In 2017, there were 420,881 children from age one to 17 residing in the state. Of those, 64% (268,729) were children aged one to 11. According to the 2016-2017 National survey of Children’s Health, 92.0% of children had excellent or very good health, 95.1% of children have health insurance, and 71.5% of parents indicated their child lived in a very safe neighborhood. Idaho does not have state-funded preschool programs.
For the Child Health domain, the MCH team chose to continue two priority needs identified for this population from the last five-year reporting cycle (FY 2011 – FY 2015): 1) reducing childhood overweight and obesity and 2) increasing immunization rates. The 2015 needs assessment reflected that both areas still need improvement. Strategies to address the respective NPM, SPM, and related objectives are discussed below. Based on the Title V guidance released in 2018, Idaho re-organized the state action plan to reflect the state’s priority need of improving access to medical homes, including dental homes, to the Child Health domain. Therefore, NPM 13 is now part of this domain and is linked to the objective of increasing the number of children and families who receive information about the importance of regular dental visits and oral health care by September 2020.
Childhood Physical Activity and Nutrition
The state selected “NPM 8: Child Physical Activity” to continue focus on reducing childhood overweight and obesity, and developed the objective of funding and supporting existing programs and initiatives to expand education and activities focused on physical activity and nutrition for children by September 2020. According to the 2017 National Survey of Children’s Health, Idaho children fare better than children nationally for maintaining a healthy weight. About 23% of Idaho children were considered overweight or obese (based on BMI) compared with about 31% of children nationally. For the same year, 33.1% of Idaho children ages 6 to 11 were physically active for at least one hour every day. Measurement of the objective will be based on fiscal support from the Title V MCH Block Grant and an inventory of activities in which the MCH Program is involved. Strategies to address this objective and NPM are discussed below.
The MCH Program funded the Oral Health Program to conduct the Smile Survey during the 2016/2017 school year. This year, the Smile Survey was done in coordination with the Body Mass Index (BMI) Survey. The results helped shed light on the current status of overweight and obesity among third-graders and help inform future strategies with the Idaho Physical Activity and Nutrition Program (IPAN). For the survey, 63 schools were randomly chosen for participation in the 2016-2017 BMI Survey. All third-grade students enrolled and in attendance on the day of the assessment were eligible to participate. Trained professionals measured student height and weight using a standard measurement protocol and data collection form. BMI estimates were calculated for the 3,591 student participants and were statistically weighted to represent all third-grade public school students in Idaho and to account for probability of selection and non-response. Statewide, 2% of students were underweight, 70% of students were normal weight, 14% were overweight, and 14% were obese during the 2016-2017 school year. There was not a significant difference in weight status between males and females.
The MCH Program and Idaho Physical Activity and Nutrition (IPAN) Program continue to meet quarterly to discuss opportunities to collaborate on childhood obesity interventions. The discussion has been robust and many options have been on the table. Teaching children healthy habits from the start will help them learn to make healthy choices as they grow older. Through the Healthy Kids, Healthy Future (HKHF) (formerly Let’s Move! Child Care) initiative, Idaho child care providers have the opportunity to promote children’s health by encouraging healthier physical activity and nutrition practices through five main goals: increasing physical activity, limiting screen time, providing nutritious foods, providing nutritious beverages, and encouraging breastfeeding. For FY2018 (October 2017 – September 2018), 114 childcare providers received the HKHF training through the Idaho STARS, which is the state’s child care training and professional development system (ESM 8.1.1). IPAN coordinators located at each of the seven public health districts are tasked with promoting the regional lending libraries for child cares. For a minimal, one-time cost, child cares can access several age-appropriate activities and items for use with their children. Accessing the regional lending libraries is one way that child cares are given the tools to put into action what they have learned in the HKHF trainings and enhance outdoor and indoor play space to encourage physical activity with all ages of children. In 2018, the MCH Program purchased a variety of items and activities focused on encouraging physical activity for all the child care lending libraries. During FY 2018, 27 child care centers had access to resources from the lending libraries through partnership with the IPAN program.
For FY 2018, the MCH Program increased the funding allocation to the IPAN Program to support the development and pilot of a Farm-to-Early Care and Education (ECE) program in the South Central Health District. IPAN contracted with the University of Idaho – Extension Office to develop and implement the program and curriculum. The Farm to ECE program will offer increased access to core elements of local food sourcing, school gardens, and agriculture education to enhance the quality of the educational and nutritional experience in the childcare settings. This program will be implemented and tested in 10 centers in Idaho. Once the program is evaluated and improvements have been made, the program will be available to childcare centers through Idaho and scaled for implementation.
The Idaho WIC Program participated in the Idaho Hunger Relief Task Force and a statewide Childhood Hunger Coalition. The WIC Program also collaborated with the Healthy Eating Active Living (HEAL) Network and participated in the Creating Healthy Communities Summit, which has a purpose of developing and maintaining an active engaged network of partners working together, investing resources and providing expertise to create and support an active living, healthy eating population in Idaho with a focus of reducing and preventing childhood obesity. Additional WIC activities during the year included a wide range of nutrition education offerings for participants and promotion of food packages aligned with the Dietary Guidelines for Americans. Food package options were expanded to include 100% whole grain pasta and low-fat/nonfat yogurt. WIC will continue to participate in the coalitions and councils stated above.
Immunizations
To address the priority need for improving childhood immunization rates, the MCH Program developed a SPM related to Idaho’s unique needs related to immunizations. For the 2017/2018 Idaho school year, 94.7% of kindergarteners and 91.9% of seventh graders met state immunization requirements for school enrollment. To support this SPM, the MCH team developed the objective of collaborating with the Idaho Immunization Program (IIP) to increase vaccination education and vaccine uptake among MCH populations. Measurement of the objective will be based on an inventory of programmatic activities related to immunizations and IIP data. Strategies to address this objective and SPM are discussed below.
One mechanism to help increase vaccine coverage in Idaho is the Vaccine Assessment Fund. The required state match for Idaho’s Title V MCH Block Grant is achieved through this dedicated fund for state-supplied vaccines for privately insured children. Private insurance companies make a yearly payment into the Idaho Vaccine Assessment fund based on the number of insured children they cover and the vaccine assessment rate. This allows the IIP to purchase vaccines at the discounted federal rate. Idaho is a universal supply state, which means all children under 19 years of age are eligible for state-supplied vaccines regardless of insurance status. Medical providers place orders for vaccine through the IIP and are able to maintain a single stock of vaccines for their pediatric patients. The universal supply is supported by the Idaho Vaccine Assessment Fund, the Vaccines for Children (VFC) Program (covers children with Medicaid or who are uninsured, underinsured, American Indian and Alaska Natives), and the Separate Children’s Health Insurance Program. Ultimately, insurance companies realize cost-savings through the assessment fund. The MCH Program will continue to support the work of the IIP to provide education to the public and health care providers about the importance of immunizations, addressing immunization hesitancy, and best practices to increase immunization rates.
The Idaho Immunization Program (IIP) continues to receive funding from the Centers for Disease Control and Prevention (CDC) and from the State of Idaho to operate the state immunization program. Improving childhood immunization rates is a primary focus for the IIP. Immunization promotion activities continue similar to previous years, including immunization awareness campaigns for the public (with special emphasis on infants, expecting parents, and new parents), provider education and trainings through statewide workshops and conferences, and implementation of the Assessment, Feedback, Incentive, and eXchange (AFIX) intervention at provider visits conducted throughout the state. AFIX is an evidence-based intervention that provides clinics with clinic-best practices that are proven to improve clinic-level infant, child, and adolescent immunization rates.
Some new activities initiated within the previous year include the implementation of the Idaho Provider Immunization Education (I-PIE) webinar series which provides live and recorded webinars to providers and other partners. Webinars have covered topics such as Maternal Influenza, HPV vaccination in adolescents, Vaccine management, and Vaccines for Children (VFC) Program re-enrollment. The Program has also begun on-site school trainings to assist school staff in maintaining student immunization records and completing the annual school immunization report. IIP staff were able to secure 100% School Immunization Report completion by Idaho schools for the 2017-2018 report.
Finally, the Program has initiated centralized immunization reminder/recall activities that include mailings to parents to remind them of missed or upcoming Tdap and the meningococcal vaccinations for their children. Reminder/recall is a proven intervention to help increase immunization rates among infants, children, and adolescents. Evaluation data were not available at the time of this report
Pediatric Oral Health
To address the priority need to improve MCH population access to medical homes and linkage to dental care, the MCH Program will continue to fund the Idaho Oral Health Program’s contracts with the public health districts (PHDs) for dental care among school-age children. In 2014, the PEW Charitable Trusts assigned the state of Idaho an “A” grade for protecting children from tooth decay with the application of dental sealants. Idaho was one of only five states to receive this distinguished grade. According to the Centers for Disease Control and Prevention (2015), dental sealants are a critical preventive dental service and can reduce decay by 60 to 80 percent in two years after application. Further, school-based dental sealant programs are a great way to reach children and result in cost-savings for families. The reason Idaho is top in the nation for protective sealants is due to many collaborative networks involving private and public entities.
The Idaho Oral Health Program (IOHP) has provided preventive oral health services to children and adolescents, especially those who are at high-risk for dental disease, for more than 35 years. The IOHP provides funding to the seven public health districts throughout Idaho in the form of subgrants. The IOHP works with communities, organizations and a wide array of partners to improve the dental health of Idaho’s children and to communicate the importance of dental disease prevention. Key to the success of this program is regular oral health surveillance, community partnerships and the development of a state oral health action plan, which serves as a roadmap for the improvement of oral health in Idaho.
During the timeframe of July 1, 2017 through June 30, 2018, all seven public health districts continued to provide school-based dental sealant clinics. Along with providing dental sealants, the public health districts also provided oral health screenings, fluoride varnish applications, oral health education, and facilitated dental home referrals as needed. Children in need of urgent care were referred immediately to a dentist. The IOHP also subgrants with the public health districts in Idaho to provide fluoride varnish programs to children at early childhood education centers, elementary schools, and Women, Infants, and Children (WIC) Clinics. As per the 2016-2017 Idaho Smile Survey Report, “More than half, 67.2 percent, of Idaho third-grade students had dental sealants on at least one tooth recommended for sealants. The Healthy People 2020 goal for children aged six to nine is a rate of 28.1 percent or better on one or more of their permanent first molar teeth. The rate has improved in each survey from 2001 with a statistically significant increase of 13.6 percent.” For FY 2018, a total of 1,429 children received dental sealants in school-based settings through the IOHP (ESM 13.2.1).
In 2016, the MCH Program contracted with St. Luke’s Children’s Clinical Integration Committee Quality Group (formerly the Idaho Health and Wellness Collaborative for Children) to host a learning collaborative focused on practice improvement and care delivery related to pediatric oral health care. A learning collaborative is “an opportunity for healthcare providers and practices to participate in a structured quality improvement process to raise the quality of care they deliver. Every learning collaborative includes a kick-off learning session to hear evidence behind best practices, coaching on how to implement process improvement in your practice, ongoing technical assistance, topic related conference calls from experts in the field, site visits from quality improvement coaches, a wrap-up session to review progress, and suggestions to create and implement a plan for sustainability.” Qualis Health (2012) indicated that medical providers must understand the impact of poor oral health on overall health status, and ideally, primary care medical providers need to be trained to conduct oral health screenings, provide education, and apply fluoride varnish during well-visits. The focus of the Pediatric Oral Health Learning Collaborative was to integrate oral health into primary care with the goal of improving oral health care for young children ages 6 months to 5 years of age. Physicians earned maintenance of certification credits by participating and practices receive comprehensive coaching and resources to implement strategies within their clinics. Practices participating in the learning collaborative were encouraged to conduct a brief oral health screening, make a referral to a dental provider, apply fluoride varnish at well-child visits, increase documentation in the electronic medical record (EMR) system, and make follow-up appointments when appropriate. The learning collaborative wrapped up in summer 2017 and realized participation from 14 clinics and 60 different providers.
To Top
Narrative Search