Progress 08/01/08 to 07/31/11
Outputs
OUTPUTS: Established programs of the Health Education Extension Leadership, KY (HEEL) project been carried out in all 120 counties of Kentucky. The majority of Kentucky is very rural, but population centers exist around the major cities Cincinnati (Northern Kentucky), Lexington, and Louisville, known as the "Golden Triangle." As with most rural states, Kentucky has many health professions shortage areas outside of its metro centers. Kentucky's health status continues to be among the worst in the nation with the United Health Foundation ranking Kentucky 44 in overall health status among the 50 states (2010). It ranks 40th in determinants (indicating that overall healthiness may improve over time according to United Health Foundation's America's Health Rankings) and 45 in health outcomes. Extension specialists have developed or enhanced existing programs to address Kentucky's determinants of poor health status. During the three year grant period, programs were implemented in all phases of health including mental health. In efforts to reduce the burden of chronic disease, the program focused on weight management and increasing physical activity through programs such as Weight the Reality Series, Literacy, Eating, and Activity for Preschoolers (adding primary grade curriculums). The Foundation for a Healthy Kentucky recognized LEAP (The Literacy, Eating, and Activity for Pre-School) Program as being a model program that works. Kentucky Educational Television featured the LEAP program in a Be Well Kentucky broadcast on model programs that work. The Get Moving Kentucky, a physical activity program has been enhanced to include the evidence based Matter of Balance program focused on improving physical activity in the aging population; as well as the NIFA partnership for America on the Move (AOM). Kentucky has been able to show improvements in physical activity, at the family level, utilizing the AOM program. Families on the Move adapted the AOM materials into 6 weekly newsletters distributed to participants. The evidence based Matter of Balance program also reduces the likely hood of falls in the aging population, reducing the costs of medical care to treat broken bones and injuries in this population. The Kentucky Team Up! Cancer pilot in nine (9) Eastern Kentucky counties demonstrated that Extension working with public health partners could increase screening rates. Mental health programs included Blue to You which was piloted in Western Kentucky and diffused to other parts of the state in 2010. The Mental Health and Aging Initiative train the trainer intervention was evaluated for efficacy. Effectiveness was evaluated by examining changes in attitudes and knowledge about mental health/substance abuse and aging, from pretest to posttest and again three and six months later. PARTICIPANTS: Nothing significant to report during this reporting period. TARGET AUDIENCES: Nothing significant to report during this reporting period. PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.
Impacts
21% of Kentuckians in 2010 (rank 35) reported consuming five or more fruits and vegetables daily. 70% of Kentuckians in 2010 reported participating in physical activities, an increase from previous years indicating overall healthiness may improve with time. The number of Kentuckians reporting a change in knowledge, opinions, skills, or aspirations regarding lifestyle changes because of participating in Extension Health programs increased from 105,512 in 2008 to 196,560 in 2010. The number of Kentuckians reporting making a lifestyle change because of participating in Extension Health programs increased from 50,626 in 2008 to 103,761 in 2010. The number of joint programs with non-Cooperative Extension organizations that focus on comprehensive health maintenance increased from 1322 programs in 2008 to 2162 programs in 2010. 61 counties participated in Weight the Reality Series with 5,348 participants. 2,036 reported losing 5% of their body weight, with 508 reporting in 2009 and 2010 maintaining the weight loss.A total of 305 families, including 435 adults and 366 children, participated in KY's AOM Family on the Move program. Fifteen percent of participants increased their steps by at least one mile or 2000 steps.The Matter of Balance program promotes exercise to increase strength and balance in elderly participants. In 2010 there were 45 counties that trained coaches with 7 counties implementing the program and reaching more than 80 elderly participants. Literacy, Eating, Activity for Preschoolers and Primary school aged children reached 20,255 youth in 86 counties of Kentucky with 15,868 children increasing their level of physical activity, 13,925 demonstrating proper hand washing, and 19, 579 sampling a variety of foods which included fruits and vegetables. 5,870 Kentuckians participated in Small Steps to Health and Wealth during 2009 and 2010. In 2010, 2046 of 3617 participants reported increasing the amount of time spent doing physical activity. 1391 participants reported decreasing the amount of month expenses as a result of this program. The Team Up Project continued until 2009. For purposes of evaluation, nine control counties were matched with the nine eastern Kentucky Counties. The Kentucky Women's Cancer Screening Program reported that in comparison of the 2005 Pap Screening data Team Up counties on average screened 14.2% of the total of rarely or never screened compared to 10.8% in the control counties. The goal of the Mental Healthiness in Aging Initiative was to build the capacity of the community to deal with the mental health issues of older community members. The fact that residents of the ten (10) pilot counties reported feeling significantly more able to help older adults with a potential mental illness than those not in the pilot counties indicates that the key message of MHAI was diffused in those counties. In evaluation of the train the trainer MHAI program,findings were statistically significant and indicated enduring improvement in awareness and knowledge about mental health/substance abuse and aging.
Publications
- Butler, KM, Hedgecock, S, Record, R, Derifield, S, McGinn, C, Murray, D, & Hahn, EJ. (2011) Evidence based Cessation Strategies: Rural Smokers Experiences with Tobacco. The Nursing Clinics of North America (In Press).
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Progress 08/01/09 to 07/31/10
Outputs
OUTPUTS: Established programs of the Health Education Extension Leadership, KY project are being carried out in all 120 counties of Kentucky. Extension specialists have developed or enhanced existing programs. These include A Matter of Balance, an evidence based program focused on reducing the fear of falling, increasing physical activity, and learning fall prevention strategies for those 55 and older, Health Literacy Partnerships, Substance Abuse Partnerships, and three multi-college, multi-disciplinary teams are currently in the third year of program implementation. Extension Agents have received training in Blue to You, a mental health program was developed through a collaboration of the Department of Family Studies and the College of Medicine and piloted in nine counties in Western Kentucky. The Reaching Low Income Smokers through Culturally Appropriate Messages, a collaboration of the School of Human Environmental Sciences and the College of Nursing, developed appropriate messages from focus groups of smokers and former smokers, in Lawrence County Kentucky. The program was piloted in that county and evaluation shows the increases in numbers of local residents enrolling and completing smoking cessation classes. The men's health project, All Star Dads, is being implemented in three pilot counties. This project is a collaboration of the College of Public Health, the Department of Kinesiology, and the School of Human Environmental Sciences. It applies the principles of Social Marketing to address increasing men's level of physical activity through involving them with activities involving their children. PARTICIPANTS: Faculty and Staff engaged in the three multi-college partnerships developing health curriculum in the Health Education Extension Leadership, KY project include: Reaching Low Income Smokers through Culturally Appropriate Messages Ellen Hahn, DNS, College of Nursing Professor and director of the Kentucky Center for Smoke Free Policy Karen Butler, DNP, College of Nursing Assistant Professor Deborah Murray, MA, EdD candidate ,Associate Director, Health Education through Extension Leadership (HEEL), College of Agriculture School of Human Environmental Sciences, Family and Consumer Sciences Stephanie Derifield, MS, Lawrence County Extension Agent for Family and Consumer Sciences Carolyn McGinn, Lawrence County Health Department, Health Educator Blue to You, Mental Health for Women Leslie Crofford, MD, College of Medicine, Ron Werner-Wilson, PhD, College of Agriculture, School of Human Environmental Sciences, Department of Family Studies, Tracey Werner-Wilson, Family Studies, Family and Consumer Science Agents in 120 counties, Men's Health Mark Swanson, PhD, College of Public Health Laura Stephenson, PhD, program leader, College of Agriculture, School of Human Environmental Sciences, Family and Consumer Sciences Family and Consumer Science Agents in Wolfe, Harrison, and Montgomery Counties. The Faces of Substance Abuse project includes Jeanne Davis, Regional Extension Coordinator, Deborah Murray, Associate Director, HEEL, Christy Neutzman, Clinton County FCS Agent, and Tracey Thornton, Butler County FCS Agent. The Matter of Balance physical activity program is led by Nicole Peritore, HEEL Extension Coordinator. TARGET AUDIENCES: Target audiences for the three pilot projects being developed by the Health Education Extension Leadership, KY program are low income smokers, women in Kentucky, and men reaching stages of physical inactivity. Reaching Low Income Smokers through Culturally Appropriate Messages is targeting low income smokers who want to quit smoking but do not have the social network support to do so. The purpose of the project is to develop and pilot test a population-based intervention to increase the reach and efficacy of culturally sensitive smoking cessation strategies for low income smokers in Central and/or Eastern Kentucky. Agents and community leaders will be trained to provide lay-appropriate brief tobacco cessation interventions. The long-term goal is to reduce the health and economic disparities from respiratory and heart disease among low income populations. Blue to You, focuses on reaching Kentucky women through on-line resources as identified by a research survey as the primary mechanism women get mental health information. Research indicates that women may also be more susceptible to depressive illnesses because of the stressors they encounter, such as work and home responsibilities, caring for children and aging parents, abuse, poverty and relationship strains. Although there is a perceived negative stigma with regard to depression- people might think that it's a sign of weakness -women are more likely to seek treatment for depression than men. All Star Dads, based on a review of epidemiologic and other data, identified physical activity as the health behavior this project addresses. This project focuses on men who were previously getting recommended levels of physical activity but have recently lapsed, based on the logic that it will be easier to restart a recently abandoned habit than to induce major behavioral changes in a longer-term sedentary population. Preliminary data points to the possibility of a focus on men's physical activity with their children; identifying father/child activity opportunities that already exist in the project communities; identifying father/child activities that are low or no cost within the community. A Matter of Balance, physical activity program, is focused on adults aged 55 and older. PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.
Impacts
The Faces of Substance Abuse conference provided training for diverse community partners and county extension agents. Of the 172 participants, 94.7% indicated that after the training they felt as if they could impact the prescription drug abuse problem. 98.3% of the participants felt more confident of their knowledge of prescription drug abuse after training. In 2002, 36,027 Kentuckians reported making lifestyle changes to improve health because of participating in Extension health programs; the number has progressively increased to 103,541 in 2009/2010. The number of joint programs conducted with public health partners has increased from 1,150 in 2002 - 2154 in 2009/2010. A random research survey showed a significant difference in the positive responses of residents being able to support aging community members with mental health issues from counties receiving a mental healthiness intervention compared to groups of counties receiving a social media program only, and control counties receiving no intervention. During 2009/2010 19,656 individuals reported experiencing a change in knowledge, opinions, skills, or aspirations regarding lifestyle changes in diet, exercise, etc. that improved their personal health. 20,255 youth participated in Literacy, Eating, and Activity for Preschool (LEAP) youth. Participant evaluations of the Matter of Balance program report feeling more comfortable talking with others about their fear of falling, 94% made changes in their environment, 100% felt more comfortable increasing their activity, and 83% were currently exercising. One participant said "My thinking has changed. I believe that exercising can help prevent a fall. Before I didn't know if I thought it could make a difference. I started to do some moderate exercise and there is less clutter in my house." Community Based Participatory (CBPR) project, Reaching Low Income Smokers: A Collaboration with County Extension Agents, developed and pilot tested an innovative, culturally sensitive intervention to maximize reach of tobacco treatment strategies with low income smokers in economically distressed counties in Eastern Kentucky. A survey conducted revealed that exposure to the intervention was predictive of talking with a doctor about quitting; further, those respondents with a higher dose of the intervention were even more likely to say they would talk to their doctor about quitting. This project is significant because Kentucky was the nation's largest producer of burley tobacco and dark fire- and air-cured tobaccos; it is an example of Extension being utilized to address complex health problems in Appalachia and its' ability to transfer the Extension Diffusion Model from growing tobacco to changing the health status of communities.
Publications
- No publications reported this period
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Progress 08/01/08 to 07/31/09
Outputs
OUTPUTS: Established programs of the Health Education Extension Leadership, KY project are being carried out in all 120 counties of Kentucky. Cooperative Extension was involved in 2,145 joint programs with other organizations focusing on comprehensive health management. Extension specialists have developed or enhanced existing programs. These include Taking Ownership of Your Diabetes, Weight the Reality Series Body Image module, and 12 new story books and lessons in the Literacy, Eating, and Activity for Primary Youth Health (LEAP). A Wally Cat cartoon wildcat was developed to reach youth and parents in a monthly newsletter series. A wallycat@uky.edu email address was established for the newsletter series. School nurses working with their local Extension Agents distributed the newsletters and encouraged youth engagement. Wally Cat was also used on flu prevention posters, hand washing posters, covering cough posters, and on posters promoting flu vaccine clinics. These posters were used in hospitals, clinics, schools, and college dormitories across the state. Adult monthly health bulletins on timely topics continue to be developed and circulated statewide. Three multi-college, multi-disciplinary teams are currently in the second year of program development and implementation. Blue to You, a mental health program developed through a collaboration of the Department of Family Studies and the College of Medicine, has been piloted in nine counties in Western Kentucky. The curriculum is currently being revised based upon the pilot data, and is in the review committee process. It is expected to be implemented statewide during the spring of 2010. The Reaching Low Income Smokers through Culturally Appropriate Messages, a collaboration of the School of Human Environmental Sciences and the College of Nursing, developed appropriate messages from focus groups of smokers and former smokers, in Lawrence County Kentucky. The program is currently being piloted in that county and will be evaluated based upon the increases in numbers of local residents enrolling and completing smoking cessation classes. The program is being piloted through the local Extension Office with the assistance of the local health department. Products include brochures, local call in radio programs, cable television programs, newspaper coverage, and materials featuring local people and quotes from the focus group proceedings. A local quilt club constructed a quilt wall hanging to be used as a traveling story board of the themes from the focus group data. The men's health pilot has finished its data collection from focus groups of men conducted across the state. This project is a collaboration of the College of Public Health, the Department of Kinesiology, and the School of Human Environmental Sciences. Data shows that men become less active as they age with a critical window to prevent inactivity in males being the early thirties age group. Focus group data indicates the need to tie family responsibilities to physical activity for this age group of men. This project is still in the program development stage and is expected to be piloted in the fall of 2010. PARTICIPANTS: Participants in the three multi-college partnerships in developing health curriculum in the Health Education Extension Leadership, KY project include: Reaching Low Income Smokers through Culturally Appropriate Messages Ellen Hahn, DNS, College of Nursing Professor and director of the Kentucky Center for Smoke Free Policy Karen Butler, DNP, College of Nursing Assistant Professor Deborah Murray, MA, EdD candidate, Associate Director, Health Education through Extension Leadership, College of Agriculture, School of Human Environmental Sciences, Family and Consumer Sciences Stephanie Derifield, MS, Lawrence County Extension Agent for Family and Consumer Sciences Carolyn McGinn, Lawrence County Health Department, Health Educator Blue to You, Mental Health for Women Leslie Crofford, MD, College of Medicine Leigh Ann Simmons, PhD, College of Agriculture, School of Human Environmental Sciences, Department of Family Studies Family and Consumer Science Agents in 9 western Kentucky counties Men's Health Mark Swanson, PhD, College of Public Health Laura Stephenson, PhD, program leader, College of Agriculture, School of Human Environmental Sciences, Family and Consumer Sciences Family and Consumer Science Agents in four counties representing the demographics of Kentucky TARGET AUDIENCES: Target audiences for the three pilot projects being developed by the Health Education Extension Leadership, KY program are low income smokers, women in western Kentucky, and men reaching stages of physical inactivity. Reaching Low Income Smokers through Culturally Appropriate Messages is targeting low income smokers who want to quit smoking but do not have the social network support to do so. The purpose of the project is to develop and pilot test a population-based intervention to increase the reach and efficacy of culturally sensitive smoking cessation strategies for low income smokers in Central and/or Eastern Kentucky. Agents and community leaders will be trained to provide lay-appropriate brief tobacco cessation interventions. The long-term goal is to reduce the health and economic disparities from respiratory and heart disease among low income populations. Blue to You, focuses on reaching western Kentucky women through on-line resources as identified by a research survey as the primary mechanism women in the western part of the Kentucky get mental health information. Research indicates that women may also be more susceptible to depressive illnesses because of the stressors they encounter, such as work and home responsibilities, caring for children and aging parents, abuse, poverty and relationship strains. Although there is a perceived negative stigma with regard to depression - people might think that it's a sign of weakness - women are more likely to seek treatment for depression than men. The Men's Health group,based on a review of epidemiologic and other data, identified physical activity as the health behavior this project will address. This project will focus on men who were previously getting recommended levels of physical activity but have recently lapsed, based on the logic that it will be easier to restart a recently abandoned habit than to induce major behavioral changes in a longer-term sedentary population. Preliminary data points to the possibility of a focus on men's physical activity with their children; identifying father/child activity opportunities that already exist in the project communities; identifying father/child activities that are low or no cost within the community; and developing a community marketing campaign to promote father/child interaction and involvement in physical activity. PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.
Impacts
During 2008-2009, Extension agents made 324,942 contacts in health and wellness programs, 54,603 of those contacts were made in physical activity programs. 113,418 individuals reported a change in knowledge and/or skills regarding lifestyle changes that will improve their health. 50,754 Kentuckians reported making lifestyle changes for the purpose of improving their health. 16,647 youth were involved in the Literacy, Eating, and Activity for Primary Youth Health (LEAP) program across the state. 10,851 children demonstrated proper hand washing techniques. 14,671 children sampled a variety of foods which included fruits and vegetables and 12,560 children increased their level of physical activity. Of 1,829 participants in Weight the Reality Series (WTRS), 722 succeeded in losing 5% of their body weight during the program. Three months following the program, 273 of 340 returning evaluation follow-up surveys, reported that they were maintaining their weight loss from the WTRS program. 153 participants reported continuing to lose weight. 262 participants reported having a more positive body image after completing the new module, Becoming Body Wise. Taking Ownership of Your Diabetes reached 136 participants in 15 counties. This program is a partnership of County Extension Agents, Diabetes educators, dietitians, physicians, and other resource experts. The program teaches basic information on controlling diabetes through improved diet, physical activity, foot care, and regular testing of blood glucose and A1C levels. Physicians are now referring patients to the local Extension offices. Many of the participants have reported being in denial of their diabetic condition. One woman reported having been denial for more than 20 years. Small Steps to Health and Wealth (SSHW) is a program teaching 25 "small steps" that participants can take to simultaneously improve their health and increase their wealth. There are many similarities between health and personal finance "issues" and behavior change strategies. The only difference is in their application. This program was conducted in 43 counties with 2253 participants. 799 tracked current eating and/or spending habits, and 931 selected a strategy to change their behavior with 853 participants reported adopting a health or financial behavior. Two Family and Consumer Science Agents served on a Kentucky Public Health Leadership Institute change project team developing a Home Visitation On-Line safety curriculum approved for social work and nursing CEUs by the Kentucky Public Health TRAIN system. To date 180 registered users have completed the module with 100% of the participants learning at least 5 safety tips to utilize when conducting home visits.
Publications
- No publications reported this period
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