Strengthening Health and Well Being Plan of Work
Breckinridge County CES
County Emphasis:
Strengthening Health and Well Being
Concentration 1:
Health and Wellbeing
Concentration 2:
Substance Use Prevention and Recovery
Concentration 3:
Work and Life Skill Development
Concentration 4:
Family and Youth Development
Situation:
Within the top 15 priority issues identified by Kentuckians in the 2023 UK Cooperative Extension Community Assessment, “ensuring individuals and families have access to affordable nutritious foods” was #4 and “reducing youth obesity through nutrition education and/or exercise” was #8. Also, it was reported that substance use prevention is the primary concern among most Kentucky counties. 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.
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. 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 and youth health and well-being.
Youth Focus
Thriving youth are healthy, productive, and engaged (Arnold, 2024). According to Kentucky Kids Count Database (AECF, 2023) 41% of Kentucky teenagers are obese or overweight. Youth are also experiencing alarming levels of negativity about themselves, their confidence in the future, and their ability to find contentment in life (McKinsey & Company, 2022). 30% of youth are chronically absent (United States Department of Education, 2024). The University of Kentucky Cooperative Extension Service Needs Assessment (2024) identified key priorities issues related to health and wellbeing as need for improved access to mental health and wellbeing resources, reducing youth obesity through nutrition education and/or exercise, minimizing bullying and/or school violence. To address these issues, Kentucky 4-H creates opportunities for youth in the five domains of physical, emotional, social, spiritual, and intellectual health and well-being.
County Situation:
Based upon the US Census Bureau, over 75% of Breckinridge County’s population lives in the rural countryside and food access is limited with only three grocery stores, two in Hardinsburg and 1 in Irvington, offering fresh produce and meats. Convenience stores provide the closest opportunity to purchase food for many families, of which 1,243 households receive SNAP benefits. Specifically, 2,697 individuals receive SNAP (food stamps) and 2,800 individuals are food insecure in Breckinridge County.
Thirty-nine percent of Breckinridge County adults are considered obese. With 11.2% diagnosed with diabetes. The limited accessibility of healthy food, limited resources and built environments that promote physical inactivity are largely responsible for the obesity epidemic.
In Breckinridge County, the number of overdoses in 5 years (2018-2022) totaled 275 cases with 21 being fatal. Recovery support is limited with only 2 residential facilities and a small number of day programs. Additionally, stress on families and farm life is at an all-time high, leading to mental health disease. Talking about stress is not a popular topic, therefore a constant simple reminder is needed to help improve mental health. In addition, 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).
Locally, Extension staff and volunteers will build partnerships to facilitate and present research-based programming to support healthy food consumption, physical activity, substance prevention and recovery assets to improve health and well-being for youth and adults.
Long-Term Outcomes:
Improved quality of life
Increased recovery capital
Decrease in farm and home accidents
Increase awareness of farm life stress
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.
Intermediate Outcomes:
Increased and/or strengthened partnerships to address community health or safety issues
Enhanced community partnerships that target recovery from substance use disorder
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.
Initial Outcomes:
Increased knowledge about health-promoting behaviors.
Improved skills related to health-promoting behaviors
Increased awareness of community resources to support prevention and recovery
Increased intentions to employ health-promoting behaviors (e.g., exercise, healthy nutrition, positive coping, etc.).
Increase awareness of farm and home hazards
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
Evaluation:
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: 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 (ST) and follow-up survey (BC).
Outcome: Increased awareness of farm
Indicator: Reports of accidents decrease
Method: Survey information from hospital and health departments
Timeline: Survey over a few years.
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: Medium Term
Indicator:
Number of youth who reported that they have used knowledge and/or skills learned in health and wellbeing programs to complete a project.
Number of youth who reported that they have used nutrition as a way to improve their overall health.
Number of youth who reported that they have taken steps to pursue gaining more knowledge for a job in health and wellbeing based on their interests.
Method: Standard Evaluation for 4-H Health and Wellbeing: Survey
Timeline: End of Club/Program Year
Outcome: Long Term
Indicator: Long-term evaluation will be conducted using the National 4-H Index Study
Method: Standard Evaluation for 4-H Health and Wellbeing: Survey
Timeline: 1 or more years
Learning Opportunities:
Audience: Families & Individuals
Project or Activity: Nutrition Education
Content or Curriculum: Nutrition Education Program, SNAP-Ed toolkit, Publications, Faithful Families, Cook Together Eat Together, Savor the Flavor, Dining with Diabetes, Plate it up! Kentucky Proud, Cook Wild Ky, Food as Health Toolkit, Recovery Garden Toolkit, Family Mealtime, maternal and child health program materials,
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: Families & Individuals
Project or Activity: Physical Activity
Content or Curriculum: Publications, Faithful Families, Story Walks, Health and wellness Ambassadors, Shared Space Agreements, Health Coalitions, WIN, Health Partners, Bingocize, Walk Your Way, Families on the Move, County Walking Challenges, Mindfulness Trails, Fit Tips, Hiking for Health
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 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), Mind Art Recovery Kentucky
Inputs: Programmatic materials, community partners, ASAP Boards and Community Coalitions, residential treatment centers, detention centers, healthcare providers, law enforcement, and clergy
Date: Ongoing
Audience: 4th Grade students
Project or Activity: Farm and Home Safety Days
Content or Curriculum: Progressive Ag Foundation Farm Safety Days
Inputs: Local volunteers and businesses to teach the classes.
Date: Fall
Audience: Farmers and families
Project or Activity: Conduct Health Screening
Content or Curriculum: Work with farmers on healthy eating stress related issues
Inputs: Local hospital, Health Department
Date: Fall
Audience: Youth
Project or Activity: Health Rocks
Content or Curriculum: 4-H Health Rocks! Curriculum.
Additional resources include Healthy Bodies: Teaching Kids What They Need to Know
Substance Abuse
Mental Health Services Administration.
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.
Kentucky Extension Homemakers Association
Four residential camping facilities.
Cooperative Extension Educational facilities.
Utilization of approved research-based curriculum.
Outreach of the Cooperative Extension Land-Grant System.
Funding from the Kentucky 4-H Foundation, Inc.
Funding from local, state, and federal sources.
Engagement of youth and volunteers in program delivery.
Engaging communities in identifying and implementing programming based on local needs
Date: September 1 – August 30
Audience: Youth
Project or Activity: Nutrition and Food Preparation
Content or Curriculum: Wellness in Kentucky
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.
Kentucky Extension Homemakers Association
Four residential camping facilities.
Cooperative Extension Educational facilities.
Utilization of approved research-based curriculum.
Outreach of the Cooperative Extension Land-Grant System.
Funding from the Kentucky 4-H Foundation, Inc.
Funding from local, state, and federal sources.
Engagement of youth and volunteers in program delivery.
Engaging communities in identifying and implementing programming based on local needs
Date: September 1 – August 30
Evaluation:
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: 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 (ST) and follow-up survey (BC).
Outcome: Increased awareness of farm
Indicator: Reports of accidents decrease
Method: Survey information from hospital and health departments
Timeline: Survey over a few years.
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: Medium Term
Indicator:
Number of youth who reported that they have used knowledge and/or skills learned in health and wellbeing programs to complete a project.
Number of youth who reported that they have used nutrition as a way to improve their overall health.
Number of youth who reported that they have taken steps to pursue gaining more knowledge for a job in health and wellbeing based on their interests.
Method: Standard Evaluation for 4-H Health and Wellbeing: Survey
Timeline: End of Club/Program Year
Outcome: Long Term
Indicator: Long-term evaluation will be conducted using the National 4-H Index Study
Method: Standard Evaluation for 4-H Health and Wellbeing: Survey
Timeline: 1 or more years
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