Extension
It Starts With Us
Improve Physical and Mental Health of Youth and Adults
Empowering Youth, Individuals and Families to Succeed
Jill Harris, Lee Ann McCuiston
Health
Active Living and Health Promotions General
Nutrition and Food Systems General
Substance Use Prevention and Recovery General
With the increased trend of chronic disease and obesity in Kentucky, individuals, families, and communities need tools and environments that support healthy and active lifestyle choices. 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.
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.
The recent statewide needs assessment identified substance use prevention and recovery as the most urgent priority for Cooperative Extension. Moreover, substance use was the focal point of the CES Advisory Council Meeting in early 2019. 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.
Healthy living is one of three 4-H mission mandates. Components of Kentucky 4-H Health Core Curriculum include: physical activity, substance abuse, bullying, safety, and character education. Moderate physical activity can reduce the risk of developing heart disease, diabetes, colon cancer, stress and high blood pressure. There were 1,160 reported opioid involved deaths (a rate of 27.9 deaths per 100,000 persons) Vaping nearly doubled among Kentucky's middle and high school students — with 27% of high school seniors reporting they had tried the product in 2018. Early substance use in childhood/adolescence affects later drug use (National Healthy Living Task Force). Almost 30% of youth in the United States (or over 5.7 million) are estimated to be involved in bullying as either a bully, a target of bullying, or both (http://www.safeyouth.org/scripts/faq/bullying.asp). Suicide rates are at a record high with Kentucky ranking the 10th highest in nation.
According to the most recent data about Todd County from KentuckyHealthFacts.org, 38% of adults lack physical activity compared to 29% for the state; 32% are obese; 70% are overweight compared to 67% statewide; only 17% eat the recommended amount of fruits and vegetables; 20% smoke compared to 27% of the state; 15% suffer from loss of 6 or more teeth; 25% of adults rate their health as less than good; 9% have diabetes; 29% have high blood pressure; deaths due to heart disease and stroke are slightly higher than the state average; 48% of women have adequate prenatal care; 8% of all babies are low birth weight; 71% of children ages 19-35 month have immunization coverage; 11% of youth smoke; 15% of children under the age of 19 are uninsured (6% higher than the state average); and drug arrests are higher than the state average. The Kentucky Cancer registry reports overall deaths from cancer slightly lower than the state average, but higher rates of colorectal cancer than the state average.\
The 2014 KIP Data from Todd County Schools shows that rates of alcohol, tobacco and other drug use by youth age 12-17 are unreasonably high. In Todd County, 11% of the 8th grade students admitted to smoking cigarettes; 21% of the 10th grade students admitted to smoking tobacco; while 13% of the 12th grade students admitted to smoking cigarettes in the last 30 days. Furthermore, 24% of the 8th graders say they have drank more than a sip of alcohol, while 35% of 10th graders drank alcohol at least once or twice a month and over 38% of the 12th graders drank within 30 days. Marijuana usage falls between 11 and 13% in the 8th-12 grades. Furthermore, Kentucky ranks 13th in the nation in oxycodone use (DEC Fact Sheet, 2005).
Currently a great need for substance abuse prevention and education exists. With little entertainment or nothing recreational to do in Todd County, youth often times hang out together on the streets with minimal parental supervision and are exposed to negative peer pressures which lead to negative behavior and activities. Children and teens are also spending an increasing amount of time using computers and the internet. The Todd County 4-H Youth Development Agent will work with community partners, 4-H volunteers and leaders to improve the self-image of youth in order that they make lasting and healthy lifestyle changes to improve their overall quality of life.
Additionally, the Todd County Health Department conducted a Community Health Needs Assessment and Community Health Improvement Plan utilizing the Mobilizing for Action through Planning and Partnerships (MAPP) in 2012. The Todd County Extension Service served as a partner in the process. Using community health data, a community forum, and individual perspectives, community partners identified obesity and substance abuse as the top two priorities to work on collectively. The group also created a vision of a healthy Todd County and is working together to address those needs. The Todd County Extension Family and Consumer Sciences survey revealed that of health issues, 93% ranked diabetes prevention the most important issue, followed by teaching children how to make healthy lifestyle choices (91%), maintaining healthy weight for adults (91%), increasing physical activity (89%), reducing the risk for chronic disease (89%), and improving oral health (84%).
The goal of the Todd County Extension Service Making Healthy Lifestyle Choices Initiative is to reverse these trends by working with various organizations, agencies, and groups to improve the physical and mental health of youth and adults in Todd County.
Youth participating in 4-H clubs will increase their physical activity and therefore build muscle, decrease obesity and improve their lifestyles.
4-H youth and other Todd County youth involved in substance abuse prevention programming will:
--Improve their self-esteem and safety and have stronger, healthier bodies
--Decrease their use of alcohol, tobacco and other drug use
--Increase their safety practices when using social media
FCS
- Routinely meet physical activity recommendations that promote health and wellness (e.g. 150 minutes a week of moderate activity)
- 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)
- The prevention and/or reduction of substance use and its related consequences
- Changed public perception of substance use via stigma reduction.
Youth will:
--Demonstrate self-esteem and an improved personal image.
--Build strong relationships with peers and adult mentors through trips and activities.
--Practice effective conflict resolution and communication skills at home and at school by controlling anger and improving personal relationships.
--Seek help in cessation programs.
–Communicate more effectively and more consistently with parents about ATOD use.
-–Use proper blocking techniques when opening internet accounts.
--Parents will...build strong relationships with their children through workbook and take home exercises through the Keep a Clear Mind Program.
FCS
- 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
- 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
- Reduced stigma from local community members
- Increased Opioid Stewardship (less rx’ing by doctors, appropriate Rx disposal, drug takebacks, etc.)
Youth will:
--Learn how to like their bodies and personalities
--Learn how to say no to alcohol and other drugs and increase their safety behind the wheel
--Learn how to be tolerant of others
--Learn how to exhibit strong character
--Gain an understanding of emotions, peer pressure, parent practices, methods and regulations
--Learn how to be a good, upstanding citizen in the community
--Learn the dangers of tobacco
--Understand the dangers of internet, chat rooms, My Space and Face Book accounts
--Parents will learn how to communicate with their child on alcohol, tobacco, and drug issues
FCS
Adults and youth will:
- 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
- Increased knowledge of substance use prevention, addiction, and recovery (or related subject matter)
- Increased ability to use destigmatized language
Long-Term Outcome: 4-H youth will increase their physical activity and healthy eating habits by acquiring new and more frequent healthy lifestyle habits through the 4-H fitness, 4-H cooking club and running/walking clubs.
Indicator: Record keeping of physical fitness routines will demonstrate an increase in habits.
Method: Pre and post tests, recorded data of fitness and follow up discussion. Plus a followup survey of multiple year participants will reveal long term growth and behavior changes in physical fitness.
Timeline: End of program year or end of program for circuit training.
Intermediate Outcome: Youth will eat more fruits and vegetables and exercise more in a given week after participating in the 4-H cooking club, fitness clubs and running/walking clubs.
Indicator: A monthly food and fitness record will demonstrate the increased frequency of eating and exercising right.
Method: Pre and post tests, record keeping.
Timeline: End of program year and end of program for fitness clubs.
Initial Outcome: Youth will understand the importance of eating healthy and exercising regularly to improve their own self image and to lead a healthy lifestyle.
Indicator: Youth will gain knowledge and aspirations of eating right and becoming more physically fit.
Method: End of program surveys will assess the knowledge learned through the health and fitness lessons provided.
Timeline: End of program and program year.
Iniital Outcome: Youth will understand the importance of staying drug, alcohol and tobacco free to lead a healthy lifestyle.
Indicator: Youth will gain refusal skills to saying no to peer pressure
Method: End of program survey with 4-H teens will assess the skills learned about ATOD issues.
FCS
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: Substance Use
Indicator: Number of individuals who reported: gained knowledge of the resources that are available for substance use in the community as a result of Extension programming
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
Outcome: Increased knowledge of substance use
Indicator: Number of individuals attending programs
Method: Retroactive pre-post
Timeline: Following every addiction 101 training
Outcome: Increased ability to use destigmatized language
Indicator: Number of individuals intend to change behavior
Method: Retroactive pre-post
Timeline: Following any program that includes language training
4-H youth development agent and 4-H volunteers will provide....
--4-H Cooking Class at 4-H Camp using the foods and SPARK curriculum in July
--4-H Cooking Club (monthly) SPARK and 4-H Foods
--Migrant Summer Day Camp (June ) SPARK and 4-H Foods
--Jump rope workshop for elementary school students and middle school students.
--Work with Todd County ASAP to educate youth at risk about alcohol, tobacco and other drugs. (all year)
--Provide an alcohol drinking and driving prevention workshop at the high school for the sophomore class called Sweet 16 Auto Safety Camp in the spring.
--Work closely with the Champions Community Group to provide substance abuse prevention programming for all youth in Todd County. (all year)
--Work with the community education coordinator and Youth Service Center to administer the KEEP curriculum to 6th grade students at Todd County Middle School. (August -May)
–-Provide safety lessons on multi-media for middle school and high school youth.
--Provide a role model class for middle school youth through the 21st Century after school grant.
FCS:
Audience: Todd County Adults
Activity: Healthy Weight Classes
Content or Curriculum: Get Moving KY/Weight the Reality Series
Date: January - June
Audience: New and Expectant Mothers
Activity: Community Baby Shower
Content or Curriculum: Family and Consumer Sciences
Date: September
Audience: School Age Children
Activity: Nutrition Programs at Schools
Content or Curriculum: LEAP, Yummy Curriculum, Organwise
Date: Fall, Spring
Audience: Todd County Adults
Activity: Physical Activity
Content or Curriculum: Fit Blue
Date: Fall
Audience: Elementary School Children
Activity: My Plate and other nutrition lessons
Content or Curriculum: UK FCS, My Plate, Organwise
Inputs: FCS Agent, School System, Community Partners
Date: School Year
Audience: Communities
Project or Activity: Policy, Systems, and Environmental Approaches
Content or Curriculum: Health Coalitions, Trail Development, resources for early care and education settings
Inputs: Volunteers, grant funds, faith-based organizations, community partners, key stakeholders, elected officials, Health Coalitions, Employee Health and Wellness, SNAP-Ed Toolkit
Date: Ongoing projects throughout the year
Audience: Families and Individuals
Project or Activity: Chronic Disease Prevention
Content or Curriculum: Publications, Health Bulletins, Cook Together Eat Together, Mastering Food Choices, Dining with Diabetes, Fit Blue, Faithful Families, Body Balance, Plate It Up! Kentucky Proud Resources, WIN, Kick Kentucky Cancer, Health Partners, Bingocize, Master Health Volunteer, Keys to Embracing Aging
Inputs: Programmatic materials, paid staff, community partners, faith-based organizations, health coalitions, Healthcare Providers, Health Department, Non-profits, Schools, Company Health & Wellness, Homemakers, Community Centers, etc.
Date: Ongoing projects throughout the year
Audience: Families and Individuals
Project or Activity: Physical Activity
Content or Curriculum: Publications, Faithful Families, Story Walk, Master Health Volunteer, Shared Space Agreements, Health Coalitions, Be More, Fit Blue, WIN, Health Partners, Bingocize, 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: Fixing Funky Foods
Content or Curriculum: FCS
Inputs: FCS Agents, Volunteers
Date: September 2020
Audience: Families and Individuals
Project or Activity: Food Preparation for Better Health
Content or Curriculum: Cook Together Eat Together, Mastering Food Choices, Dining with Diabetes, Super Star Chef, Champion Food Volunteer, Faithful Families, Body Balance, Plate It Up! Kentucky Proud Resources, plans for prenatal- and infant/toddler-specific curriculum, resources for early care and education settings
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, Champion Food Volunteers
Inputs: Paid staff, volunteers, facilities, programmatic materials, NEP
Date: July – September for adults and youth
Audience: Extension Homemakers
Project or Activity: Addiction 101 Leader Training
Content or Curriculum: Addiction 101
Inputs: Paid staff, extension homemakers
Date: 2021
Audience: Extension Homemakers
Project or Activity: Nutrition Misinformation
Content or Curriculum: FCS
Inputs: FCS Agents, volunteers
Date: March 2021
Audience: Extension Homemakers
Project or Activity: Deceptively Delicious
Content or Curriculum: FCS
Inputs: FCS Agents, volunteers
Date: April 2021
Audience: Extension Homemakers
Project or Activity: Decorating Cookies
Content or Curriculum: FCS
Inputs: FCS Agents, adults, youth
Date: June 2021
Author: Jill Harris
Major Program: Nutrition and Food Systems General
After the death of a spouse, eating can become a chore. Many people do not have an appetite; others do not want to cook for one person; and others overlook their own physical well-being in the midst of grief and loneliness. However, those who are alone should make good nutrition and health a priority in order to properly fuel their body. Protein is important to keep muscles stronger and reduce the risk of falling; grains provide fiber for gut health and helping lower cholestero
Author: Jill Harris
Major Program: Active Living and Health Promotions General
Research is starting to demonstrate that practicing mindfulness can bring improvements in both physical and psychological symptoms as well as positive changes in health, attitudes, and behaviors.In response to these findings, the Todd County Extension Agent for Family & Consumer Sciences taught the workshop Mindfulness & Meditation for the Todd County Extension Homemaker Association in November, 2019. Emphasis was placed on understanding the different types of mindfulness practices,
Author: Jill Harris
Major Program: Nutrition and Food Systems General
Early during the pandemic, many people found their grocery stores temporarily out of certain food products. People were also concerned about contracting Covid-19 and tried to minimize trips to grocery store. As a result, they stocked up on groceries for their pantries, refrigerator, and freezer. A well-stocked pantry has benefits aside from emergency preparedness: It can increase the likelihood to cook, decrease the amount of prep time, reduce the need to use a recipe, sa
Author: Jill Harris
Major Program: Active Living and Health Promotions General
Low levels of physical activity, unhealthy nutrition, and poor mental health are all determinants of several chronic diseases. These behaviors are now considered major public health concerns and require effective behavior change interventions. Fit Blue is a community-based campaign to increase physical activity and health awareness in the Commonwealth of Kentucky. Building physical activity into the day does not require special equipment or a certain location. As participants take part in Fit Bl
Author: Lee Ann McCuiston
Major Program: Family and Consumer Science
Mental health, already a pressing issue for young people, has become an acute concern for millions in 2020. One in five people in households with children (21%) have reported feeling down, depressed or hopeless in the previous week. Realizing the need for improved resiliency in youth, the Todd County 4-H program provided a mindfulness training to 26 youth during the summer migrant program in a day camp setting. Youth learned how to categorize their stressors into things they cannot c
