Owsley County CES

County Emphasis:

Building a safe, healthy community with strong connections

Concentration 1:

Substance Use Prevention and Recovery

Concentration 2:

Health and Wellbeing

Situation:

Substance Use Prevention:  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. Youth Focus Substance use and substance use disorder are persistent public health problems in Kentucky. Kentucky youth fare worse than their US counterparts in terms of numerous indicators of drug use and drug-related harm including cigarette and smokeless tobacco use, vaping, alcohol use, and illicit drug use such as opioid and methamphetamine use. Accordingly, the recent University of Kentucky Cooperative Extension Service Needs Assessment (2023) indicated substance use prevention is the primary concern among most Kentucky counties. Nevertheless, few Kentucky communities support prevention efforts that are informed by research. Cooperative Extension is well-positioned with deep collaborative community ties to support evidence-based prevention programming. Such programs may target substance use directly or indirectly by focusing on pertinent risk and protective factors and promoting overall well-being for Kentucky youth. Health and Wellbeing:  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:

Substance Use Prevention and Recovery: 

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.

Youth Focus

Substance use and substance use disorder are persistent public health problems in Kentucky. Kentucky youth fare worse than their US counterparts in terms of numerous indicators of drug use and drug-related harm including cigarette and smokeless tobacco use, vaping, alcohol use, and illicit drug use such as opioid and methamphetamine use. Accordingly, the recent University of Kentucky Cooperative Extension Service Needs Assessment (2023) indicated substance use prevention is the primary concern among Owsley County. Nevertheless, few Kentucky communities support prevention efforts that are informed by research. Cooperative Extension is well-positioned with deep collaborative community ties to support evidence-based prevention programming. Such programs may target substance use directly or indirectly by focusing on pertinent risk and protective factors and promoting overall well-being for Kentucky youth.

 

Health and Wellbeing:

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 Owsley Countians , “ensuring individuals and families have access to affordable nutritious foods” was #3 and “Support for substance use, addiction prevention/recovery” was #4. 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). Youth are 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. These same issues and concerns were echoed throughout the 2023 UK Cooperative Extension Community Assessment. Within the top 15 priority issues identified by Owsley Countians, “Minimizing youth substance use” was #1 and :minimizing bullying and /or school violence” was #2.  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.

 

 

Long-Term Outcomes:

Substance Use Prevention and Recovery: 

Adult 

Reduced stigma related to adult substance use

Improved quality of life

Reduced adult substance use

Improved social and emotional competency

Youth 

Reduced youth substance use

Reduced stigma related to youth substance use

Health and Wellbeing

Adult

Community environments that equitably support health-promoting behaviors where people live, learn, work, and play

Increased availability and accessibility to community-based health resources

Improved quality of life

Youth

Increased number of 4-Hers who pursue employment in the health and wellbeing field.

Intermediate Outcomes:

Substance Use Prevention and Recovery: 

Adult 

Increased availability and accessibility of evidence-based recovery capital-building program

Enhanced community partnerships that target recovery from substance use disorder

Youth 

Increased availability and accessibility of evidence-based prevention programs

Enhanced community partnerships that target youth prevention

Health and Wellbeing

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:

Substance Use Prevention and Recovery: 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 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.). Youth  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.). Health and Wellbeing  Adult  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 knowledge of positive mental health practices   Youth 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:

Substance Use Prevention and Recovery: 

Initial 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

Initial Outcome: Increased awareness of community resources to support prevention and recovery 

Indicator: Number of partnerships with community organizations, institutions, agencies, or individuals to address substance use/recovery in the community. 

Method: Program metrics agents will track, and report based on their activities and partnerships related to substance use prevention, addiction, and/or recovery)

Timeline: Post-program/curricula survey administration (ST) and follow-up survey (BC).

Intermediate Outcome: Increased confidence making decisions related to substance use (i.e. substance use refusal skills) 

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 (ST) and follow-up survey (BC)

Intermediate outcome: Increased intentions to employ health-promoting behaviors (e.g., exercise, healthy nutrition, positive coping, etc.). 

Indicator: 

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

*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)

Health and Wellbeing:

Initial Outcome: Increased knowledge about health-promoting behaviors (e.g., how to prepare nutritious foods, benefits of routine vaccinations/screenings)  

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 

Initial Outcome: Increased confidence and motivation to engage in health-promoting behaviors (e.g. add physical activity, consume more nutritious foods, receive vaccination or screen) 

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

Intermediate Outcome: Increased health-promoting behaviors that support family and community health (e.g., physical activity, consuming nutritious foods, routine vaccinations and screenings)

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

Intermediate Outcome: Increased organizational/site/community supports for health-promoting behaviors that equitably address community health and safety issues

Indicator: Number of projects or initiatives working to improve a community health or safety issue

Method: Documentation (direct observation, photo, repeated survey) or interviews

Timeline: Ongoing/as changes are made and projects progress

Outcome: Initial 

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 doe 4-H Health and Wellbeing 

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:

Substance Use Prevention and Recovery:

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: Fall 2026-2027 School Year 

Audience: Communities 

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

Content or Curriculum: Addiction 101, Recovering Your Finances (RYF), PROFIT, Building Recovery Ready Communities (e.g. presenting to coalitions), Resources for Family Members and Concerned Others, Parenting in Recovery 

Inputs: Programmatic materials, paid staff, volunteers, community partners, health coalitions, and other key stakeholders

Date: Ongoing

Health and Wellbeing: 

Audience: Families and 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: Youth 

Project or Activity: Nutrition ad Food Preparation 

Content or Curriculum: Jump Into Food and Fitness 

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 

Evaluation:

Substance Use Prevention and Recovery: 

Initial 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

Initial Outcome: Increased awareness of community resources to support prevention and recovery 

Indicator: Number of partnerships with community organizations, institutions, agencies, or individuals to address substance use/recovery in the community. 

Method: Program metrics agents will track, and report based on their activities and partnerships related to substance use prevention, addiction, and/or recovery)

Timeline: Post-program/curricula survey administration (ST) and follow-up survey (BC).

Intermediate Outcome: Increased confidence making decisions related to substance use (i.e. substance use refusal skills) 

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 (ST) and follow-up survey (BC)

Intermediate outcome: Increased intentions to employ health-promoting behaviors (e.g., exercise, healthy nutrition, positive coping, etc.). 

Indicator: 

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

*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)

Health and Wellbeing:

Initial Outcome: Increased knowledge about health-promoting behaviors (e.g., how to prepare nutritious foods, benefits of routine vaccinations/screenings)  

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 

Initial Outcome: Increased confidence and motivation to engage in health-promoting behaviors (e.g. add physical activity, consume more nutritious foods, receive vaccination or screen) 

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

Intermediate Outcome: Increased health-promoting behaviors that support family and community health (e.g., physical activity, consuming nutritious foods, routine vaccinations and screenings)

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

Intermediate Outcome: Increased organizational/site/community supports for health-promoting behaviors that equitably address community health and safety issues

Indicator: Number of projects or initiatives working to improve a community health or safety issue

Method: Documentation (direct observation, photo, repeated survey) or interviews

Timeline: Ongoing/as changes are made and projects progress

Outcome: Initial 

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 doe 4-H Health and Wellbeing 

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