During the reporting period, the Florida Department of Health promoted activities to improve the health of children and adolescents and promote participation in extracurricular and/or out-of-school activities in a safe and healthy environment. These activities prioritized National Performance Measure 9; the percent of adolescents, ages 12-17, who are bullied or who bully others.

The Adolescent Health Program (AHP) provides education, resources, training, and referrals that support teen pregnancy prevention, reduction in sexually transmitted infections among youth, healthy relationships, bullying prevention, skill-building, and positive youth development. Through a holistic approach, the AHP supports the physical, mental, emotional, and social health of youth as they transition into adulthood. One facet of this approach is the Title V State Sexual Risk Avoidance Education (SRAE) Grant, which began in 2010. This grant is administered by the Administration for Children and Families (ACF), Family and Youth Services Bureau (FYSB).

The SRAE grant funds 12 providers, seven county health departments, and five community-based organizations to offer sexual risk avoidance education in middle school, high school, and community settings. This education promotes the delay of sexual activity, the development of healthy friendships, family relationships, and romantic relationships, as well as goal setting. Additionally, health educators offer best practices and resources to parents, guardians, and significant adults supporting youth in healthy decision-making. The grant cycle begins in October and ends in September. During the Fiscal Year (FY) 2020-2021 grant year, the SRAE grant successfully served 12,985 youth and 2,815 parents and guardians.

The AHP provides ongoing support for SRAE providers including an annual technical assistance training, monthly check-in calls, and monitoring. AHP staff ensures medical accuracy, up-to-date best practices, and fidelity to the approved curriculum models used. During monitoring, classes are observed by AHP staff and real-time feedback is given to the providers. In addition to the grant-required education, AHP staff train providers in frameworks that support youth thriving including positive youth development, trauma informed care, 40 developmental assets, and youth mental health first aid.

Section 1006.147, Florida Statutes, requires Florida school districts to adopt a policy prohibiting bullying and harassment of students and staff on school grounds or school transportation, at school-sponsored events, and through the use of data or computer software accessed through school computer systems or networks. The Department of Education (DOE), Office of Safe Schools has created a model policy against bullying and harassment that school districts can use to craft their individual policies.

Bullying is a serious detriment to a child’s health, sense of well-being, safety, education, and emotional development, and greatly increases the risk of self-injury and suicide. According to the 2021 CDC Youth Risk Behavioral Survey (YRBS), 12.7 percent of Florida high school students were bullied on school property and 12.9 percent were bullied electronically. Bullying is defined as an attack or intimidation with the intention to cause fear, distress, or harm that is either physical (hitting, punching), verbal (name calling, teasing), or psychological/relational (rumors, social exclusion); a real or perceived imbalance of power between the bully and the victim; and repeated attacks or intimidation between the same children over time. Data from the 2021 YRBS indicate that a significantly higher number of students experiencing bullying, as compared to students that do not experience bullying, described their grades as Ds and Fs in school during the past 12 months. The number of ninth and tenth grade students reporting being bullied is significantly higher than for students in eleventh and twelve grade. Female students are significantly more likely than males to have experienced some form of bullying, name calling, or teasing in the past year.

Adolescents who report frequently bullying others and youth who report being frequently bullied are at increased risk for suicide-related behavior. According to the National Vital Statistics System, adolescent suicide rates for ages 15-19 increased slightly from 9.0 deaths per 100,000 for 2016-2018 to 9.3 deaths per 100,000 for 2018-2020. Adolescent mortality for ages 15-19 also increased slightly from 49.6 per 100,000 deaths in 2019 to 59.4 deaths per 100,000 in 2020.

The Violence and Injury Prevention Section (VIPS) participates in the Children Safety Network’s (CSN) Child Safety Learning Collaborative (CSLC). The CSLC is an opportunity for states and jurisdictions to advance evidence-based policies, programs, and practices at the state and local levels to reduce fatal and serious injuries among infants, children, and adolescents. The Learning Collaborative focuses on five topic areas: Bullying Prevention; Motor Vehicle Traffic Safety (which includes child passenger safety and teen driver/passenger safety); Poisoning Prevention (which includes the prevention of prescription medication misuse/abuse); Sudden Unexpected Infant Death (SUID) Prevention, and Suicide and Self-Harm Prevention. Florida participates with peers nationwide for both Motor Vehicle Traffic Safety (MVTS) and Suicide and Self Harm Prevention (SSHP).

During this Cohort (November 2021 through April 2023), the Florida SSHP team focus is the development of agreements for partner data sharing. Specifically, the team is interested in identification of those most affected by suicidal ideation in the Volusia county school system. Volusia county is located in the east central part of the state (population 554,000). The Volusia county school system plans to expand its multi-tiered system of supports (MTSS) in Volusia County’s 14 middle and 11 high schools. Within a multi-tiered system of supports, resources are allocated in direct proportion to student needs. Data collected at each tier are used to measure the efficacy of the supports so that meaningful decisions can be made about which instruction and interventions should be maintained and layered. The multi-tiered system involves the systematic use of multi-source assessment data to most efficiently allocate resources to improve learning for all students, through integrated academic and behavioral supports. Partners include Department of Education, University of South Florida (data), Florida Behavioral Health Association and Volusia County Schools. A training was held for teachers on the summer of 2022 to learn more about MTSS.

The Florida MVTS Team noted an increase in teen-related crashes in FY 21-22, particularly in St. Lucie County, on the east coast in the southern part of the state (population 329,000). The “Impact Teen Drivers” initiative was launched. Twenty-five community partners were trained to implement the program, which includes presentations in schools. Additional data indicates an increase in teen drivers in noncompliance with graduated driver license (GDL) standards. Additionally, surveyed youth indicate another trend: serving as a designated driver for an intoxicated adult. The Impact Teen Drivers is expanding to include a public education campaign for parents and caregivers to address this issue.