Adolescent Health

Report for October 2019 - September 2020

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

NPM Strategy 13.1. Distribute the Bright Futures Oral Health Pocket Guide to all providers who have the opportunity to promote children’s oral health.

The Bright Futures Oral Health Pocket Guide is a resource for all health professionals and staff that discusses oral health and dental care for pregnant and post-partum women, infants, children, and adolescents. WCFH distributed 635 pocket guides between Fall 2019 and Spring 2020 to oral health providers and Head Start staff. In November of 2019, twenty pocket guides were shared with the Alaskan Dental Hygienists Association (AKDHA), at the annual AKDHA meeting. Additional guides were shared at the Alaska Area Dental Meeting of the Tribal Dental Chiefs, in the Indian Health Service. Remaining guides were dispensed to Head Start during Spring 2020 to support oral health education needs during program limitations imposed by the COVID-19 pandemic.

WCFH has since retired this strategy, having determined that other areas of outreach and work demonstrate a higher impact on the NPM of children who had a preventative dental visit in the last year.

NPM Strategy 13.2. Collaborate with Division of Health Care Services to increase preventative dental visits with children ages 1-20 enrolled in Medicaid program.

The Alaska EPSDT Coordinator from Medicaid has remained an active member in the Alaska Dental Action Coalition, meeting with the Coalition members quarterly. Throughout 2019-2020, the Title V Director and Maternal Child Health Epidemiology Unit Manager have maintained participation in a Children’s Core Set Workgroup, with the EPSDT Coordinator and Medicaid Medical Director. This group continued to meet on regular basis. The goals of the workgroup are to improve the number of children evaluated for Core Sets standards, and to improve the reporting of data to CMS related to Core Set standards. One of the Child Core Set measures is the percentage of eligible children who received preventive dental services.

NPM Strategy 13.4. Develop a strategy with school nurses to examine opportunities for school nurses to connect students to oral health services.

School interventions were found to have moderate evidence for effectiveness in improving dental utilization in childhood (Johns Hopkins University, Aug 2017). It had been planned for the Title V funded School Health Nurse Consultant to continue to facilitate or coordinate trainings on oral health at the annual conference for school nurses. However, due to the COVID-19 pandemic, all Alaska schools were closed from March 2020 to June 2020. The planned annual school nurse conference in April 2020 was not held. District nurse leaders were encouraged to include on yearly health history forms whether a child had a dental home and the date of the last dental exam. Due to COVID-19 school closures continuing into the first semester starting August 2020, the plan to track the number of school nurses trained in oral health topics was not feasible since nurses’ attention and energy was focused almost entirely on COVID-19 mitigation efforts.

NPM Strategy 13.5. Continue to lead and facilitate the Alaska Dental Action Coalition (ADAC) quarterly meetings.

WCFH continues to administrate and lead quarterly meetings of the Alaska Dental Action Coalition (ADAC). The Coalition includes multiple stakeholders such as private dentists, dental hygienists, federally qualified health center directors and staff, Medicaid program staff, the Alaska Dental Society, the Alaska Primary Care Association, the Alaska Native Tribal Health Consortium, the Alaska Mental Health Trust, the Governor’s Council on Disabilities and Special Education, the Alaska AARP, and the Alaska University of Alaska-Anchorage. The Coalition is the only active group in Alaska that takes a multidisciplinary approach to improving oral health in the state.

During the 2020 reporting period, ADAC established two co-chairs to manage and maintain momentum of ongoing Coalition projects. The Coalition held in-person meetings in November of 2019 and in February of 2020 but has since transitioned onto a virtual platform in response to the COVID-19 pandemic. ADAC has commenced work on an updated oral health action plan for the years 2021-2023, in collaboration with the 2021 Primary Care Needs Assessment, forming four sub-committees to inform oral health initiatives state-wide. Sub-committees are dedicated to fluoride education and advocacy, dental care access, oral health and preventative education, and oral health workforce improvement.

SPM 2: Percent of students who report that they would feel comfortable seeking help from at least one adult besides their parents if they had an important question affecting their life.

SPM Strategy 2.1. Develop a Fourth R for Healthy Relationships Parent Engagement Toolkit, which includes information about the Fourth R topics and tips for parents/caregivers to facilitate healthy relationships conversations with their children.

The WCFH Adolescent Health Program has continued to provide trainings for Fourth R and Healthy Relationships Plus Health curriculum to community agencies, schools, and school districts across the state of Alaska. The trainings were offered in-person during the fall 2019 reporting period. However, they transitioned to virtual and an online recording for January through Fall 2020 due to the COVID-19 pandemic. The Adolescent Health Program shifted focus to emphasize the development of resources to support virtual learning/implementation of the Fourth R for teachers and community educators during the pandemic. WCFH staff also assisted with development of a cloud-based tracking system to provide effective training and grant data management of trained teachers and community educators in the Fourth R and Healthy Relationships Plus curriculum. The WCFH Adolescent Health Program will continue to focus on development of individualized resources rather than one set toolkit to ensure resources are available for culturally responsive implementation, and virtual curriculum adaptions of the Fourth R and Healthy Relationship Plus. The WCFH Adolescent Health Program continues to plan development of an online training accessible for teachers and community educators across Alaska that is engaging and informative for the implementation of the Fourth R and Healthy Relationship Plus Curriculum, while also providing needed resources regarding the content that is covered within the curricula, adaptions and supportive teaching strategies as part of the training.  This work is funded by the Administration for Children and Families

SPM Strategy 2.4. Support statewide training and dissemination of Coaching Boys into Men (CBIM).

During the 2019-2020 reporting period the WCFH Adolescent Health Program partnered with the Alaska School Activities Association to implement a statewide training of trainers program of Coaching Boys into Men (CBIM) for Alaska’s athletic coaches. CBIM is an evidence-based prevention program that trains and motivates high school coaches to teach their young male athletes healthy relationship skills and that violence never equals strength. This comprehensive violence prevention curriculum for coaches and their athletes was developed by Futures without Violence. The curriculum provides high school athletic coaches with the resources they need to promote respectful behavior among their players and help prevent relationship abuse, harassment, and sexual assault. The curriculum consists of a series of coach-to-athlete trainings that illustrate ways to model respect and promote healthy relationships. The curriculum instructs coaches on how to incorporate themes associated with teamwork, integrity, fair play, and respect into their daily practice and routine. This is funded by a CDC Rape Prevention Education grant.  In March 2020, in response to the COVID-19 pandemic, Gov. Mike Dunleavy closed schools in Alaska to in-person learning. After consultation with Futures Without Violence, the Alaska School Activities Association proceeded with training coaches - virtually and in very small groups when mitigation was possible - but very little implementation occurred for students during March through September 2020 since both in-person school and sports were limited.

SPM Strategy 2.5. Maintain statewide dissemination of Teen Speak publications and Adolescent Focused Motivational Interviewing Skills training and resources for Supportive Adults, Parents, Caregivers and Clinicians.

During the reporting period, the WCFH Adolescent Health program continued to partner with Possibilities for Change (P4C) to host an Alaska specific resources website for all Alaskans to access Motivational Interviewing training, learning materials and sign-ups for virtual skills sessions. Adolescent Health Program Coordinator, Jennifer Baker, facilitated four sessions in person and virtually in this reporting period with 17 clinicians and 14 community partners from Homer, Palmer, Wasilla, and Anchorage. Ms. Baker will be trained in 2021 as a state certified trainer for other trainers to further increase the reach of this strategy.