In children under 5 years old, E.coli infections are more likely to lead to hemolytic uremic syndrome (HUS), a severe complication that can cause chronic kidney disease, kidney failure and death. During the 2018-19 school year a series of LEAP (Literacy, eating and activity for pre-school/primary) lessons were taught.

Through the collaboration of the Owsley County School System and the Owsley County Extension office lessons were taught that included nutritious foods, healthy eating habits, hand washing, food safety and being physically active.

During the course of lessons kindergarten students participated in new food sampling, book reading and also the importance of good handwashing. At the conclusion of these lessons sixty eight percent of students improved diet quality and over seventy nine percent of students improved hand washing practices.