Relevance:

Dietary choices are the number 1 risk factor for chronic diseases such as heart disease, diabetes, and high blood pressure. In the U.S., 7 out of 10 leading causes of death are related to diet. This is compounded by food insecurity, which means people do not have access to or the ability to afford nutritious foods. Because of the known health outcomes observed among children and adults, food insecurity is now recognized as a leading nutrition-related healthcare issue. To address diet-sensitive chronic disease, food insecurity must be acknowledged as an important part of the solution.

Response: 

The UK Food as Health Alliance (Lauren Batey, MS, RD) and the UK Department of Dietetics and Human Nutrition (Anna Cason, Senior Extension Associate, Heather Norman-Burgdolf, Extension Specialist) partnered to develop the Food as Health Toolkit to provide a framework and guide for Extension Agents to address the growing concerns of food insecurity and diet-sensitive chronic conditions in their county. The toolkit is built upon evidence-based principles that prevent or manage chronic conditions, emphasizes practical and affordable food choices, and incorporates strategies related to food resource management to improve food security.

Results:

This 402-page toolkit was developed in spring 2024 and was pilot-tested in 14 Kentucky counties during summer 2024. FCS Agents piloted the program and provided critical feedback during early fall 2024. Necessary corrections and revisions were made that improved the functionality and implementation of toolkit resources. With the support of the Alliance and FCS Extension, the toolkit was graphically designed and professionally printed in winter 2024 and served as the foundation of a statewide agent training in Spring 2025. To date, 75 agents (63% of counties) have been trained and received the Food as Health Toolkit to use in their county programming.

Of the agents trained (n=75), 69 completed the post-training survey. 59% (n=41) shared they planned to use the toolkit within the next 6 months, while 94% (n=65) shared they would use the toolkit resources within the next 6-12 months. Almost 2 out of 3 agents (64%) reported they intend to collaborate with a clinical partner in their county to offer the program. Agents overwhelmingly found the toolkit resources beneficial. When asked which components of the toolkit were most helpful, lesson materials (96%, n=66), publications (91%, n=63), and the toolkit guide (84%, n=58) were most often selected. Agents did cite other resources they would like to see incorporated into the toolkit, including more health conditions and topics (61%, n=42) and additional recipes (58%, n=40). Overall, agents viewed the training as a valuable experience, sharing that the toolkit overview (80%, n=53), physical materials and binder (76%, n=50), and the in-depth overview of chronic health conditions (68%, n=45) were most valuable. Future program evaluation will take place to look at the knowledge and behavior change of Kentucky residents who participate in Food as Health programming.

Public Value Statement:

The Food as Health Toolkit equips Extension Agents with evidence-based strategies to address food insecurity and diet-sensitive chronic diseases, fostering healthier communities through practical nutrition education and resource management. With widespread adoption and positive feedback from trained agents, this initiative strengthens local clinical-community partnerships and enhances the accessibility of nutrition-focused programming to improve long-term health outcomes.