NPM-9: Percent of adolescents, ages 12 through 17, who are bullied or who bully others

Annual Report FY21:

The performance measure was not achieved. The Performance Objective was 23.0% and the Annual Indicator was 24.4%.

Program Activities:

During FY21, the Family & Youth Outreach Program (FYOP), the Violence Injury Prevention (VIPP) and Healthy Environments Active Living (HEAL) Program, continued implementing strategies to decrease bullying of adolescents. Physical aggression can be common among toddlers, and most children learn alternatives to using violence to solve problems. However, children with higher risk factors can continue to be aggressive, and if their problematic behaviors are not addressed their aggression can persist and increase. Individual and interpersonal risks for perpetrating violence include impulsiveness, youth substance use, antisocial or aggressive beliefs and attitudes, low levels of school achievement, weak connection to school, experiencing child abuse and neglect, exposure to violence in the home or community, involvement with delinquent peers or gangs, lack of appropriate supervision, parental substance abuse, and parental or caregiver use of harsh or inconsistent discipline.

Our strategies are intended to reduce the risk factors known to influence bullying behavior as well as other types of youth violence. Community factors, such as residential instability, crowded housing, density of alcohol-related businesses, poor economic growth or stability, unemployment, concentrated poverty, neighborhood violence and crime, lack of positive relationships among residents, and views that drug use and violence are acceptable behaviors can also contribute to bullying. FYOP, VIPP, and HEAL continue to provide training and resources to communities through the following strategies: Bystander Intervention training; gatekeeper training for suicide prevention; increasing physical activity; Wyman Teen Outreach Program; increasing the percentage of Earned Income Tax Credit filers among eligible Utahns; and increasing connectedness in families, schools, and community.

Accomplishments / Successes:

FYOP, VIPP, and HEAL strategies are intended to reduce the risk factors and social determinants of health known to influence bullying behavior. FYOP used the Wyman Teen Outreach Program, which is designed to build teens' educational success, life and leadership skills, and healthy behaviors and relationships. The Wyman Teen Outreach Program® is an evidence-based positive youth development program that allows youth to develop a positive sense of self, positive connections with others, and practice social emotional learning (SEL) skills through lessons, a weekly supportive peer group environment, and community service learning. For FY22, three local partners (Salt Lake County, Weber-Morgan, and TriCounty Health Departments) implemented the program for the entire 2021-2022 school year at ten sites, including schools and other youth-serving organizations. Two sites served refugee youth exclusively. 162 youth participated and over 450 hours of community service were completed by the end of the school year. Data shows improvements in participants’ SEL skills, an increase in positive connections with peers and the community, as well as an overall experience of the Wyman Teen Outreach Program as a safe and supportive environment. All these outcomes ultimately lead to more positive and healthy interactions with others, including decreased bullying behaviors.

Teen Speak is a program that equips parents and other trusted adults with communication skills they can use to overcome the common challenges of connecting with a teen. Better communication with teens helps to create a trusted relationship that supports their positive decision-making. Teen Speak is built on sound, science-based techniques and strategies that are taught through a practical, real-world approach.

The HEAL program implements the following strategies: Increasing physical activity shows a positive impact on adolescent perceived health, health-risk behaviors, and mental health. Increased levels of physical activity can play a vital role in adolescent health promotion and schools are an excellent setting to promote and provide physical activity spaces and to encourage students to be more physically active.

Studies show that increasing family connectedness through eating family meals together enhances the health and well-being of adolescents. Family meals are also an opportunity to cultivate communication skills, improve family relationships, bolster self-esteem, decrease obesity rates, and develop life-long healthy eating and lifestyle habits.

The VIPP Bystander Intervention training teaches positive actions to prevent bullying and to address it while it is happening or after it occurs. We are currently adapting the Bystander Intervention training to be provided virtually. We hope this will increase the reach of the program as it has been difficult for local health departments (LHDs) to provide this training in-person.

Gatekeeper training for suicide prevention teaches people to identify individuals who are showing warning signs of suicide risk and help these individuals get the services they need. VIPP provides Question, Persuade, Refer (QPR) and Mental Health First Aid training for communities and partners. In FY21, VIPP reached 398 individuals with gatekeeper training.

Concentrated poverty is a known risk factor for bullying, and each year Earned Income Tax Credits (EITC) lift over 60,000 Utahns (half of them children) out of poverty. However, 24.7% of eligible Utahns did not claim the EITC which is higher than the national percentage of 22%. Data show that eligible Utahns of Hispanic Ethnicity had a lower rate of EITC filings than other races/ethnicities in Utah. In response, in FY21, VIPP's EITC awareness activities focused on mediums shown to reach the Latinx community. Unfortunately, data from the IRS on EITC filings has not been updated since 2018 so we can't report on any change in filings.

Another effort being implemented that is shown to reduce risk factors for bullying is  increasing connectedness in families, schools, and community. VIPP has developed a "Connectedness Toolkit" for schools to help them implement activities that will increase school cohesiveness and connectedness.

Increasing trauma-informed approaches in schools and community organizations working with families can also reduce bullying. VIPP contracts with Trauma-Informed Utah to provide technical assistance and training to organizations on implementation of a trauma-informed approach. VIPP has conducted an assessment and revised policies in line with the trauma-informed approach.

Increasing family-friendly work policies: VIPP has contracted with the Kem C. Gardner Policy Institute at the University of Utah to conduct a survey of families on family friendly work-policies. Additionally, VIPP is partnering with the Salt Lake Chamber of Commerce to utilize the survey to develop a strategy for increasing family friendly policies among its member companies. Decreasing child abuse and neglect through the Essentials for Childhood program: VIPP facilitates the Utah Coalition for Protecting Childhood (UCPC). UCPC has released a comprehensive strategic plan for reducing child abuse and neglect through the prevention of risk factors and the promotion of protective factors.

Summary of successes and accomplishments on “Moving the Needle” in relation to NPM-9 (July 1st 2020 - June 30th, 2021):

• Many Spanish-speaking, working, but low-income individuals and families don't know they are eligible for a tax credit, or that one even exists. The Earned Income Tax Credit campaign targeted the Latinx community to increase awareness of free help available with filing taxes to get the EITC. From 2/22/21 - 5/17/21, Spanish Spots aired more than 450 times on Telemundo: https://youtu.be/igbw5ARfjPg https://youtu.be/qzFpwRNssng https://youtu.be/Uc9Mf4xmhqg.
• In order to provide the Bystander Intervention training to more Utahns, VIPP is partnering with Bonneville Communications to develop virtual training for LHDs and other partners.
• Gatekeeper training for suicide prevention teaches people to identify individuals who are showing warning signs of suicide risk and help these individuals get the services they need. VIPP provides Question, Persuade, Refer (QPR) and Mental Health First Aid training for communities and partners. In FY21, VIPP reached 398 individuals with gatekeeper training.

Challenges / Gaps / Disparities Report:

COVID-19 has continued to present challenges in implementing strategies to students and youth-serving organizations. Many schools have been operating on hybrid or virtual learning platforms and partners have had fewer opportunities to reach these individuals with training and education. Despite these challenges, FYOP, VIPP and HEAL continued to provide training and resources to communities through these strategies.

In terms of victimization there are disparities among those in 11th grade and under. Students in grades 9, 10, and 11 were more likely than those in the 12th grade to be a victim of bullying. Females were much more likely than males to report being bullied (29% and 19.9% respectively). Students who identified as Lesbian, Gay, or Bisexual or who are not sure of their sexual orientation were much more likely than students who identify as straight/heterosexual (36.3% for LGB identifying students and 22.6% for straight identifying students)

Agency Capacity/Family Partnerships/Collaboration:

By targeting the risk and protective factors for bullying, the approaches to prevention are designed to improve outcomes for multiple populations. This is done through collaboration of government, businesses, and community organizations to align efforts justly, equitably, and positively to impact the social determinants of health. This approach requires cooperation across disciplines and sectors. We will continue to partner with the Injury Community Implementation Board and the Utah Coalition for the Protection of Childhood to continue to design and implement cross-collaborating strategies.

Report of ESMs related to NPM-9

ESM 9.1 - Number of parents and youth between 10-18 years of age that complete the communications course (Teen Speak).

 

Goal/Objective:

Implement the training with 500 Utah parents in five years. Parents will learn and implement one strategy learned through Teen Speak.

Significance of ESM 9.1:

Teen Speak is a communications program (total four hours: including self-study and in-person presentation) that provides parents a menu of strategies they can use to improve communication with their youth. This evidence-based program utilizes motivational interviewing principles to support parents and trusted adults in improving communication skills and strengthening youth-adult relationships. Data suggests that teens who can identify a strong relationship with at least one trusted adult are less likely to use drugs or alcohol, engage in sexual activity, or attempt suicide.

ESM 9.1 Progress Summary:

Between July 1, 2021 - June 30, 2022, the Family & Youth Outreach Program (FYOP) team held 24 virtual Teen Speak classes, with 160 parents and youth-serving professionals attending. FYOP also produced one Fostering Communications podcast (https://utahfostercare.org/feed/podcast) to promote the program, in collaboration with Utah Foster Care. The podcast episode reached approximately 150 foster parents.

94% of Teen Speak participants indicated on a post survey that the workshop provided them with new communication skills that they will use in the future. Additionally, participants indicated that their overall communication skills, sense of self-efficacy when talking with their teen, and quality of their relationship with their teen all improved as a result of the intervention.

ESM 9.2 - The number of adolescents who receive bystander training (Upstanding)

Goal/Objective:

Increase the number of adolescents who have received the Upstanding curriculum.

Significance of ESM 9.2:

Bullying is the unwanted, aggressive behavior among school aged children that involves a real or perceived power imbalance. Passive bystanders provide the audience a bully craves and the silent acceptance that allows bullies to continue their hurtful behavior. A bystander to bullying is anyone who witnesses bullying either in person or in digital forms like social media, websites, text messages, gaming, and apps. When bullying occurs, bystanders are present 80 percent of the time. A bystander has the potential to make a positive difference in a bullying situation, particularly for the youth who is being bullied. Studies show, when youth who are bullied are defended and supported by their peers, they are less anxious and depressed. The Upstanding Program teaches children simple strategies for standing up to bullying that effectively removes, rather than provides, more peer attention.

ESM 9.2 Progress Summary:

Strengthening youth’s skills is an important component of a comprehensive approach to preventing youth violence such as bullying. The likelihood of violence increases when youth have under-developed or ineffective skills in the areas of communication, problem-solving, conflict resolution and management, empathy, impulse control, and emotional regulation and management. Skill-development has an extensive and robust research base, which shows building youth’s interpersonal, emotional, and behavioral skills can help reduce both youth violence perpetration and victimization. Enhancing these skills can also impact risk or protective factors for youth violence, such as substance use and academic success. These life skills can help youth increase their self-awareness, accuracy in understanding social situations, ability to avoid risky situations and behaviors, ability to intervene when necessary, and capacity to resolve conflict without violence. Multiple systematic reviews of various universal school-based programs demonstrate beneficial impacts on youth’s skills and behaviors, including delinquency, aggression, bullying perpetration and victimization, and bystander skills that lower the likelihood of violence and support victims. In one bystander program a longitudinal evaluation found after the second year of implementation, participants had a 31% decrease in bullying and victimization, 36% decrease in non-bullying aggression, and 72% decrease in harmful bystander behavior. A large-scale replication evaluation found significantly lower levels of physical bullying perpetration among participants relative to controls, and significant increases in school anti-bullying policies, positive school climate, and positive bystander behavior.

ESM 9.3 - Percent of adolescents who are physically active at least 60 minutes per day

Goal/Objective:

Increase the number of students who are active for at least 60 minutes a day through a variety of options throughout the school day.

Significance of ESM 9.3:

Physical activity has brain health benefits for school-aged children, including improved cognition (e.g., academic performance, memory) and reduced symptoms of depression. Regular physical activity in childhood and adolescence can also be important for promoting lifelong health and well-being and preventing risk factors for various health conditions like heart disease, obesity, and type 2 diabetes.

ESM 9.3 Progress Summary:

LHDs provided support to local education agencies to get students physically active through Safe Routes to School (SR2S) activities. These include monthly Walk and Roll Challenge, Walk to School Day, offering SR2S K-3 and 4-6 assemblies (virtually or in person), strengthening SR2S policies and maps, and/or assisting in applying for SR2S grant funding to improve infrastructure.

LHD staff continue to have high turnover and difficult to continue training new staff throughout the year. School staff were also cautious as to who could enter school buildings at the beginning of the year. LHDs were able to communicate and offer services virtually.

State staff worked with the Utah State Board of Education to create a Model Wellness Policy (https://www.schools.utah.gov/file/bf0e58b9-70c8-416b-8d2b-9d769d37afee) for local education agencies to follow when creating new policies.

ESM 9.4 - The number of youth participating in the Wyman Teen Outreach Program (TOP) Goal/Objective:

Increase the opportunities for 400 youth to build positive connections with others through weekly TOP peer meetings and participation in 20 hours of community service learning.

Significance of ESM 9.4:

The Wyman Teen Outreach Program® (TOP®) increases teens' ability to build positive connections with others through weekly peer group meetings and community service learning.                                         

ESM 9.4 Progress Summary:

The Wyman TOP® is an evidence-based positive youth development program that allows youth to develop a positive sense of self, positive connections with others, and practice social emotional learning (SEL) skills through lessons, a weekly supportive peer group environment, and community service learning.

For FY22, three local partners (Salt Lake County, Weber-Morgan, and TriCounty Health Departments) implemented the program for the entire 2021-2022 school year at ten sites, including schools and other youth-serving organizations. Two sites served refugee youth exclusively. 162 youth participated and over 450 hours of community service are expected to be completed by the end of the school year.

Data shows improvements in participants’ SEL skills, an increase in positive connections with peers and the community, as well as an overall experience of (TOP®) as a safe and supportive environment. All these outcomes ultimately lead to more positive and healthy interactions with others, including decreased bullying behaviors.

ESM 9.5 - Strengthen Household Economic Security through an uptick in files for the Earned Income Tax Credit.

Goal/Objective:

Increase the number of Utahns filing for the Federal Earned Income Tax Credit

Significance of ESM 9.5:

Bullying is associated with a number of community-level risks, such as concentrated poverty, residential instability, and density of alcohol outlets. Reducing exposure to these community-level risks can potentially yield population-level impacts on youth violence outcomes. Prevention approaches to reduce these risks include changing, enacting, or enforcing laws, city ordinances and local regulations, and policies to improve household financial security, safe and affordable housing, and the social and economic sustainability of neighborhoods. Public-private partnerships and community-driven needs and services are important elements of these approaches. Strengthening household financial security through tax credits, such as the Earned Income Tax Credit (EITC), can help families increase their income while incentivizing work or offsetting the costs of child-rearing and help create home environments that promote healthy development. The evidence suggests that the EITC can lift families out of poverty. Simulations show that a Child Tax Credit of a $1000 allowance per child, paid to each household regardless of income or tax status, would reduce child poverty in the United States from 26.3% to 23.2%; a $2000 allowance per child would reduce child poverty to 20.4%; a $3000 allowance per child would reduce child poverty to 17.6%; and a $4000 allowance per child would reduce child poverty to 14.8%.

ESM 9.5 Progress Summary:

Every year, 1 in 4 eligible Utahns fails to claim the earned income tax credit. In 2019, 171,000 tax filers received the credit, while another 57,000 eligible Utahns did not apply for the credit. Last year, the average credit for a Utah tax filer with children was $2,130. For single people without children earning less than $15,000, the average tax credit was $300. The Violence and Injury Prevention Program has teamed up with the Department of Workforce Services, Utah Tax Help, and the Utah Coalition for Protecting Childhood to raise awareness of the credit among Utahns.

 

ESM 9.6 - Number of Utahns who have been trained in Question, Persuade, Refer (QPR)

Goal/Objective:

Utahns are trained to recognize bullying and suicide ideation and have resources to help them

Significance of ESM 9.6:

While the QPR intervention was developed specifically to detect and respond to persons emitting suicide warning signs, QPR has also been more widely applied as a universal intervention for anyone who may be experiencing emotional distress. It has been suggested by independent researchers and federal leadership that originally funded and conducted QPR studies, that the QPR intervention could be useful in a much broader application, and not just for the detection of persons at risk for suicide.

ESM 9.6 Progress Summary:

When QPR is applied to distressed youth with informed compassion and understanding, the intervention becomes useful for the detection of a wide range of "troubled" behavior, e.g., non-suicidal self-injury, perfectionism, eating disturbances, sleep problems, bullying, and other behavioral indices of youth who may be at risk, identified, and treated "upstream" of the onset of suicidal ideation. The Violence and Injury Prevention Program is a member of the Utah Suicide Prevention Coalition and will continue to use partners from that coalition to advertise availability of QPR training.

State Priority Area: School Lunch

SPM-3: Percent of students enrolled in free or reduced price lunch programs

Annual Report FY21:

Program Activities:

The Performance Measure was achieved. The Performance Objective was 35.0% and the Annual Indicator was 41.7%.

As a response to the novel coronavirus pandemic, USDA Food and Nutrition Service, state agencies, public and private schools, community programs, and advocacy groups worked together to continue program operations that provided meals, snacks, fresh fruits, and vegetables to children throughout Utah.

The Families First Coronavirus Response Act of 2020 (FFCRA, Pub. L. 116-127), enacted March 18, 2020, included a general provision that allows the Department of Agriculture to approve state plans to provide temporary emergency Supplemental Nutrition Assistance Program (SNAP) assistance to households with children who would otherwise receive free or reduced price meals, if not for their schools being closed due to the COVID-19 emergency (also known as Pandemic EBT, or P-EBT). The authority for P-EBT under FFCRA expired on September 30, 2020. The Continuing Appropriations Act, 2021 and Other Extensions Act (Pub. L. 116-159), enacted October 1, 2020, extended the authority for P-EBT through September 30, 2021. This legislation also expanded the program to include childcare facilities affected by the closures and schools with reduced attendance hours. The Consolidated Appropriations Act, 2021 (Pub. L. 116-260), enacted December 27, 2020, provided additional eligibility requirements and state flexibility for both school and childcare components of this program. The American Rescue Plan Act of 2021 (ARPA, Pub. L. 117-2) enacted on March 11, made several significant changes to P-EBT. Among these changes is the extension of P-EBT to the summer of 2021, school year 2021-2022, and summer 2022.

LHDs helped promote school meals by partnering with community organizations such as WIC, DWS, and school districts to provide families information that all students 18 years of age and younger would eat free of charge during the school year. The USDA extended the free meal waiver until the end of the 21-22 school year. LHDs also provided materials, resources, and support to encourage students to eat school meals during national school breakfast and lunch week. Many of the health educators are new. Building this relationship has helped strengthen the relationship between the health department and schools. The state and LHDs continue to work with schools to strengthen local wellness policy. WellSAT is an evaluation tool used to facilitate the strength and comprehensive language around school meals. WellSAT scoring reflects best practices. The purpose of using this tool is to identify strengths and weaknesses in the policy.

Accomplishments / Successes:

The USDA Food and Nutrition Service (FNS) issued several nationwide waivers and state waiver requests as a response to the COVID-19. USDA-FNS issued 80 nationwide waivers specific to Child Nutrition Programs between July 2020 and June 2021. Utah chose to opt into all USDA waivers available. The use of USDA waivers allowed all program sponsors with eligible sites to provide meals at no charge for children aged 18 and under from July 2020 through June 2022. LHDs provided technical assistance and support to local education agencies in a variety of ways during the 21-22 school year.

Many activities included support with the COVID-19 response such as testing, contact tracing, vaccines, and many other tasks. LHDs worked with families to educate them about services and benefits that provided resources to help support hardship during this time. Many provided information regarding free breakfast and lunch for the school year to all students. The Utah State Board of Education provided professional development opportunities to ensure that school nutrition program personnel have the knowledge and skills to manage and operate the National School Breakfast and Lunch Programs correctly and successfully throughout the school year. Town halls were implemented during the year to help provide technical assistance to child nutrition directors. These were held virtually every month.

Many of our LHDs work with the Seamless Summer Option (SSO) program. This is a component of the National School Lunch Program (NSLP). The purpose of SSO is to ensure that children continue to receive nutritious meals when school is not in session. These sites may be established in the same types of locations such as community centers, libraries, parks, pools, and schools. Sites must be located in low-income areas and sponsors can be reimbursed for up to two meal types per day.

Summary of successes and accomplishments on “Moving the Needle” in relation to SPM-3 (Oct 1st, 2020 - September 30th, 2021):
 

• The Start Smart Utah Program was enacted following the passing of House Bill 222 to promote and expand the availability of school breakfast for Utah's children. Start Smart Utah requires schools participating in the National School Lunch Program to offer a breakfast program. House Bill 016 amended Utah Code to expand the use of state funds, which may be used to support breakfast programs. The Start Smart website https://startsmartutah.org/ was created by a variety of partners.
• LHDs provided support and resources to Local Education Agencies (LEAs) to help increase the awareness and participation of sponsored sites who offered seamless summer options (SSO). LHD educated the public about these services by providing information through school newsletters, social media and collaborating with other county programs.
• The Utah Breakfast Expansion Team provided a breakfast conference to LEAs. Breakout sessions included breakfast cycle menus, engaging with community partners, and alternative breakfast models. LEAs were given the opportunity to provide guidance from the Utah State Board of Education Child Nutrition Program and support from the HEAL program.

Challenges / Gaps / Disparities Report:

The COVID-19 pandemic resulted in school closures and contingencies across the U.S. that limited access to school meals for students. While some schools attempted to provide alternative meal access points where students or parents could pick up meals, many students—especially those in low-income households—lacked adequate transportation to these access points. Thus, physical proximity to meal access points was particularly important during the pandemic.

LEAs and schools also were faced with procurement, staffing, and substitute challenges and barriers. Due to the increase of breakfast and lunch programs many child nutrition staff felt the overwhelming burden of increased demands. Although providing free breakfast and lunch was needed during the pandemic the future school years will return to normal and free universal meals will no longer be available to all families starting in the 22-23 school year. This means that families who qualify for this service must apply and provide necessary documentation. This process starts as early as July 1st. Staffing was a huge challenge for the child nutrition program. There were many LEAs that had multiple positions available during the school year. It was difficult to hire and sustain employees as well as provide substitutes for these jobs. This will be an ongoing challenge as we move away from the pandemic. These positions are not enticing and comparable in wages.

Agency Capacity / Collaboration Report:

The COVID-19 response has been a challenge however, some underlining positive outcomes during this time is the relationship and communication with families in the communities. LHDs were able to interact with the public and understand where there are gaps and needs to help better align programs and services to the community. Building upon the relationship that the LHDs have established with the local education agencies and schools will help position themselves to create breakfast and lunch models that fit the communities’ needs.