Annual Report Fiscal Year 2022:

This section provides a summary of FFY22 activities, accomplishments, and challenges related to NPMs and SPMs for the YAYAHP.

The Wyoming and U.S. rates for adolescent motor vehicle traffic (MVT) mortality have been decreasing, with the U.S. rate declining significantly since 2007. However, teens contribute to, and suffer from, the consequences of motor vehicle collisions at a disproportionate rate. The 2019-2021 adolescent (ages 15-19) motor vehicle mortality rate in WY was 22.4/100,000, similar to the rate reported for 2018-2020 (21.9/100,000), and still significantly higher than the U.S. 2019-2021 rate of 12.0/100,00 (NVSS, 2019-2021).

Strategy 1

Implement and expand Teens in the Driver Seat (TDS) in high schools through collaboration with statewide partners

TDS is a peer-to-peer traffic safety program that focuses on five major risk factors for adolescent car wrecks:

• Distracted driving (including texting while driving)
• Nighttime and drowsy driving
• Speeding and street racing
• Low seat belt use
• Impaired driving

The program is designed to engage adolescents in educating peers and caregivers. TDS was selected as an evidence-based strategy in part because of the YAYAHP’s participation in the Child Safety Learning Collaborative convened by the Child Safety Network. The YAYAHP has engaged with other states implementing TDS, including Nebraska, to identify common challenges and key facilitators in early stages of TDS implementation.

The YAYAHP contracted with the Texas Transportation Institute (TTI) in August 2021 to support a pilot of TDS at up to five high schools in the state during FFY22.  TTI was charged with providing technical assistance to participating schools for TDS implementation. During this time, three schools expressed interest, but only one school was onboarded and began implementation.

The YAYAHP is working to further engage state traffic safety stakeholders, including Wyoming Department of Transportation (WYDOT) and WDE in promoting TDS and linking TDS to existing adolescent motor vehicle traffic safety (MVTS) work across the state.

The Wyoming adolescent suicide rate is significantly higher than the U.S. rate and has been since 2007. Both the U.S. and Wyoming adolescent suicide rates have increased; however, the Wyoming rate is increasing at a faster rate. In 2007-2019, the Wyoming rate (18.0/100,000) was 2.5 times higher than the U.S. rate (7.2/100,000). The 2019-2021 WY adolescent suicide rate was 30.4/100,000, continuing to be significantly higher than the U.S. rate of 10.6 in 2019-2021. Suicide among adolescents continues to be a serious problem, and current statewide efforts do not focus predominantly on adolescents.

Strategy 1

Promote the adolescent well visit to youth (ages 10-20) through partnership with Medicaid, providers, and the Youth Council

In FFY22, YAYAHP, with approval from MCHB, removed NPM 10 and discontinued ESM 10.1. The vast majority of suicide prevention efforts are not specifically targeting adolescent well-visit, so discontinuing this strategy to allow focus on other activities was deemed best for the YAYAHP at this time.

Strategy 2

Improve the ability and capacity of Wyoming clinics to provide mental health screening and care to adolescents in continued partnership with the University of Michigan Health Initiative to implement Adolescent-Centered Environment-Assessment Process (ACE-AP)

The YAHAHP closed out the ACE-AP pilot program in March 2022. There is no further progress to report.

Strategy 3

Implement and expand SOS in Wyoming junior high and high schools

SOS is “a best practice youth suicide prevention project designed to harness the power of peer social networks to change unhealthy norms and culture, ultimately preventing suicide, bullying, and substance abuse.” SOS is designed to increase help-seeking behaviors and promote connectedness between and among peers and caring adults.

The YAYAHP has partnered with the WDH WIVPP to support the expansion of SOS in Wyoming junior high and high schools. SOS was chosen because: 1) it is evidence-based to increase connectedness in school settings when implemented with fidelity, and 2) SOS is already in place in several communities in Wyoming. WIVPP funds currently support the implementation of SOS in three of 23 counties in Wyoming. The YAYAHP engaged in in-depth partnership building and needs assessment work to determine the best way to support existing SOS efforts, and leverage knowledge and expertise already in place in the state, for promotion of SOS expansion. Conversations with WIVPP staff and county-based community prevention specialists determined that hosting a train-the-trainer (T4T) workshop in Wyoming for schools to attend was an important first step in MCH support for SOS implementation and expansion.

YAYAHP sponsored twoT4T workshops in FFY22. As a result, 28 people working within nine Wyoming school districts became a SOS trainer. These individuals are now able to train additional district employees and students in the program and implement the program in schools. The number of counties supporting implementation of SOS has more than doubled from six in state biennium 2021-2022 to 14 in state biennium 2023-2024.

Strategy 4

Develop and maintain statewide Youth Council to assure youth voices are included in program development, implementation, and evaluation

The YAYAHP seeks to promote youth voice in the development of strategies, materials, and activities. The support of a statewide Youth Council brings youth voices and experience together with health programs, promoting success, increased youth engagement, and quality improvement. One council member shared, “I joined YaYA [the statewide Youth Council] because I feel it is important to give youth and young adults from the Wind River Reservation a voice. I hope to promote change on the reservation and show the younger generations that they have a voice that people want to hear..”

The Youth Council was launched in the summer of 2020, and was able to convene virtually and start work despite the COVID-19 pandemic. The council meets virtually twice a month to discuss current projects and hear from organizations and agencies across Wyoming that are currently engaging in activities to promote youth wellness. The council also maintains a website to engage young adults across the state.

The Youth Council provides feedback to YAYAHP on proposed strategies and program implementation. In FFY24, YAYAHP intends to pursue a contract to transition the Council from a fully Title V funded entity to an independent organization that can receive Title V funds through a subrecipient relationship, and can also receive other funding to allow the Council to address issues beyond Title V priorities.

Other YAYAHP Activities:

YAYAHP Partnership Development

The YAYAHP Manager continued to develop and build partnerships with many youth-serving organizations, other WDH programs, and other agencies to increase the effectiveness of YAYAHP programming. Partnerships include:

• Wyoming Equality
• Wyoming Primary Care Association
• Strong Families Strong Wyoming
• Wyoming Health Council
• Students Against Destructive Decisions
• Wyoming Children’s Trust Fund
• Wyoming Department of Education
• Wyoming Highway Patrol
• Wyoming Department of Transportation
• Wyoming Medicaid
• Uplift
• Wyoming County Prevention Specialists
• Office of Health Equity of WDH
• Injury and Violence Prevention Program of WDH
• Communicable Disease Unit of WDH
• Immunization Unit of WDH
• Wyoming Division of Victim Services
• Wyoming Coalition Against Domestic Violence and Sexual Assault
• Wyoming Department of Family Services

Partnership with Wyoming State School Nurse Coordinator

WY MCH entered into a formal MOU with the WDE in 2021 to support a State School Nurse Coordinator. The YAYAHP Manager meets regularly with this coordinator, and has participated in the work of the coordinator to improve health and wellness outcomes among students in Wyoming. This crosses over with child health and CYSHCN domain activities as well.

The State School Nurse aids in identifying school nurse professional development needs and sourcing training and resources to meet their needs. She is responsible for aggregate health data collection across districts, and is currently piloting the data collection in nine districts. Data collected may further inform YAYAHP and CYSCHN programs. The State School Nurse also provides a key linkage between WY MCH and the WDE. The YAYAHP is working with the State School Nurse on suicide prevention activities in Wyoming K-12 schools.

YAYAHP Manager Memberships

The YAYAHP Manager has remained an active member of AMCHP. The YAYAHP Manager is an active participant in the National Network of State Adolescent Health Coordinators, and is a member of the third cohort of the Child Safety Learning Collaborative.

Annual Report Fiscal Year 2023 Supplement:

This section provides an interim update for FFY23 activities currently in process for the YAYAHP.

Motor Vehicle Safety

During FFY22, the one participating school began program implementation.The YAYAHP met with the implementing school, TTI, and key state stakeholders to discuss any changes that need to be made to better support program implementation.

The YAYAHP and MCH Epi applied to and were accepted to the CDC Harvard Practicum for program evaluation. Harvard graduate students developed a comprehensive evaluation plan for TDS, which included school recruitment and implementation recommendations. The plan also identified capacity and sustainability challenges that YAYAHP will take into consideration for future planning.  

Suicide Prevention

In addition to partnering with WIVPP, the YAYAHP is working with the WDE Substance Abuse and Mental Health Services Administration-funded Advancing Wellness and Resiliency in Education project (Project AWARE) to engage Project AWARE-funded schools to participate in the SOS T4T and potentially leverage Project AWARE funds for program implementation. The YAYAHP Manager has also been engaged in school-based health center planning discussions with the Office of Rural Health and the School Based Health Alliance, and working to advance the Pediatric Mental Health Care Access Grant. The YAYAHP and the WDE, including Project AWARE, have developed a model suicide postvention policy, and are coordinating roll out trainings for K-12 school districts on suicide postvention best practice and policy implementation to be delivered in late summer 2023.

The YAYAPH partnered with CHP to assure mental health screening and guidelines were emphasized in the Bright Futures ECHO series, and promoted Bright Futures guidelines among pediatric providers to encourage universal mental health screening of adolescents. This was done in coordination with the PMHCA grant.

Finally, YAYAHP is also engaging in partnership with UW, College of Education to support the development of suicide assessment training modules for clinical and non-clinical participants. The training will focus on rural populations, as well as those disproportionately dying by suicide in Wyoming – adolescents, middle-aged persons, and older adults. Broader distribution of the training module is expected in FFY24.

Young Adult Survey

WY MCH Epi was matched with a GSEP intern for a summer 2023 project. The intern will lead a social determinants of health analysis of the Young Adult Survey data. This analysis will assist YAYAHP in prioritizing populations and partners who are experiencing the largest health disparities in motor vehicle safety and suicide.