2020 Child Health Annual Report

Priority Need:  Developmental Screening

NPM 6: Percent of children, ages 9-35 months, who received a developmental screening using a parent-completed screening tool in the last year.

The most recent federally available data (2019) on the percent of children, ages 9-35 months, who received a developmental screening using a parent-completed screening tool in the last year indicates the following:

• 20.6% of children ages 9-35 months completed a developmental screening (National Survey for Children’s Health NSCH)

Objective

By December 31, 2022, increase the number of children who receive a developmental screening by 10%.

ESM 6.1 – Percent of WIC-enrolled children ages 2 through 59 months at Learn the Signs Act Early (LTSAE) sites who received developmental monitoring.

The Arkansas Department of Health (ADH) continued efforts to promote awareness of developmental screening using LTSAE educational materials. These efforts were completed through a partnership between the Child Health, Women, Infants, and Children (WIC), Vital Records and School Health Services departments to continue progress toward targets. Unfortunately, progress in 2020 is minimal due to the COVID-19 pandemic and resulting changes in delivery methods for services. WIC initially planned to increase implementation of the LTSAE pilot by rolling the program out statewide in March 2020. This expansion of LTSAE sites would have increased the number of children receiving developmental monitoring. However, WIC began providing services via telephone due to the pandemic and there is not a virtual option to deliver the LTSAE program. ADH continued the LTSAE education campaign by promoting the use of the CDC’s Milestone Tracker app (https://www.cdc.gov/ncbddd/actearly/milestones-app.html) through the distribution of 9,012 developmental milestone letters with birth certificates for children under the age of 3 in 2020 and via the Child Health website (https://www.healthy.arkansas.gov/programs-services/topics/parent-support), which received 1,531 views from 1,233 first-time visitors.

Lastly, School Based Health Centers (SBHC) conducted developmental screening/monitoring at 23 of 39 centers. Six centers are located at elementary campuses. SBHCs reported 2,282 (4%) children receiving a developmental screening/monitoring. While the strategy for this ESM is feasible in supporting efforts to reach the objective, targets will need to be modified due to the adverse effects of the COVID-19 pandemic.

ESM 6.2 – Percent of children, ages 2 through 59 months, in home visiting programs who were referred for therapy after receiving developmental screening using a validated parent-completed tool.

• The December 2020 HRSA HVIS MCPH Report indicates 48.7% of children receiving home visiting services completed developmental referrals. 

Priority Need:  Injury Hospitalization

NPM 7: Rate of hospitalization for non-fatal injury per 100,000 of children ages 0-9.

The most recent federally available data (2019) on the rate of hospitalization for non-fatal injury per 100,000 children ages 0-9 indicates the following:

• 107.1 per 100,000 children ages 0-9 were hospitalized

Objective

By December 31, 2022, reduce hospitalizations of children and adolescents due to maltreatment by 10%.

ESM 7.1.1 – Percent of families served in home-visiting programs who have reports of child maltreatment.

• The December 2020 HRSA HVIS MCPH Report indicates 8.1% of families receiving home visiting services reported child maltreatment.

Priority Need: Overweight/Obesity

NPM 8: Percent of children ages 6-11 and adolescents ages 12-17 who are physically active at least 60 minutes per day.

The most recent federally available data (2019) on the percent of children ages 6 through 11 who are physically active at least 60 minutes per day revealed the following:

• 30.1% of children ages 6 through 11 were physically active at least 60 minutes/day (Data source: National Survey for Children’s Health, 2018-2019 combined data)
• 22.7% of adolescents ages 12 through 17 were physically active at least 60 minutes/day (Data source: YRBSS, 2019 data)

Objective

By December 31, 2022, increase the percent of students, grades K through 5, attending Coordinated School Health priority schools who are classified as having a healthy weight to 61%.

ESM 8.1.1 – Percent of children at Coordinated School Health priority schools, grades K through 5, who are in the normal or healthy weight zone for Body Mass Index.

The School Health Services Programs at ADH and the Division of Elementary and Secondary Education (DESE) continued efforts to create healthier environments for children to support increases in physical activity. Activities included offering quarterly trainings and technical assistance, participating in state initiatives, and purchasing playground and physical education classroom equipment.

• DESE reported that 49.6% of children at Coordinated School Health (CSH) priority schools, grades K-5, were in the normal or healthy weight zoon for Body Mass Index (BMI). In 2019, the Arkansas General Assembly passed Act 641 to include recess as part of the instructional day and increase the required minutes for recess (unstructured physical activity) to 40 minutes per day for elementary students. This decision was made based on available scientific literature indicating correlations between learning behavior, cognitive skills, and physical activity. While the COVID-19 pandemic caused school to halt, Arkansas students continued to push forward with virtual learning including physical activity. Parents/guardians received several virtual options providing instruction on how to perform physical activity at home to allow students to maintain 90 minutes of physical activity each school day (https://www.healthy.arkansas.gov/images/uploads/pdf/Activity_Resources_for_Parents_and_Students_5-19-20.pdf). Over 250,000 Arkansas students from kindergarten through grade 6 continued physical activity brain breaks as well as physical education classes throughout the school closure. 
• Act 1220 and Coordinated School Health Coordinators at ADH and DESE provided trainings/technical assistance during the project period to address topics such as Foundations of Wellness Blended Learning, Assessing Your School Wellness, Comprehensive School Activity Plan, Essential Components of Physical Education, Characteristics of Effective Health Education, and Cross Walking the Arkansas Health Standards with Healthy Behavioral Outcomes. During the project period, approximately 250 school personnel representing more than 100 districts participating in these trainings.
• School Health Services (SHS) staff is an integral part of the Healthy Active Arkansas program. Recently, due to the COVID-19 pandemic, the Community Access to Physical Activity (CAPA), which focused on providing access to quality physical activity, was put on pause with plans to resume soon. The team switched focus to ensuring that all students have access to water while in school. The SHS staff assisted in reviewing grants for water bottle filling stations to schools provided by HAA. Additionally, staff supported and promoted the Arkansas Coalition for Obesity Prevention’s (ArCOP) Better Together project, aimed at promoting optimal health for young children in early childhood centers to support children developing healthy physical activity habits early in life for the next three years.
• The School Health Services team used available funding (Coordinated School Health and CARES Act) to purchase playground and physical education classroom equipment. Additional playground stencils were purchased for each of the 15 educational cooperatives to provide options for contactless games and activities for physical education and recess for school districts statewide.

The School Health Services program was unable to establish a child’s fitness promotion project to monitor measured data on students’ fitness improvement throughout the year; however, the program will continue efforts during the next project period.

ESM 8.1.2 – Percent of school personnel who participated in Coordinated School Health training with increased knowledge of evidence-based physical activity practices and curriculum and physical activity services provided by School Health Services.

Coordinated School Health (CSH) implements all 10 components of the Whole School Whole Community, Whole Child Model recognized by the Association of Supervision and Curriculum Directors and the CDC. Arkansas is one of 16 states receiving financial support from the CDC to implement and evaluate evidenced-based strategies and activities to prevent obesity, reduce the risk of children developing chronic diseases, and manage students’ chronic health conditions. There are over 90 school districts, including six priority school districts, representing over 250,000 K-12 students participating in the CSH program. The program offered quarterly professional development meetings with topics addressing school wellness policies and reporting plans, School Health Index reporting, health literacy and classroom physical activity, family and community engagement, and human trafficking in schools. There were approximately 490 school personnel representing over 240 schools in attendance virtually. Approximately 350 school personnel (70%) reported increased knowledge of physical activity and/or physical education.

CSH priority schools were provided funds to purchase social/emotional learning curricula, and some schools were able to purchase additional playground equipment for special needs children.