Marshall County CES

County Emphasis:

Health & Well Being

Concentration 1:

Health and Wellbeing

Concentration 2:

Substance Use Prevention and Recovery

Concentration 3:

Mental Health and Well-Being

Concentration 4:

Family and Youth Development

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:

LDM, VW, NR 

According to the 2024-25 Cooperative Extension Service State wide Community Needs Assessment -- Marshall County Youth Development Data -- In the Top 12

#1 -- Minimizing Youth Substance use -- 4.4 out of 5

#4 -- Reducing youth obesity through nutrition education and/or exercise  -- 4.2 out of 5

#5 -- Minimizing bullying and/or school violence -- 4.2 out of 5

#7 -- Social, emotional, and/or behavioral education for adults working with youth -- 4.2 out of 5

#8 -- Coping strategies to support youth wellbeing -- 4.1 out of 5

#10 -- Strengthening youth peer-peer relationships -- 4.1 out of 5

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   Youth Kentucky 4-H members report decreased obesity.     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

1. Increased health-promoting behaviors that support family, community, and occupational health and safety
2. Increased and/or strengthened partnerships to address community health or safety issues
3. Increased organizational/site/community support for health-promoting behaviors that equitably address community health or safety issues

 

Youth

1. Increased self-reflection and exploration of personal values and beliefs related to health and well-being 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   Youth Increased knowledge of positive mental health practices   Improved attitudes and beliefs towards healthy habits and practices among 4-Hers.   Increased knowledge of general wellness practices

Evaluation:

ADULT

 

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

 

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 organizational/site/community supports for health-promoting behaviors (intermediate)
Indicator	Number of volunteers who supported health and well-being programming in the community
Method	Agent record of volunteers utilized in programming
Timeline	Ongoing: Each volunteer should be reported once per reporting period

 

Outcome	Increased organizational/site/community supports for health-promoting behaviors that equitably address community health and safety issues (intermediate)
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

 

YOUTH

 

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 how physical activity contributes to overall health  Number of youth who reported that they learned how food impacts their overall health.
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.
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	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(s)	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(s)	Ongoing/seasonal

 

Audience	Families & Individuals
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, Cook Wild Ky, Food as Health Toolkit, Recovery Garden Toolkit, Family Mealtime, maternal and child health program materials,
Inputs	Programmatic materials, paid staff, community partners, volunteers, faith-based organization, health coalitions, healthcare Providers and local clinics, health department, non-profits, schools, company health and wellness, Homemakers, farmers’ markets, local farms/growers/producers, commodity groups, community centers, etc.
Date(s)	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(s)	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.  Marshall County ASAP Programs & Initiatives
Date(s)	Ongoing

 

Youth

Audience	Youth
Project or Activity	Health Rocks
Content or Curriculum	4-H Health Rocks! Curriculum.   Substance Misuse Prevention Programs Mental Health Services Administration
Inputs	4-H Health & Well Being programs in which youth experience a sense of belonging, and developmental relationships, explore their spark, and actively engage in meaningful opportunities.   Marshall County 4-H STAR Team Regional Prevention Center Accredited and certified volunteers in 4-H projects.  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
Date(s)	September 1 – August 30

 

Audience	Youth
Project or Activity	Nutrition and Food Preparation
Content or Curriculum	Wellness in Kentucky
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.   Kentucky Extension Homemakers Association   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
Date(s)	September 1 – August 30

Evaluation:

ADULT

 

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

 

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 organizational/site/community supports for health-promoting behaviors (intermediate)
Indicator	Number of volunteers who supported health and well-being programming in the community
Method	Agent record of volunteers utilized in programming
Timeline	Ongoing: Each volunteer should be reported once per reporting period

 

Outcome	Increased organizational/site/community supports for health-promoting behaviors that equitably address community health and safety issues (intermediate)
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

 

YOUTH

 

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 how physical activity contributes to overall health  Number of youth who reported that they learned how food impacts their overall health.
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.
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