Marion County CES

County Emphasis:

Substance Use Prevention and Recovery

Concentration 1:

Substance Use Prevention and Recovery

Concentration 2:

Mental Health and Well-Being

Situation:

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.

More than ever before, people are feeling the burden of stress on their wellbeing. More than 1 in 5 adults in the United States lives with a mental illness; in Kentucky, 43% of adults report signs or symptoms of anxiety or depression across their lifespan. At the same time, suicide is a leading cause of preventable death in Kentucky for individuals aged 10-34, and those over the age of 59.

Concern over the state of mental health and access to care was echoed in the Cooperative Extension Community Needs Assessment, where respondents listed “improved access to mental health and wellbeing resources” as one of the top 6 priority issues. Kentuckians are aware of their need for knowledge and skills to recognize and respond to a mental health challenge, whether it be their own or to help someone else, and the ability to advocate for more mental health resources in all areas of the state.

Cooperative Extension is poised with the research and evidence-based resources needed to serve as a beacon of hope in times of distress through our ability to help overcome stigma, connect people to care, and amplify the voices of many to advocate for better quality of life for all.

Youth Focus

Kentucky’s youth population deserves safe and nurturing environments that foster their growth and wellbeing. Unfortunately, mental health challenges affect a significant portion of our youth, with 17% of those aged 6-17 experiencing mental health disorders, according to the National Alliance on Mental Illness (2023), and only 50% receiving treatment. The impact is profound, with one person in the U.S. dying by suicide every 11 minutes, and in Kentucky alone, 800 lives were lost to suicide in 2022. Recognizing the urgency, the Kentucky Cooperative Extension Service’s 2019 and 2023 statewide programming issue surveys highlighted mental health and wellbeing as priority areas. Nationally, 45% of 4-H participants reported high stress in a 2023 survey by 4-H.org. The University of Kentucky Community Needs Assessment (2023) indicates priorities of improve access to mentalhealth and wellbeing resources, minimizing bullying and/or school violence, stronger parenting and relationship-building skills, and social, emotional, and/or behavioral education for adults working with youth. To address these concerns, the 4-H Program provides evidence-based educational programs focused on positive mental health and self-care, aiming to empower youth with decision-making and critical thinking skills, fostering resilience and overall wellbeing. By emphasizing mental health and offering targeted educational initiatives, we can create a brighter future for Kentucky’s youth.

County Situation:

All councils are supportive of mental health and substance abuse awareness programs. From the Community Assessment Survey results, mental health and substance abuse was one of the highest priorities of focus for our county.

Long-Term Outcomes:

Reduced adult substance use

Reduced adult substance use disorder

Reduced stigma related to adult substance use

Reduced youth substance use

Reduced incidence of mental health crises and suicide

Increased access to mental health care and resources for all

Increased use of de-stigmatized language

Increased use of self-care and other coping strategies

Increased advocacy for mental health and wellbeing resources

Increased partnerships (number or strength) to address mental health and wellbeing issues within the community

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

Kentucky 4-H members report a reduced number of youth that are considering suicide.  

Increased number of 4-Hers who pursue mental health & well-being employment.  

Youth will increase contributions to their communities through applying critical thinking, problem-solving, and effective communication learning in 4-H Health and Well Being.

Intermediate Outcomes:

Enhanced community partnerships that target recovery from substance use disorder

Enhanced community partnerships that target youth prevention

Increased availability and accessibility of evidence-based prevention programs

Enhanced community partnerships that target youth prevention

4-H members will practice general wellness habits.    

Increased self-reflection and exploration of personal values and beliefs related to mental health and wellbeing among 4-Hers.

Initial Outcomes:

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.).

Increased ability to recognize and respond to a mental health concern

Increased ability to use de-stigmatized language

Increased knowledge of self-care and other coping strategies

Increased knowledge of mental health and well-being resources (interpersonal and community-based)

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.).

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 knowledge about addiction as a chronic disorder (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

Intermediate Outcome:

Outcome: Increased knowledge of mental health and well-being resources (interpersonal and community-based)

Indicator: Number of participants who intend to adopt strategies to support or promote mental health and well-being in their community

Method: Post-participation survey/evaluation results

Timeline: On-going; Surveys should be administered immediately after a program

Outcome: Increased advocacy for mental health and wellbeing resources

Indicator: Number of participants who adopted strategies to support or promote mental health and well-being in their community.

Method: Follow-up survey/evaluation results

Timeline: On-going; Surveys should be administered at least 3-6 months after a program

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

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 confidence making decisions related to substance use (i.e. substance use refusal skills) (Short-term, ST, and Intermediate, BC).

Indicator: 

Number of participants who reported intended behavior change as a result of participation in substance use prevention and/or recovery programming.

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

Method: Self-reported surveys

Timeline: Post-program/curricula survey administration

Outcome: Increased confidence and motivation to use destigmatized language (intermediate)

Indicator: Number of participants who reported an increased ability to use destigmatized language

Method: Self-reported surveys

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

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) and follow-up survey (BC)

Outcome: Short Term 

Indicator: 

Number of partnerships with community organizations, institutions, agencies, or individuals to address mental health and wellbeing for youth in the community.

Number of youth who reported an increased knowledge of how to respond to mental health concerns.

Number of youth who intend to adopt self-care strategies to improve their own mental health and wellbeing.

Number of youth who intend to adopt strategies to support or promote mental health and wellbeing in their community.

Number of youth who reported intended behavior change as a result of participation in mental health and wellbeing programming.

Method: Survey 

Timeline: Immediately post-program

Outcome: Medium Term 

Indicator: 

Number of youth who adopted self-care strategies to improve their own mental health and wellbeing.

Number of youth who adopted strategies to support or promote mental health and wellbeing in their community.

Number of youth who reported behavior change as a result of participation in mental health and wellbeing programming.

Method: Survey 

Timeline: 3-6 Months post-program 

Outcome: Long Term 

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

Method: Survey or Interview 

Timeline: 1+ years 

Learning Opportunities:

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: Families and Individuals

Project or Activity: Addiction Education

Content or Curriculum: Publications, Addiction 101, Harm Reduction 101

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

Date: Ongoing

Audience: Families and Individuals

Project or Activity: Mental Health Education Programming

Content or Curriculum: Adult Mental Health First Aid, QPR (Question, Persuade, Refer), CODE RED, ACT (Awareness, Communication, and Triage and Treat) for Farm Families, Understanding and Coping with Trauma after Natural Disasters, After the Storm, Blue to You  

Inputs: Programmatic materials, state specialist support, staff training, facilities, community partners (health coalitions, schools, local non-profits, etc.) UK Healthcare mental health resources, 988 community resources.

Date: Ongoing; 2025-2029

Audience: Families and Individuals

Project or Activity: Promoting Well-being

Content or Curriculum: MARK (Mind, Art, Recovery, Kentucky), Take a Beat: Healing Hearts and Minds, Handling Farm Stress: A Workshop for New and Beginning Farmers, Mindfulness Trails, Yoga-ta Try This (KEHA lesson), Self-care programming, Mindfulness programming, Recovery Gardens, Mental Health and Wellbeing Series, The Mind-Body Connection

Inputs: Programmatic materials, state specialist support, staff training, facilities, community partners (health coalitions, schools, local non-profits, etc.) UK Healthcare mental health resources, 988 community resources.

Date: Ongoing; 2025-2029

Audience: Families and Individuals

Project or Activity: Substance Use Prevention Programming

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

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

Date: Ongoing

 

Audience: Families and Individuals

Project or Activity: Positive Youth Development

Content or Curriculum: Health Rocks, Positive Employability,  Mindful Mechanics, Get Experience in Mindfulness (GEM), Social/Emotional Health-Focused Programming

Inputs: Programmatic materials, paid staff, volunteers, community partners, faith-based organizations, health coalitions, schools and school staff

Date: Ongoing

 

Audience: Communities

Project or Activity: Community-Based Substance Use Prevention

Content or Curriculum: Substance Use Prevention Education (i.e. Addiction 101, Ad Hoc Webinars, etc.), Engaging People with Lived Experience (testimonies), Strengthening Families

Inputs: Programmatic materials, paid staff, volunteers, community partners, elected officials, faith-based organizations, health coalitions, and faith-based organizations

Date: Ongoing

Audience: 4-Hers, Extension Professionals, Clientele

Project or Activity: Behavioral Health Fellowship

Content or Curriculum: Curriculum is sourced from the University of Kentucky College of Social Work’s master of social work program. All curriculum pieces focus on social work practices that include mental health, communication, and community engagement.

Inputs: These programs are supported by the research base of the Martin-Gatton of Agriculture, Food, and Environment, Cooperative Extension, and College of Social Work, funding is provided by the College of Social Work and Cooperative Extension, state and federal sources, and the engagement of volunteers, youth, communities, and students. 

Date: Academic Year

Audience: 4-Hers, Extension Professionals, Clientele 

Project or Activity: Community, Access & Engagement Programs

Content or Curriculum: 4-H LIFE utilizes the curriculum Essential Elements which is sourced from Shop 4-H. Additional curriculum and content is sourced from Shop 4-H and other Land Grant Systems. Content for Adelante 4-H has been developed by the Land Grant System and sourced from other Land Grant systems. Content for Jr. MANRRS is sourced from the MANRRS society. All curriculum and content focuses on building community, as well as increasing access and engagement of youth. 

Inputs: These programs are supported by the research base of the Cooperative Extension Land Grant System, funding from the Kentucky 4-H Foundation, Inc., local, state, and federal sources, grants and the engagement of volunteers, youth, communities, and external stakeholders such as civic groups. 

Date: Program Year

Audience: 4-Hers, Extension Professionals, Clientele

Project or Activity: 4-H State Task Forces 

Content or Curriculum: Curriculum is sourced from Shop 4-H and the Land Grant System, focuses on health and wellbeing. Additional resources include Healthy Bodies: Teaching Kids What They Need to Know, Mental Health First Aid, National Alliance on Mental Illness, and Youth Strong: Helping Youth and Families in Times of Disaster and Stress 

Inputs: These programs are supported by the research base of the Cooperative Extension Land-grant system, funding from the Kentucky 4-H Foundation, Inc., local, state, and federal sources, grants, and the engagement of volunteers, youth, communities, and external stakeholders such as civic groups.

Date: Program Year

Audience: 4-Hers, Extension Professionals, Clientele

Project or Activity: Youth Strong: Helping Youth and Families in Times of Disaster and Stress (Club/Group/Individual) 

Content or Curriculum: Youth Strong: Helping Youth and Families in Times of Disaster and Stress Guidebook. Additional resources include Healthy Bodies: Teaching Kids What They Need to Know, Mental Health First Aid, and National Alliance on Mental Illness.

Inputs: These programs are supported by the research base of the Cooperative Extension Land-grant system, funding from the Kentucky 4-H Foundation, Inc., local, state, and federal sources, grants, and the engagement of volunteers, youth, communities, and external stakeholders such as civic groups. Focus is on Youth who have experienced traumatic experiences or disasters.

Date: Program Year

Audience: 4-Hers, Extension Professionals, Clientele

Project or Activity: Your Feelings Matter (Club/Group/Individual)

Content or Curriculum: Your Feelings Matter Curriculum. Additional resources include Healthy Bodies: Teaching Kids What They Need to Know, Mental Health First Aid, and National Alliance on Mental Illness.

Inputs: These programs are supported by the research base of the Cooperative Extension Land-grant system, funding from the Kentucky 4-H Foundation, Inc., local, state, and federal sources, grants, and the engagement of volunteers, youth, communities, and external stakeholders such as civic groups. Focus is on Grades 4-8. 

Date: Program Year 

Audience: 4-Hers, Extension Professionals, Clientele 

Project or Activity: Your Thoughts Matter (Club/Group/Individual) 

Content or Curriculum: Your Thoughts Matter Curriculum. Additional resources include Healthy Bodies: Teaching Kids What They Need to Know, Mental Health First Aid, and National Alliance on Mental Illness

Inputs: These programs are supported by the research base of the Cooperative Extension Land-grant system, funding from the Kentucky 4-H Foundation, Inc., local, state, and federal sources, grants, and the engagement of volunteers, youth, communities, and external stakeholders such as civic groups. Focus is on Grades 7-12. 

Date: Program Year

Audience: 4-Hers, Extension Professionals, Clientele

Project or Activity: Mental Health First Aid 

Content or Curriculum: Mental Health First Aid (Youth). Additional resources include Healthy Bodies: Teaching Kids What They Need to Know, and National Alliance on Mental Illness

Inputs: These programs are supported by the research base of the Cooperative Extension Land-grant system, funding from the Kentucky 4-H Foundation, Inc., local, state, and federal sources, grants, and the engagement of volunteers, youth, communities, and external stakeholders such as civic groups. Focus is on Adults working with youth. 

Date: Program Year 

Evaluation:

Outcome: Increased knowledge about addiction as a chronic disorder (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

Intermediate Outcome:

Outcome: Increased knowledge of mental health and well-being resources (interpersonal and community-based)

Indicator: Number of participants who intend to adopt strategies to support or promote mental health and well-being in their community

Method: Post-participation survey/evaluation results

Timeline: On-going; Surveys should be administered immediately after a program

Outcome: Increased advocacy for mental health and wellbeing resources

Indicator: Number of participants who adopted strategies to support or promote mental health and well-being in their community.

Method: Follow-up survey/evaluation results

Timeline: On-going; Surveys should be administered at least 3-6 months after a program

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

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 confidence making decisions related to substance use (i.e. substance use refusal skills) (Short-term, ST, and Intermediate, BC).

Indicator: 

Number of participants who reported intended behavior change as a result of participation in substance use prevention and/or recovery programming.

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

Method: Self-reported surveys

Timeline: Post-program/curricula survey administration

Outcome: Increased confidence and motivation to use destigmatized language (intermediate)

Indicator: Number of participants who reported an increased ability to use destigmatized language

Method: Self-reported surveys

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

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) and follow-up survey (BC)

Outcome: Short Term 

Indicator: 

Number of partnerships with community organizations, institutions, agencies, or individuals to address mental health and wellbeing for youth in the community.

Number of youth who reported an increased knowledge of how to respond to mental health concerns.

Number of youth who intend to adopt self-care strategies to improve their own mental health and wellbeing.

Number of youth who intend to adopt strategies to support or promote mental health and wellbeing in their community.

Number of youth who reported intended behavior change as a result of participation in mental health and wellbeing programming.

Method: Survey 

Timeline: Immediately post-program

Outcome: Medium Term 

Indicator: 

Number of youth who adopted self-care strategies to improve their own mental health and wellbeing.

Number of youth who adopted strategies to support or promote mental health and wellbeing in their community.

Number of youth who reported behavior change as a result of participation in mental health and wellbeing programming.

Method: Survey 

Timeline: 3-6 Months post-program 

Outcome: Long Term 

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

Method: Survey or Interview 

Timeline: 1+ years