Mercer County CES

County Emphasis:

Nurturing community safety, well-being and mental health.

Concentration 1:

Mental Health and Well-Being

Concentration 2:

Health and Wellbeing

Concentration 3:

Substance Use Prevention and Recovery

Concentration 4:

Connected & Resilient Communities

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. 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. 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.  

The UK Cooperative Extension Community Assessment identified top issues and concerns across Kentucky. 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. 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. The 2023 Community Needs Assessment identified improved broadband and digital literacy as top priorities for enhancing community resilience. 

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. 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, amplify the voices of many to advocate for better quality of life for all and to address the holistic needs of Kentuckians who use drugs including mental health, fair housing, second-chance employment, nutrition and physical health. Extension’s connectivity and resilience efforts focus on supporting local economies and helping communities recover from economic shifts and natural disasters (CEDIK, 2024). By promoting digital literacy, educating on safe and vibrant outdoor spaces, and implementing place-based disaster preparedness programs, Extension strengthens community connections and economic sustainability. 

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). 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. 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. In today’s rapidly evolving world, youth are and can play a pivotal role in shaping the future of connected and resilient communities. Young people are leveraging technology and social networks to foster strong, supportive relationships that transcend geographical boundaries. Their innovative approaches to problem-solving and their commitment to sustainability are essential in addressing the complex challenges of the 21st century. As they continue to collaborate and share knowledge, youth are laying the foundation for a more connected and resilient world.  

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, stronger parenting and relationship-building skills, social, emotional, and/or behavioral education for adults working with youth and substance use prevention. 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.  

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. Furthermore, 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. 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. 4-H is committed to providing the resources necessary to promote youth connection in their communities. 

County Situation:

Mercer County stands at a pivotal juncture in its commitment to enhancing community safety, well-being, and mental health. While the county boasts a lower violent crime rate (9.9) compared to the national average (22.7) (bestplaces.net), residents have identified pressing health concerns. A 2023 community assessment highlighted addiction (81%), mental health (57%), and obesity (58%) as top health priorities (mercerkyhd.org).  Access to mental health services remains a challenge, with a patient-to-mental health provider ratio of 788:1. Economic factors further influence well-being; 18.3% of children live in poverty, and 12% of residents report financial difficulties (datausa.io). Despite these challenges, Mercer County's proactive approach—evident in community surveys and health forums—demonstrates a collective commitment to fostering a safer, healthier environment. By addressing these issues head-on, the county aims to build a resilient community where all residents can thrive.

Long-Term Outcomes:

Increased digital access improves economic and educational opportunities.

Communities recover faster from disasters/economic disruptions

Sustained investment in public spaces strengthens local economies

Cultural heritage is preserved and integrated into communities

Expanded partnerships enhance problem-solving and resource-sharing

Improved quality of life through connection and civic engagement

Youth will demonstrate necessary leadership, teamwork, and communication skills needed to be successful in the workplace.? 

Youth participation in community involvement increases.??? 

Youth will serve in leadership roles in their community.?? 

Youth will more effectively communicate, work with others, and contribute to driving change and shaping the future

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

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 recovery capital

Reduced adult substance use

Reduced adult substance use disorder

Reduced adult overdose fatalities

Reduced stigma related to adult substance use

Improved quality of life

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

Reduced incidence of mental health crises and suicide

Increased access to mental health care and resources for all

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:

More citizens adopt digital tools for work and daily life.

Communities implement disaster preparedness and recovery strategies.

More public spaces are revitalized for community engagement.

Increased participation in cultural and arts-based programs.

More individuals engage in local governance and civic groups.

New partnerships and networks address community challenges

Youth will practice teamwork, responsibility, communication, conflict resolution techniques, and problem-solving skills.?? 

Youth will plan and implement a service project.?

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

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 availability and accessibility of evidence-based recovery capital-building programs

Enhanced community partnerships that target recovery from substance use disorder

Increased availability and accessibility of evidence-based prevention programs

Enhanced community partnerships that target youth prevention

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

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 of digital tools and online resources.

Improved understanding of disaster preparedness and recovery strategies.

Greater awareness of the benefits of public spaces.

Increased understanding of cultural development and community identity.

Improved awareness of civic engagement opportunities.

Greater knowledge of community partnerships and collaboration strategies

Youth identify personal strengths that contribute to leadership skill development (communication, teamwork, civic engagement).?? 

Youth successfully worked in a team environment to accomplish a task.?? 

Youth realize how their actions impact others. 

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  

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

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.).

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)

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: 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: 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

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 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: 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: 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 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 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

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: Short Term 4-H Camp

Indicator: 

•    Number of youth who reported that they take responsibility for their actions.   

•    Number of youth who reported 4-H Camp improved their ability to manage their emotions. 

Method: Survey 

Timeline: End of Camp

Outcome:  Improved quality of life through connection and civic engagement

Indicator:  Number of participants who reported experiencing stronger ties to their community as a result of participating in Extension arts programming with others.

Method: pre- and post- surveys from program participation

Timeline: after program participation

Outcome: increased participation in cultural and arts-based programs

Indicator: Number of participants in Extension arts or design-based community programs (e.g., story circles, murals, design charettes, creative placemaking) who reported increased connection or belonging.

Method: pre- and post- surveys from program participation,

Timeline: after program participation

Learning Opportunities:

Audience: Youth, Families, Adults and Seniors 

Project or Activity: Pickleball 

Content or Curriculum: Get Healthy with Pickleball 

Inputs: Extension Staff, Community Center, Volunteers 

Date(s): Summer/Fall 

Audience: Community Leaders, Adults, Homemakers 

Project or Activity: PowerPoint, Publications, Hands-on activities 

Content or Curriculum: Pathways to Wellness: Navigating the People, Places, and Spaces that influence health. 

Inputs: Extension Staff and Extension Specialists 

Date(s): Spring 

Audience: Families, Adults, Homemakers 

Project or Activity: PowerPoint, Publications 

Content or Curriculum: Mental Health Matters 

Inputs: Extension Staff, Mercer County Health Department, Mercer County Public Library 

Date(s): Fall 

Audience: Seniors 

Project or Activity: Bingo, Chair Exercises 

Content or Curriculum: Bingocize 

Inputs: Extension Staff, WKU 

Date(s): Year Round 

Audience: Clientele in Recovery Centers 

Project or Activity: Making Better Choices through Healthy Cooking 

Content or Curriculum: Healthy Choices for Recovering Bodies 

Inputs: NEP Assistant, Recovery Centers 

Date(s): Ongoing 

Audience: Youth 

Project or Activity: Safety Day for all 6th graders in Mercer County 

Content or Curriculum: Emergency preparedness, ATV curriculum, curriculum from partner organizations 

Inputs: Volunteers, Mercer County School System, Burgin School System, Extension Staff 

Date(s): Spring 

Audience: Youth 

Project or Activity: Babysitting 

Content or Curriculum: 4-H Babysitting 

Inputs: Extension Staff, Volunteers 

Date(s): Fall, Spring, Summer 

Evaluation:

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: 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

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 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: 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: 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 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 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

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: Short Term 4-H Camp

Indicator: 

•    Number of youth who reported that they take responsibility for their actions.   

•    Number of youth who reported 4-H Camp improved their ability to manage their emotions. 

Method: Survey 

Timeline: End of Camp

Outcome:  Improved quality of life through connection and civic engagement

Indicator:  Number of participants who reported experiencing stronger ties to their community as a result of participating in Extension arts programming with others.

Method: pre- and post- surveys from program participation

Timeline: after program participation

Outcome: increased participation in cultural and arts-based programs

Indicator: Number of participants in Extension arts or design-based community programs (e.g., story circles, murals, design charettes, creative placemaking) who reported increased connection or belonging.

Method: pre- and post- surveys from program participation,

Timeline: after program participation