SLIDE 1 Adolescent Health Activities in State Title V Programs: Data From an Environmental Scan
Webinar April 14, 2014 | 3:00-4:00 PM, EST
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SLIDE 4 Objectives
By the end of the webinar participants will be able to:
- Identify the most prevalent adolescent health activities
currently performed by Title V staff and programs.
- Analyze a diverse range of adolescent health activities
conducted under Title V programs.
- Identify common themes across Title V adolescent health
programs.
- Describe the three common issues Title V adolescent health
programs are addressing via National Performance Measures: teen birth rates, transition for YSHCN, and youth suicide rates.
- Interpret state case studies and perspectives from Title V staff
doing the work in the states.
SLIDE 5 Agenda
- I. Findings from AMCHP’s Environmental Scan of
Adolescent Health Activities in Title V
Purpose and Research Questions Background on Title V Reporting Data and Findings National Performance Measures State Performance Measures State Adolescent Health Coordinators Survey
Iowa Dept. of Public Health: Mary Greene, Gretchen Hageman, Addie Rasmusson Ohio Department of Health: Karen Hughes, Laura Rooney
SLIDE 6
Purpose of AH Environmental Scan
To utilize the abundance of data in the Title V Information System (TVIS), as reported by states in annual block grant reports, in order to better understand state adolescent health programming under Title V.
SLIDE 7
Strengths
Most recent national analysis of Title V adolescent health activities Provides a snapshot of activities in the states Utilizes the abundance of information available in TVIS Categorized state activities for future reference and continued analysis
SLIDE 8
Limitations
Limitations of block grant narratives Language differences affect categorization and analysis Snapshot of activities from one point in time (Title V Block Grant reports, 2011-2012) Only one piece of the puzzle of adolescent health work
SLIDE 9
Research Questions
What Adolescent Health activities are Title V programs engaged in? What kinds of adolescent health issues are Title V programs addressing? What can we learn about adolescent health in the states from Title V Block Grant reports?
SLIDE 10 Title V Reporting
National Performance Measures:
- All States must report on 18 national performance measures
State Performance Measures:
- Measures that each State has identified as additional
priority areas
- Selected by each state
- Used to gauge progress towards achieving state-specific
goals
SLIDE 11 Methodology
- 1. Analyzed the narratives of 2011-2012 state Block Grant
applications/reports to collect information about activities that address:
- Select National Performance Measures
- State Performance Measures
- And any activities with keywords adolescent, youth,
- r teen
- 2. Analysis of adolescent-specific State Performance
Measures
- 3. Analysis of data from March 2014 State Adolescent
Health Coordinators’ survey
SLIDE 12
Chose National Performance Measures strictly related to adolescents: NPM 6: The percentage of youth with special health care needs who received the services necessary to make transitions to all aspects of adult life, including adult health care, work, and independence NPM 8: The rate of birth (per 1,000) for teenagers aged 15 through 17 years NPM 16: The rate (per 100,000) of suicide deaths among youths aged 15 through 19
Methodology: National Performance Measures
SLIDE 13 Research Questions: National Performance Measures
Analysis addressed the following questions:
- How are states addressing successful transition into
adulthood for youth with special health care needs, teen birth rates, and teen suicide rates?
- How many states reported activities of the various activity
types?
- What activities under each NPM
are most common in the states?
SLIDE 14 How are states addressing successful transition into adulthood for youth with special health care needs?
- Systemic approaches: coalitions, statewide coordination, tools and
resources, youth leadership
How are states addressing teen birth rates?
- Personal Responsibility Education Program (PREP) and Abstinence
Education programs
- Evidence-based interventions
- Trainings, Surveillance, Family Planning, Reproductive Health,
Outreach, Education
How are states addressing teen suicide prevention?
- Both systemic and intervention approaches: statewide coordination,
trainings and interventions, surveillance, mental health services
Findings: National Performance Measures
SLIDE 15 National Performance Measure 6:
The most common ways states are addressing NPM 6 are:
- 1. Participation in Statewide Collaborations & Coalitions
- 2. Development of Trainings & Curricula
- 3. Practical Transition Tools (checklists, etc.)
- 4. Creation and Dissemination of Online Resources &
Websites
- 5. Implementation of or Participation in Conferences, Fairs,
Seminars, & Summits
NPM 6: The percentage of youth with special health care needs who received the services necessary to make transitions to all aspects of adult life, including adult health care, work, and independence.
SLIDE 16 National Performance Measure 6
Top 10 Types of Activities Under NPM6 % of states reporting at least 1 activity in this area (N=59) Participation in Statewide Collaborations & Coalitions 68 Development of Trainings & Curricula 46 Practical Transition Tools (checklists, etc.) 31 Creation & Dissemination of Online Resources & Websites 31 Implementation of or Participation in Conferences, Fairs, Seminars, & Summits 39 Development & Creation of Resources 39 Distribution of Resources 44 Development/Implementation of Consultation & Referral System 20 Collaboration with Medical Providers (including pediatrician and adult health care provider relations) 25 Support Youth Advisory & Youth Leadership Programs 20 Care Coordination Programs 17 Direct Services: Transition Planning & Specialists 27
SLIDE 17 National Performance Measure 8:
The most common ways states are addressing NPM 8 are:
- 1. Personal Responsibility Education Program (PREP)
- 2. Abstinence Education/Abstinence Programs
- 3. Implementation of Evidence-Based Models/Programs
- 4. Family Planning Programs
- 5. Skills Training, Peer Leadership Training, and other types
- f Training
NPM 8: The rate of birth (per 1,000) for teenagers aged 15 through 17 years.
SLIDE 18 National Performance Measure 8
Top 10 Types of Activities Under NPM8 % of states reporting at least 1 activity in this area (N=59) Personal Responsibility Education Program (PREP) 36 Abstinence Education/Abstinence Programs 27 Implementation of Evidence-Based Models/Programs 25 Family Planning Programs 25 Skills Training, Peer Leadership Training, and other types
19 Implementation of or Participation in Conferences, Summits, and other Events 17 Community and Youth Outreach 17 Data Collection and Analysis 15 Educational Programs 15 Reproductive Health Information and/or Services 15
SLIDE 19 National Performance Measure 16:
The most common ways states are addressing NPM 16 are:
- 1. Suicide Prevention Trainings
- 2. Collaboration with Statewide Partners/Coalition
- 3. Outreach To/Collaboration With Schools
- 4. Data Collection and Analysis
- 5. Development or Implementation of a Statewide Plan to
Address Suicide Among Youth
NPM 16: The rate (per 100,000) of suicide deaths among youths aged 15 through 19.
SLIDE 20 National Performance Measure 16
Top 10 Types of Activities Under NPM8 % of states reporting at least 1 activity in this area (N=58) Suicide Prevention Trainings 36 Issue-Specific Collaboration with Statewide Partners/Coalition 36 Outreach To/Collaboration With Schools 32 Data Collection and Analysis 27 Development of Implementation of a Statewide Plan to Address Suicide Among Youths 27 Development and/or Distribution of Prevention Materials 22 Mental Health Services 22 Technical Assistance to LHDs, Community Organizations, Grantees, or Coalitions 15 Collaboration with State Fatality Review Committee 15 Local Suicide Prevention Coalitions 15
SLIDE 21 Comparison of NPM Activities
Activities under NPM 6 (transition for YSHCN) are more systemic
- Transition is one of six core systems outcomes for CYSHCN
- Reflects federal priorities
Activities under NPM 8 (teen birth rate) are focused on interventions
- Reflects federal funding and priorities, as well as strong
research base for interventions Activities under NPM 16 (teen suicide rate) combine both systemic approaches and interventions
- Learning from and applying the best of both worlds?
SLIDE 22 State Performance Measures in Title V
- Measures that each State has identified as additional
priority areas
- Selected by each state
- Used to gauge progress towards achieving state-specific
goals
SLIDE 23 Analysis of SPMs answered the following questions:
- What adolescent health issues have states chosen to
address with their SPMs?
- What adolescent-specific issues and themes are most
common across state program activities?
- How many states have SPMs that address specific
adolescent health outcomes?
Research Questions: State Performance Measures
SLIDE 24 What adolescent health issues have states chosen to address with their SPMs?
- Wide variety of issues and approaches are included under
SPMs
What adolescent-specific issues and themes are most common across state program activities?
- Teen Pregnancy Prevention and Reproductive Health are the
most common issues
- Positive Youth Development appears as an activity AND an
- utcome
Findings: State Performance Measures
SLIDE 25 Top 10 Activity Areas: Percent of All Activities
as Identified in SPM Narratives, 2011-2012
18.64% 20 states 18.64% 19 states 13.56% 14 states 12.71% 13 states 11.86% 12 states 11.86% 13 states 10.17% 12 states 8.47% 8 states 6.78% 7 states 6.78% 7 states 2 4 6 8 10 12 14 16 18 20 22 24
Teen Pregnancy Prevention Reproductive Health School Health YSHCN Obesity/Overweight/Healthy Weight Positive Youth Development Substance Abuse Hunger/Healthy Food/Food Assistance Injury Prevention Youth Leadership
- No. of States With at Least 1
Activity of that Type
SLIDE 26 Teen Pregnancy Prevention Activities as described in SPM Narratives, 2011-2012 (N=22)
PERSONAL RESPONSIBILITY EDUCATION PROGRAM (PREP) TPP-EDUCATION TPP-FAMILY PLANNING TPP-PREGNANT & PARENTING TEENS TEEN OUTREACH PROGRAM (TOP) TPP-ONLINE RESOURCES TPP-PEER PROGRAM TPP-POSITIVE YOUTH DEVT/HEALTHY YOUTH DEVT Other TPP activities 36% 25% 7% each 5% each
SLIDE 27 Reproductive Health Activities as described in SPM Narratives, 2011-2012 (N=22)
REPRODUCTIVE HEALTH SEXUAL HEALTH FAMILY PLANNING OTHER ACTIVITIES PRECONCEPTION HEALTH INTERCONCEPTION HEALTH / CARE REPRODUCTIVE LIFE PLAN FOLIC ACID REPRODUCTIVE HEALTH PLAN SEX EDUCATION TRAINING OUNCE OF PREVENTION 23% 27% 3% each 7% each 10% 13% each
SLIDE 28 School Health Activities as described in SPM Narratives, 2011-2012 (N=16)
COORDINATED SCHOOL HEALTH SCHOOL BASED HEALTH CENTER SCHOOL HEALTH SCHOOL BASED HEALTH CARE SCHOOL HEALTH SCREENING 13% 38% 38%
6% each
SLIDE 29 Substance Abuse Activities as described in SPM Narratives, 2011-2012 (N=12)
ALCOHOL USE/ DRINKING BEHAVIOR SUBSTANCE ABUSE/ PREVENTION 36% 64%
SLIDE 30 Youth Leadership Activities as described in SPM Narratives, 2011-2012 (N=8)
YOUTH LEADERSHIP DEVELOPMENT DIABETES YOUTH AMBASSADOR PEER EDUCATORS TEEN TALK STUDENTS TAKING CHARGE YOUTH CONSULTANT PEER-TO-PEER 33% 11% each
SLIDE 31 Injury Prevention Activities as described in SPM Narratives, 2011-2012 (N=8)
INJURY PREVENTION DRINKING AND DRIVING GRADUATED DRIVER LICENSING BIKE SAFETY UNINTENTIONAL INJURY HELMET USE PASSENGER SAFETY PEDESTRIAN SAFETY ATV SAFETY 29% 14% each
7% each
SLIDE 32 Analysis of State Performance Measures (SPM) that Specifically Address Adolescents
Issues reflected in State Performance Measures
- vs. Activities outlined in state block grant narratives:
- Reproductive Health/Pregnancy Prevention are #1 across
both SPM and activities
- Activities with/in schools are popular across states, but only
3 states have SPM related to school health
- Positive Youth Development (PYD) shows up in more
activities than SPM because it can be applied to address any issue, but only 4 states have a SPM on PYD.
SLIDE 33 Analysis of State Performance Measures that Specifically Address Adolescents
Top 10 Issue Areas Addressed in Adolescent-Specific SPMs: Top 10 Types of Activities Conducted Under SPMs:
1. Reproductive Health (includes pregnancy/birth rates, STDs, contraception, prenatal care, preconception care) 1. Teen Pregnancy Prevention 2. Substance Abuse (includes alcohol and drugs) 2. Reproductive Health 3. Weight/Physical Activity/Nutrition 3. School Health 4. Interpersonal Violence (includes bullying, fighting, intimate partner violence) 4. YSHCN 5. Tobacco 5. Obesity/Overweight/Healthy Weight 6. Access to Health Care (physical, preventive services, mental health, oral health, school-based, insurance, services for LGBT/runaway youth, immunizations) 6. Positive Youth Development 7. Unintentional Injury 7. Substance Abuse 8. YSHCN 8. Hunger/Healthy Food/Food Assistance 9. Mental Health Status/Depression 9. Injury Prevention
- 10. Positive Youth Development (includes
school connectedness)
SLIDE 34
Research Question: Survey of State Adolescent Health Coordinators, March 2014
How do these data compare to what State Adolescent Health Coordinators report as their focus of work?
SLIDE 35
- Coordinators report largest focus of their work as
coordination and partnership across agencies and bringing the youth perspective to other programs and projects
- Teen Pregnancy Prevention and Youth Development are
- ther two most common focus areas
- Coordination work/activities not captured in narratives
- What they are bringing to other programs and projects
may not be captured
Findings: Survey of State Adolescent Health Coordinators, March 2014
SLIDE 36 5 10 15 20 25 General Adolescent Health – coordination/partnership across agency General Adolescent Health – bring youth perspective to others' programs/projects Youth Development Teen Pregnancy Prevention - PREP Teen Pregnancy Prevention (includes sexuality education)
Percent of respondents
25 respondents (response rate 58%)
What is the CURRENT FOCUS on adolescent/young adult health in your work/your adolescent health program?
SLIDE 37 What Have We Learned?
- Breadth of activity in adolescent health
- Prevalence of Youth Leadership programs =
application of Positive Youth Development research
- Positive Youth Development is both a content area
AND a strategy—unique in that way
- Achievement of high level of buy-in
- n Positive Youth Development approaches
and programs
SLIDE 38 Acknowledgements
Caroline Stampfel, AMCHP Senior Epidemiologist Alma Reyes, AMCHP Program Associate Veronica Helms, AMCHP Program Manager Kate Taft, AMCHP Senior Program Manager
SLIDE 39
Environmental Scan Report Forthcoming
Disseminate information on Title V work in adolescent health Disseminate information on specific state approaches, highlight specific states’ adolescent health work Provide access to more data
SLIDE 40
Adolescent Health in Iowa
Mary Greene, Community Health Consultant Addie Rasmusson, Community Health Consultant Iowa Department of Public Health
SLIDE 41 Adolescent Health in Iowa
– Professional development trainings
– AH Collaborative – IAMincontrol.org Using TPP dollars as a vehicle for a broader, holistic adolescent health vision
SLIDE 42 Adolescent Health in Iowa
- No dedicated funding specific to adolescent
health
– Educating IDPH staff, grantees, and outside partners – Planting a seed with MCH agencies
SLIDE 43
Contact Information
Mary Greene - CHC for the Abstinence Education Grant Program (AEGP), Iowa Department of Public Health mary.greene@idph.iowa.gov 515-725-0047 Addie Rasmusson- CHC for the Personal Responsibility Education Program (PREP), Iowa Department of Public Health addie.rasmusson@idph.iowa.gov 515.281.6071
SLIDE 44 Adolescent Health
Karen Hughes , MPH Chief, Division of Family & Community Health Services Laura Rooney, MPH Adolescent Health Program Manager
SLIDE 45 Table of Organization
Director Division of Prevention Division of Family Division of Quality Bureau of Community Health Services and Patient Centered Primary Care School and Adolescent Health Section
SLIDE 46 School and Adolescent Health Section
- Abstinence Only Education
- Adolescent Health
- CDC Chronic Disease Grant – School Health
- Nutrition Education/BMI
- Personal Responsibility Education Program (PREP)
- School Nursing
- Youth Risk Behavior Survey (YRBS)
SLIDE 47
Title V – Adolescent Health
National Performance Measures
NPM 2,3,4,5,6 - Children with Special Healthcare Needs - contribute NPM 8 - Birth rate for teens – contribute NPM 10 - Deaths by MV crashes <14 years – contribute NPM 16 - Suicide deaths by 15-19 year olds – facilitate
SLIDE 48
Title V – Adolescent Health
State Performance Measures
SPM 1 – Reduce unintended pregnancies - contribute SPM 3 – Health Services in Schools – facilitate SPM 6 – Preconception Health – contribute SPM 8 – Adolescent Deaths intentional/unintentional - facilitate
SLIDE 49 Adolescent Health within DOH
Health Care Needs
Prev/Management
Reproductive Health
- Immunizations
- Injury Prevention
- Nutrition/Physical
Activity
Bullying Prevention
- School Environment
- Substance Abuse Prev/
Opiods
SLIDE 50 Collaborating and Coordinating
- Adolescent Health Advisory Council
– Provided guidance to Departmental programs, primarily pre-conception health
- Title V Program Measure Committees
– Connecting staff across Bureaus for implementation and measurement
- Intra-Agency School Health Committee
– Assessed overlap, gaps and connection to schools
SLIDE 51 Ohio Adolescent Health Partnership
- Transitioned Adolescent Health Advisory
Council to Ohio Adolescent Partnership
– External to DOH but facilitated by MCH staff – Reflects expanded purpose of providing statewide leadership beyond advisory role to MCH program
- Developed Strategic Plan (2013-2020)
SLIDE 52 Added Connectivity
- Increased/strengthened relationships
internally and externally
- Increased attention and focus on adolescent
health and unique characteristics/needs
SLIDE 53 Recognized in other plans and grants
– State Chronic Disease Plan – Public Health Accreditation Application – HPV Grant and Plan – Injury and Violence Prevention Partnership – Ohio Suicide Prevention Plan – Ohio Domestic Violence Network’s Plan – Transition for Children with Special Healthcare Needs – Ohio Department of Mental Health & Addiction Services
- Safe Schools Healthy Students
- ENGAGE – Youth and Young Adults in Transition
– Ohio Start School Later Campaign – The Ohio State University – 1st Adolescent Health Class
SLIDE 54 Links
- ODH Adolescent Health webpage:
http://www.odh.ohio.gov/odhprograms/chss/ad _hlth/adhlth1.aspx
- Ohio Adolescent Health Partnership webpage:
http://tinyurl.com/OAHP2020
SLIDE 55
Thank you!
Karen Hughes, MPH Chief, Division of Family & Community Health Services Karen.hughes@odh.ohio.gov 614.644.7848 Laura Rooney, MPH Adolescent Health Program Manager Laura.rooney@odh.ohio.gov 614.466.1335
SLIDE 56
Evaluation
Please take a moment to complete this brief evaluation survey and let us know what you thought. Your feedback is very important in helping us plan for future events. https://www.surveymonkey.com/s/AH_EnvScn The recording will be posted at: http://www.amchp.org/programsandtopics/AdolescentHealth
SLIDE 57 Healthy Children. Healthy Families. Healthy Communities.
WWW.AMCHP.ORG
Maritza Valenzuela, MPH CHES Senior Program Manager Adolescent Health mvalenzuela@amchp.org (202) 266-5252 Alma Reyes Program Associate Child and Adolescent Health areyes@amchp.org (202) 775-1474
Thank You!
Please contact us with any questions!
