Grayson County CES

County Emphasis:

Community Health and Wellbeing

Concentration 1:

Health and Wellbeing

Concentration 2:

Mental Health and Well-Being

Concentration 3:

Food Safety, Quality, and Access

Concentration 4:

Substance Use Prevention and Recovery

Situation:

The opportunities and resources available to support the health and well-being of adults and families in Kentucky vary widely. Disparities in health-promoting knowledge, resources, and infrastructure contribute to higher rates of chronic health conditions and lower quality of life. Prevention, early detection, and care are essential to maintain and/or improve quality of life. Yet, this burden is often placed on individuals to navigate the healthcare system and traditional public health entities. Additionally, for decades, little attention has been given to the external factors that undoubtedly affect health such as access to care, education, nutritious foods, and safe physical spaces. These same issues and concerns were echoed throughout the 2023 UK Cooperative Extension Community Assessment. Within the top 15 priority issues identified by Kentuckians, “ensuring individuals and families have access to affordable nutritious foods” was #4 and “reducing youth obesity through nutrition education and/or exercise” was #8. Guided by the Cooperative Extension’s National Framework for Health Equity and Well-being, UK Extension aims to become a critical public health partner for addressing disparities in health-promoting knowledge, resources, and infrastructure through comprehensive health, nutrition, and wellness programming that supports adult physical health and well-being.

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:

In Grayson County, Kentucky, access to resources that support adult and family health varies widely. Disparities in health knowledge, services, and infrastructure have contributed to higher rates of chronic diseases and a lower quality of life. While prevention, early detection, and care are critical, individuals are often left to navigate complex healthcare systems alone. Broader factors like access to healthcare, education, nutritious foods, and safe spaces have been historically overlooked. The 2023 UK Cooperative Extension Community Assessment echoed these concerns, with “access to affordable, nutritious foods” ranked #4 and “reducing youth obesity through nutrition education and/or exercise” ranked #8 among top priorities. Guided by the Cooperative Extension’s National Framework for Health Equity and Well-being, UK Extension in Grayson County is working to close gaps in health resources through comprehensive wellness programming that supports adult health and well-being.

 

Youth Focus
Healthy, engaged youth are essential to thriving communities. In Grayson County, 41% of teens are overweight or obese (Kentucky Kids Count, 2023), and 30% experience chronic absenteeism (U.S. Department of Education, 2024). Youth also report declining self-confidence and future outlooks (McKinsey & Company, 2022). The 2024 UK Cooperative Extension Needs Assessment identified priorities like expanding mental health access, reducing youth obesity, and addressing bullying and violence. In response, Grayson County 4-H fosters youth development across five key domains: physical, emotional, social, spiritual, and intellectual well-being.

Long-Term Outcomes:

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
Reduced incidence of mental health crises and suicide
Increased access to mental health care and resources for all
More Kentuckians routinely met the guidelines for the consumption of (locally-grown) fresh fruits and vegetables.

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

Intermediate Outcomes:

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

Increased advocacy for mental health and wellbeing resources

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

Increase in the number of farmers’ markets and local food retailers that accept one or more food benefits as payment.

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. 

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

Initial Outcomes:

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.

Increased ability to recognize and respond to a mental health concern related to health-promoting behaviors

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

 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 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

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 and/or strengthened partnerships to address community health issues (intermediate)

Indicator: Number of community partners (community organizations, institutions, agencies, or individuals) worked with to offer health and well-being programming in the community

Method: Agent record of community partnerships utilized in programming

Timeline: Ongoing; Each partnership should be reported once per reporting period

Outcome: Increased partnerships (number or strength) to address mental health and well-being issues within the community

Indicator: Number of partnerships with community organizations, institutions, agencies, or individuals to address mental health and well-being in the community.

Method: Agent record of community partnerships utilized in programming

Timeline: Ongoing; Each partnership should be reported once per reporting interval

Youth

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: 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: Communities

Project or Activity: School, Community or Recovery Gardens

Content or Curriculum: NEP “Grow your own” publications, Hort. Dept. publications, youth gardening curriculum, Recovery Garden Toolkit

Inputs: Gardening materials, paid staff, community partners, 4-H, volunteers, grant funds, local organizations and community partners, schools, recovery centers, Nutrition Education Program

Dates: Ongoing

 

Audience: Communities

Project or Activity: Farmers’ Market 

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: Families & Individuals

Project or Activity: Physical, Environmental, and Occupational Safety

Content or Curriculum: Publications, presentations, trainings, demonstrations, In the Face of Disaster, Pest Control Short Course, Stop the Bleed, … … …

Inputs: Programmatic materials, paid staff, community partners, businesses, creative entrepreneurs, local farms/growers/producers, commodity groups, housing authorities

Date: Ongoing/seasonal

 

Audience: Communities

Project or Activity: Policy, Systems, and Environmental (PSE) Approaches

Content or Curriculum: Pathways to Wellness, Faithful Families, Story Walks, Shared Space Agreements, parks and trail development, Active Community Toolkit, resources for early case and education settings, food system work (e.g. farmers’ markets, backpack programs, community gardens), SNAP-Ed toolkit, creating and Maintaining Health Coalitions, Arts in Health publications, CEDIK Healthy Communities toolkit

Inputs: Programmatic materials, paid staff, community partners, volunteers, grant funds, local organizations and community partners, health coalitions, Nutrition Education program, local farms/growers/producers, key stakeholders, elected officials, Department of Transportation, employee health and wellness, schools, etc. 

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: Youth and adults, general public

Project or Activity: Farm Safety Day

Content or Curriculum: Progressive Ag Farm Safety Day curriculum and local community partners' safety materials

Inputs: UK Publications, agents, FSA, NRCS commodity groups, local farmers, schools, community partners

Date: Annually fall/spring

Audience: Elementary youth

Project or Activity: Ag Literacy in the Classroom

Content or Curriculum: Kentucky Agriculture & Environment in the Classroom curriculum, National 4-H Curriculum (Natural Resources/Agriculture)

Inputs: Agents, classroom teachers

Date: school calendar year annually (August through May)

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

Audience: Individuals & Farmers

Project or Activity: Home Based Micro Processing

Content or Curriculum: HBMP Training materials

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

Dates: Ongoing

Audience: Individuals & Farmers

Project or Activity: Food Preservation

Content or Curriculum: Food preservation curriculum, So Easy to Preserve materials, National Center for Home Food Preservation materials.

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

Dates: Spring/Fall

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

Evaluation:

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

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 and/or strengthened partnerships to address community health issues (intermediate)

Indicator: Number of community partners (community organizations, institutions, agencies, or individuals) worked with to offer health and well-being programming in the community

Method: Agent record of community partnerships utilized in programming

Timeline: Ongoing; Each partnership should be reported once per reporting period

Outcome: Increased partnerships (number or strength) to address mental health and well-being issues within the community

Indicator: Number of partnerships with community organizations, institutions, agencies, or individuals to address mental health and well-being in the community.

Method: Agent record of community partnerships utilized in programming

Timeline: Ongoing; Each partnership should be reported once per reporting interval

Youth

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