal skills.

Method: Self-reported surveys

Timeline: Post-program/curricula survey administration (ST) 

Youth

Outcome: Increased knowledge about substance use and its effects (initial)

Indicator: Number of participants who reported an increased knowledge of substance use prevention, addiction, and/or recovery (or related subject matter)

Method: Self-reported surveys

Timeline: Post-program/curricula survey administration