Children's Health Branch

 

NPM 6-Percent of children, ages 10 through 71 months, receiving a developmental screening using a parent completed screening tool

 

ESM 6.2 - Establish an agreement with the Alabama Partnership for Children's Help Me Grow (HMG) Program to utilize their online Ages & Stages Questionnaires, Third Edition (ASQ-3) assessment tool so that parents can complete developmental screens prior to child health visits at county health departments.

 

According to the Child and Adolescent Health Measurement Initiative (CAHMI), in 2017-2018 39.8 percent (53,496) of Alabama’s children age 9-35 months received a developmental screening using a parent completed tool; 60.2% (80,818) of the developmental screenings were not completed by the parent.

 

Again, according to CAHMI, Alabama fared better than the national average of 33.5 parent completed vs. 66.5 parent did not complete the developmental screening.

 

According to the Alabama State Department of Education (ALSDE), in 2017-18, Alabama had 1,473 public schools in a total of 137 local school systems. The Alabama Department of Mental Health is collaborating with the ALSDE and local education agencies to ensure children and adolescents have access to high quality mental health services, early intervention and treatment services. Fifteen mental health centers will receive additional funds for the expansion of School- Based Mental Health services with $750,000 in FY21. Currently 71 school systems and all 19 community mental health centers participating in the School Based Mental Health Collaboration Program.

 

Oral Health Office

 

NPM 13.2: Percent of children, ages 1 through 17, who had a preventive dental visit in the past year

ESM 13.2-lncrease the proportion of infants and children, ages 1-17 years, who report receiving a preventive dental visit in the past 12 months by piloting the Home by One Program.

 

National Dental Hygiene Month

 

A 30 second Spectrum cable television and streaming advertisement began showing in September 2020 and ran through the month of October, National Dental Hygiene Month. The ad promoted preventive dental visits for expectant mothers and children ages 1-17, in addition to the newly FDA approved (age appropriate) HPV vaccine, for expectant mothers and children ages 9-17 years. The following summarizes the public reach of the Spectrum advertisement.

 

Television Overview

1,006 Airings

31 Networks

12 Zones

 

Streaming TV Overview

95,067 Impressions

93,727 Completions

98.59% Completion Rate

 

Ongoing activities in Alabama to improve oral health:

 

OHO hosted its first ever Oral Health and Community Water Fluoridation Conference, virtually. This event provided four free CE hours to 187 water plant operators. OHO partnered once again with the City of Troy for an in-person conference in Troy, Alabama. This conference provided seven free ADEM approved CE hours to 85 water plant operators and environmentalists. Approximately 721,699 residents will be positively impacted from the educational information provided by the conference.

 

OHO provided grants totaling $100K to water plants for purchase of new or additional fluoridation equipment and the OHO fluoridation toolkit pamphlet was updated to indicate observance of the 75th year of Community Water Fluoridation in the U.S. The toolkit and pamphlet continue to  be available through the ADPH website and was the pamphlet distributed to all public water systems after the redesign.

 

In accordance with the State Oral Health Plan, Goal 4.1.1: Conduct a statewide Basic Screening Survey (BSS) for K and 3rd grade children, OHO initiated this project in 2020. Fifty schools were selected by the Association of State and Territorial Dental Directors (ASTDD) to have  students screened during the 2021-2022 school year. In addition to an oral exam, height and weight will be collected so as to report BMI. Also, each child received an oral health kit and school nurses and counselors receive OHO backpacks with resources highlighting HPV vaccination, community water fluoridation,  tobacco cessation,  and more.

 

TCHD provides preventive and restorative care for children, young adults, and pregnant women under the age of 21 who are covered by Medicaid, ALLKids, or Alabama Blue Cross Blue Shield. OHO utilized Title V  funds to equip TCHD’s dental clinic with new digital radiography equipment. Free oral hygiene supplies, educational material, and other assistance were provided to TCHD as requested. In 2020 there were a total of 1,672 patient visits to TCHD dental clinic. Of that total, 1,299 were preventive dental visits.

TCHD is currently in the fourth year of the a HRSA grant with UAB School of Dentistry. This grant focuses on increasing the dental student’s clinical experience with children under the age of six. Two or three fourth-year dental students rotate through the clinic three days per week during their academic year. The students provide preventive and restorative care and participate in screenings/educational programs. Pediatric dental residents treat patients two days per month under the supervision of a pediatric dentist. Because of the COVID19 pandemic the 2020 rotations ended in March. The students resumed their rotations in August 2020. Due to scheduling issues related to the pandemic, the residents/UAB faculty were unable to resume rotations. As part of the HRSA grant, the fourth-year dental students rotate one day per week through the WIC clinic. The students provide counseling, which addresses establishing a dental home by age one and the importance of dental care during pregnancy. They also distribute dental educational materials and supplies. If the WIC patient does not have an established dentist, they are given a referral. Many patients elect to schedule an appointment in the TCHD clinic, and often are seen the same day.

 

ADPH's Northern Public Health District continued to partner with OHO to provide healthy habits "gifts" to children in immunization clinics and also at appropriate health fair venues. OHO provided the district with 3,500 additional oral health kits. ln addition to providing a toothbrush, toothpaste, and dental floss in a "gift bag", county staff are using it as an opportunity to provide outreach, especially for WlC services, but also for other health department services such as family planning, additional immunization, breast and cervical cancer program, etc.

 

Sarrell Dental, which managed several dental clinics within CHDs, has moved those clinics to free standing buildings. While no longer connected to ADPH, these clinics continue to provide dental homes for a significant number of Medicaid children and their families. Furthermore, new patients of Sarrell Dental are identified through screenings by ADPH in collaboration with Sarrell. Family Health Dental operates clinics in Mobile CHD which provide dental services via community health center-managed dental programs, which included dental services for uninsured or underinsured adults. The only ADPH operated dental clinic that remains is located within the Tuscaloosa CHD.

 

Each year OHO purchases and creates educational resources and promotional items with plans to distribute during oral health month and by request of its partners. OHO provided 2,200 oral health kits and educational materials to Head Start and Early Head Start. OHO provided, to schools and multiple agencies, 4,300 oral heal kits and educational materials during Children’s Dental Health Month.

 

The office conducted oral health screenings for early Early Headstart sites and created an Oral Health Flip book that will be used in training for daycare homes and Headstart training centers.

 

OHO continued to partner with HCCA to provide free oral hygiene supplies and education material. There were 3,040 oral health kits and educational materials distributed to HCCA in 2020.

 

OHO continues to mail “Tiny Teeth” custom education materials to each of the 66 CHDs and others by request.

 

OHO continued its partnership with WlC, providing oral health kits to children enrolled in the program. The distribution is now more widespread. There were 5,000 oral health kits and educational materials, including “Tiny Teeth”, provided to WIC clinics in 2020.

 

OHO continues to promote "Brush, Book, Bed" program, targeted to children ages 0-3 years. The American Academy of Pediatrics program provides partners  with resources ( brochures, stickers, etc). to promote good oral health through a repeatable and repetitive nighttime routine.  

 

Schools and other entities were able to submit a material request via the OHO webpage. OHO will continue to print and distribute as requests are made. New brochures and fliers featuring and promoting oral health topics and programs were developed on an ongoing basis.

 

Oral Cancer Awareness Month

 

ln April  2020, the OHO requested Governor Kay lvey sign a proclamation declaring April  as Oral Cancer Awareness Month in Alabama.

 

ln February 2020, the 3nd annual "Share Your Smile with Alabama" campaign was launched for third grade children in public, private, and home schools statewide to bring attention to National Children's Dental Health Month. Two children, one girl and one boy, were selected from photo submissions as the overall winners of the "Share Your Smile with Alabama" campaign. Prizes of oral health products and a photo shoot in the RSA studio were met with accolades from children's families as well as the ADPH staff. The winners appeared at a live news conference from Montgomery and were featured in OHO marketing campaigns to promote children‘s oral health in the state throughout the year. The campaign is designed to increase awareness about the importance of good oral health and the value of a great smile. OHO advertisements have been published statewide in Birmingham Parent Magazine, Montgomery Parents, River Region's Journey, River Region's Boom, Auburn-Opelika Parents, Mobile Bay Parents, Eastern Shore Parents, Anniston Star, and Lagniappe (Mobile / Eastern Shore). ln the first magazine ad, not only are the children featured, ESM 13.2 was also highlighted.

 

ln FY19, the OHO Director coordinated a partnership with Father Purcell's (Pediatric) Nursing Home. The partnership continued in FY20 with OHO supplying quarterly shipments of oral health kits for all residents of the facility. This partnership continues to grow and be appreciated by Father Purcell’s. OHO increased the supplies to allow more frequent changing of toothbrushes during the COVID-19 pandemic.

 

County Health Departments

 

District MCH Coordinators submitted plans in 2020 to address needs within the Child Health Domain, with several projects focused on access to oral health care, increasing EPSDT visits, injury prevention and suicide prevention. While COVID-19 caused numerous disruptions and delays during FY 2020, the coordinators were able to establish partnerships, purchase equipment and take other steps that would propel the projects in FY21 once schools and clinics reopened.  

 

Highlights

• West Central Public Health District:  Developed a dental referral system. TCHD dieticians screened 940 children, referred 522, and 73 were examined by a dentist. MCH Coordinator assisted TCHD dental staff with dental screenings for Pre-K children at a local elementary school. Promotional dental items and resources, such as pamphlets, tooth brushes, tooth paste, and t-shirts were distributed during community events to bring about awareness of preventive dental care in Perry, Pickens and Tuscaloosa counties. Two QPR (Question, Persuade, and Refer) Gatekeeper Training for Suicide Prevention curriculum trainings were facilitated and suicide prevention resources and promotional items were provided to residents in Perry, Pickens and Tuscaloosa counties.

 

• Northeastern Public Health District:  Developed a dental referral system; 6,459 WIC children were screened for oral health needs, 3,595 children were referred to local dentists, and 250 exams completed during the fiscal year 2020.

 

• Mobile County Health Department:  Provided referral services, linkages to preventive care and immunization services, and education on car seat safety for participants in the Family Support/Home Visitation program for pregnant and parenting teens in Mobile County as well as participants in the Fatherhood Initiative.

 

• Northern District: Developed partnerships with local agencies, including CPSC,  County Interagency Councils, Caring Connection of the Shoals, Alabama Society of Health Care Social Workers, Children’s Policy Councils, hosted dental health awareness days in all 12 northern district counties, providing education and incentives for pregnant women and children. The MCH coordinator presented QPR training to 96 individuals and provided suicide prevention  resources to community partners such as meals on wheels, NARCOG, and NACOLG.

Barriers

• West Central Public Health District:  COVID-19 caused numerous disruptions and delays during FY 2020, therefore, the coordinator was not able to fully implement this dental plan  or QPR and Response trainings as planned.

 

• MCHD:  The Covid-19 pandemic caused significant changes in the functions of the agency and the delivery of MCH services. Family Support/Home Visitation and Fatherhood programs saw some declines due to the Covid 19 pandemic. Some participants were out of work and trying to navigate the closure of daycares and schools.  In-person education classes were replaced with virtual education and follow-up, which introduced new barriers for participants such as a lack of adequate phones, computers, internet services and other technology. The number of participants for virtual activities experienced a drop compared to the in-person meetings.

 

Other ADPH Child Health Programs

 

Youth Suicide Prevention

 

Suicide is the eleventh leading cause of death in the state, with 804 citizens lost to suicide in 2018. In 2020, ADPH’s Alabama Youth Suicide Prevention Program began its fourth year working to reduce the rate of suicides and suicide attempts for youth ages 10 to 24. The program provides grants to crisis centers, the state suicide prevention coalition, and colleges and universities to provide education, outreach, screenings, and referrals to promote suicide prevention, awareness, and services in communities throughout the state. Grantees implement three evidence based- curriculums:  QPR, Response, and Kognito. In 2020, suicide prevention program partners conducted 129 trainings, resulting in 2,237 individuals trained as gatekeepers to identify and refer individuals at risk for suicide. 

 

Child Passenger Safety

 

ADPH has long been a leader and partner in injury prevention and child passenger safety in the state; new funding has allowed for the expansion of those efforts. In 2019 the BPPS (ADPH) received a grant from the Alabama Department of Economic and Community Affairs, which allowed that bureau to develop the Alabama Child Passenger Safety Program. The goals of the Alabama Child Passenger Safety Program are to educate Alabamians on the safe use of child passenger restraints, provide training for individuals to become certified Child Passenger Safety technicians, and establish new car seat fitting stations. Due to COVID-19 and the temporary reassignment of program staff as a result, this program was on hiatus for the majority of 2020.