Lewis County CES

County Emphasis:

Community Nutrition and Health

Concentration 1:

Food Safety, Quality, and Access

Concentration 2:

Health and Wellbeing

Situation:

Adult

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.

Adult

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.

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:

Respondents to the 2023 Extension Community Assessment hold the issue of Community Health and Nutrition as a top priority in Lewis County. Ensuring individuals and families have access to affordable nutritious food, improved access to mental health and wellbeing resources, safe, accessible community places for outdoor physical activity, coping strategies to support youth wellbeing, reducing youth obesity through nutrition education and/or exercise, and food as health are some prevalent responses in the Extension Community Assessment for Lewis County. Respondents also commented on practical education and support on topics related to hunger and food insecurity; food banks and pantries; nutrition education and access to healthy food; education on growing, preserving, and canning food; a need for youth development programs including recreation and physical activities; and  programs and advocacy to promote holistic health, healthy choices, and healthy lifestyle advocacy. The County Extension Agents worked with the Lewis County Extension Council to brainstorm ideas for future programming and ways to improve existing programming related to these issues.

Long-Term Outcomes:

Adult

• Individuals and families of all incomes levels have access to affordable and nutritious foods
• Family farms become economically viable.
• Kentucky’s local food and agriculture industry are thriving.
• Decrease in the number of Kentuckians with chronic health conditions such as diabetes, obesity and cardiovascular disease.
• More Kentuckians routinely met the guidelines for the consumption of (locally-grown) fresh fruits and vegetables.

Youth

• Youth report reduced risk for poor health, developmental delays, obesity, and malnutrition.    
• Youth increase educational outcomes.  
• Youth decrease poor overall health. 

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.

Intermediate Outcomes:

Adult

• Increase and/or strengthen statewide and regional partnership to address community food system issues.
• Increased production of Kentucky-grown food and increased market opportunities for those products.
• Increase in the number of farmers’ markets and local food retailers that accept one or more food benefits as payment.
• Improved dietary habits through: consumption of more fruits and vegetables, a variety of proteins and the number of meals prepared at home.
• Increased number of entrepreneurial food businesses.

Youth

• Youth will practice making wise nutrition choices.  
• Youth will practice food safety.  
• Youth will access nutritious foods.  
• Youth will prepare nutritious foods.  
• Youth will eat a variety of healthy foods daily. 

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. 

Initial Outcomes:

Adult

• Increased awareness of and use of Food Connection Programs: Value Chain Coordinators, TFC Learning Kitchen, and Cultivate KY resources.
• Increased awareness of Extension resources and programs supporting food access.
• Improved skills related to safe food preparation and food preservation.
• Increased participation in Homebased Microprocessing workshops.
• Increased awareness and accessibility of community resources available to access fresh foods.
• Increase the number of partnerships and/or coalitions involved in promoting awareness of local food systems, healthy eating, and active living (e.g. Program councils, Health Advisory Boards, etc.).

Youth

• Youth will learn how to make wise nutrition choices.  
• Youth will learn the importance of food safety.  
• Youth learn how to access nutritious foods.  
• Youth will learn how to prepare nutritious foods.  
• Youth will aspire to eat a variety of healthy foods daily.

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

Evaluation:

ADULT

Outcome: Increased awareness and accessibility of Extension resources and programs supporting food access. (initial)

Indicator: 

• Number of individuals reporting an increased awareness of how to find and prepare local food including responsible hunting/fishing/foraging. 
• Number of policy, systems, and/or environmental changes implemented within communities and organizations to promote active living, and healthy eating, including local food production and/or hunting/foraging and consumption (e.g. local food pantry can accept fresh foods or local game; starting/revitalizing a school or community garden; starting a walking club, etc.). 
• Number of individuals who reported increasing their knowledge, skills, or intentions regarding nutrition and accessing healthy foods through Extension programs and resources. 
• Number of individuals who were introduced to healthy food access points (e.g. farmers’ markets, CSAs, WIC, food pantries) through Extension programs or resources.  

Method: Pre/post participant evaluations from: NEP agent-led curricula, Food Preservation, Champion Food Volunter Leader Training; the Learning Kitchen Participant follow-up eval. TBD; # of certified Champion Food Volunteers in each county;

Timeline: Post-program/curricula survey administration; annual fiscal year (food system impact survey)

Outcome: Improved skills related to safe food preparation and food preservation. (initial)

Indicator: 

• Number of individuals who reported increasing their knowledge, skills, or intentions regarding the safe storage, handling, preparation and/or preservation of food through Extension programs and resources.  
• Number of individuals who reported supplementing their diets with healthy foods that they grew, harvested, or preserved (e.g. community or backyard gardens, fishing, hunting). 

Method: Pre/post participant evaluations from: NEP agent-led curricula, Champion Food Volunteer, Food Preservation;

Timeline: Post-program/curricula survey administration; annual fiscal year (food system impact survey)

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

Youth

Outcome: Short Term  

Indicator: 

• Number of youth who reported that they learned the difference between healthy and unhealthy snacks. 
• Number of youth who reported that they learned about safe food handling and preparation.  
• Number of youth who reported that they learned about kitchen safety.  
• Number of youth who reported that they have identified an interest in Family Consumer Sciences. 
• Number of youth who reported an increased knowledge of egg and/or poultry food safety practices.
• Number of youth who demonstrated/reported improved egg and/or poultry cooking skills.

Method: Evaluation Provided by Animal Food Sciences Department

Timeline: Immediate Post Program

Outcome: Medium Term  

Indicator: 

• Number of youth who reported that they applied skills and/or knowledge to prepare healthy snacks for self or family.  
• Number of youth who reported that they practiced safe food handling and preparation.  
• Number of youth who reported that they practiced kitchen safety. 
• Number of youth who reported that they have used the skills   and/or knowledge gained to complete a Family Consumer Sciences Project. 

Method: Standard Evaluation Tool for Family Consumer Sciences: Survey

Timeline: End of the program year

Outcome: Long Term

Indicator: Long-term evaluation will be conducted using the National 4-H Index Study. 

Method: Standard Evaluation Tool for Family Consumer Sciences: Survey 

Timeline: 1 or more 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: Communities

Project or Activity: Farmers’ Market Toolkit

Content or Curriculum: Farmers’ Market Toolkit

Inputs: Programmatic materials, paid staff, volunteers, community partners, facilities, health department, non-profits, schools, faith-based organizations, Homemakers, community centers, farmers, farmers’ markets, etc.

Dates: Ongoing

 

Audience: Individuals & Farmers

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, Food as Health Toolkit, Family Mealtime, maternal and child health program materials, www.planeatmove.com, Super Star Chef, Farm to School, Hunger in Kentucky

Inputs: Programmatic materials, paid staff, community partners, volunteers, faith-based organizations, health coalitions, healthcare Providers and local clinics, health department, non-profits, schools, company health & wellness, 4-H, Homemakers, farmers’ markets, local farmers/growers/producers, commodity groups, community centers, etc. 

Dates: Ongoing

 

Audience: Youth  

Project or Activity: Nutrition and Food Preparation

Content or Curriculum: Exploring My Plate  

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

Dates: September 1 – August 30 

Audience: Youth  

Project or Activity: Nutrition and Food Preparation

Content or Curriculum: What’s On Your Plate 

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

Dates: September 1 – August 30 

Adult

Audience: Families and Individuals

Project or Activity: Family & Community Health

Content or Curriculum: Publications, presentations, trainings, demonstrations, Health Bulletins, Pathways to Wellness, resources for early care and education settings, Health Literacy for the Win, Health Family Guides, Healthy Homemakers, Vaccine and on-site clinic opportunities, 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, 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

Evaluation:

ADULT

Outcome: Increased awareness and accessibility of Extension resources and programs supporting food access. (initial)

Indicator: 

• Number of individuals reporting an increased awareness of how to find and prepare local food including responsible hunting/fishing/foraging. 
• Number of policy, systems, and/or environmental changes implemented within communities and organizations to promote active living, and healthy eating, including local food production and/or hunting/foraging and consumption (e.g. local food pantry can accept fresh foods or local game; starting/revitalizing a school or community garden; starting a walking club, etc.). 
• Number of individuals who reported increasing their knowledge, skills, or intentions regarding nutrition and accessing healthy foods through Extension programs and resources. 
• Number of individuals who were introduced to healthy food access points (e.g. farmers’ markets, CSAs, WIC, food pantries) through Extension programs or resources.  

Method: Pre/post participant evaluations from: NEP agent-led curricula, Food Preservation, Champion Food Volunter Leader Training; the Learning Kitchen Participant follow-up eval. TBD; # of certified Champion Food Volunteers in each county;

Timeline: Post-program/curricula survey administration; annual fiscal year (food system impact survey)

Outcome: Improved skills related to safe food preparation and food preservation. (initial)

Indicator: 

• Number of individuals who reported increasing their knowledge, skills, or intentions regarding the safe storage, handling, preparation and/or preservation of food through Extension programs and resources.  
• Number of individuals who reported supplementing their diets with healthy foods that they grew, harvested, or preserved (e.g. community or backyard gardens, fishing, hunting). 

Method: Pre/post participant evaluations from: NEP agent-led curricula, Champion Food Volunteer, Food Preservation;

Timeline: Post-program/curricula survey administration; annual fiscal year (food system impact survey)

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

Youth

Outcome: Short Term  

Indicator: 

• Number of youth who reported that they learned the difference between healthy and unhealthy snacks. 
• Number of youth who reported that they learned about safe food handling and preparation.  
• Number of youth who reported that they learned about kitchen safety.  
• Number of youth who reported that they have identified an interest in Family Consumer Sciences. 
• Number of youth who reported an increased knowledge of egg and/or poultry food safety practices.
• Number of youth who demonstrated/reported improved egg and/or poultry cooking skills.

Method: Evaluation Provided by Animal Food Sciences Department

Timeline: Immediate Post Program

Outcome: Medium Term  

Indicator: 

• Number of youth who reported that they applied skills and/or knowledge to prepare healthy snacks for self or family.  
• Number of youth who reported that they practiced safe food handling and preparation.  
• Number of youth who reported that they practiced kitchen safety. 
• Number of youth who reported that they have used the skills   and/or knowledge gained to complete a Family Consumer Sciences Project. 

Method: Standard Evaluation Tool for Family Consumer Sciences: Survey

Timeline: End of the program year

Outcome: Long Term

Indicator: Long-term evaluation will be conducted using the National 4-H Index Study. 

Method: Standard Evaluation Tool for Family Consumer Sciences: Survey 

Timeline: 1 or more 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