Adolescent Health Annual Report
Habits and behaviors frequently started during adolescence (healthy weight management, exercise, sexual behavior, nicotine/tobacco, alcohol, substance use, etc.) can impact unfavorable health outcomes in the short and long term. Mental health disorders and related conditions often surface during adolescence and are best addressed early to ensure optimal health. The MCAH Section focuses on protective factors to decrease the likelihood of adverse health outcomes.
Title V MCH Program selected NPM 10, NPM 12, and NPM 15 to improve adolescent health outcomes. Title V MCH and partners implement strategies to increase the percent of adolescents, ages 12-17 y.o. with a preventive medical visit in the past year (NPM 10), increase the percent of adolescents with and without special health care needs, ages 12-17 y.o., who received services necessary to make transitions to adult health care (NPM 12) and increase the percent of children, ages zero-17 y.o. who are adequately insured (NPM 15). Health outcomes may improve when young people receive yearly wellness visits, possess health literacy, and are adequately insured. Program activities and successes related to these efforts are highlighted below.
MCAH staff and funded partners disseminated information and resources on adolescent well-visits, youth-friendly health, risk screening, transition from pediatric to adult health care, emotional health, and well-being to improve adolescent health and wellness outcomes. The materials included, but were not limited to, calls to action, health and wellness tips, insurance enrollment, self-advocacy, and health literacy. Evidence-based materials were from Bright Futures, Got Transition, Adolescent Health Initiative, National Adolescent and Young Adult Health Information Center, Youth Screening, Brief Intervention, and Referral to Treatment, and AMCHP.
Well-Visits
The 2020-2021 National Survey of Children’s Health (NSCH) showed 58.5% of Nevadans, ages 12-17- y.o., received a preventive health visit, compared to 69.6% nationwide. Although adolescent well-visits for Nevada reduced from the 2019-2020 NSCH report, improvements were made in the gap between Nevada (62.1%) and the nation (75.6%). Efforts to increase preventive medical visits included partnering with outside agencies to increase the percent of adolescents, ages 12-17 y.o. who are adequately insured. The 2020-2021 NSCH data found 63.9% of Nevadans ages 12-17- y.o. had adequate and continuous insurance coverage compared to 68.2% nationwide. The Affordable Care Act mandates insurance plans cover preventive health services with no out-of-pocket cost to help improve uptake of health screenings addressing physical, emotional, cognitive, and social changes. Well-visit appointments provide substance use screening, behavioral health and depression assessment, reproductive health and sexually transmitted infection (STI) prevention counseling and screening, administration of age-recommended vaccines, and weight management plans.
Title V MCH Program participated in the NPM 10 special interest group organized by the State Adolescent Health Resource Center (SAHRC), a funded Health Resources and Services Administration (HRSA) agency, to advance adolescent health and wellness. A small group of state adolescent health coordinators and SAHRC leaders met to share efforts conducted and planned to improve uptake of yearly well-visits and improve quality of care.
Title V MCH Program awarded funding to DP Video Productions to create video posts for youth, parents, and caregivers to increase the percent of yearly adolescent well-visits. Campaign messaging was pilot tested by Nevada youth of various socioeconomic and cultural backgrounds, including individuals living with special health needs. The one-month campaign on Facebook, Instagram, and Twitter contained six video messages (three each in English and Spanish). The content reached the desired aged audience, racial and ethnic groups, and met both Americans with Disability Act and culturally and linguistically appropriate services (CLAS) standards. Twitter resulted in 126,398 media impressions. Facebook had 161,613 media impressions, 81,006 viewers, 32% watching the videos, and 2% engaged users. DP Video created refreshed adolescent well-visit messaging in animated format to enhance youth exposure. A diverse group of adolescents viewed draft materials and provided input during its creation. The two new messages, for young people, will be boosted on social media throughout the next funded year and viewable by both English and Spanish speakers. All DP Video created social media content contain video descriptors for individuals who are visually impaired.
Title V MCH Program distributed the operational DP Video created social media content to funded partners and outside agencies. This provided agencies the opportunity to share the messages through their Facebook and Twitter platforms.
Health Care Transition
According to the 2020-2021 NSCH report, 10.4 % of CYSHCN in Nevada received services necessary to transition into adult health care compared to 20.5% nationwide. This is an increase from 8.6% in 2019-2020. The 2020-2021 NSCH data for non-CYSHCN found 8.3% in Nevada received services necessary to transition to adult health care compared to 16% nationwide. This is a decrease for Nevada from 10.6% in 2019-2020.
To increase awareness of transition services, the Title V MCH Program continued collaborative efforts with funded partner DP Video Productions for social media campaigns on health care transition and health literacy. DP Video promoted health care transition video posts on Facebook, Instagram, and Twitter, using the state-operated Nevada Wellness social media platform. DP Video conducted a one-month campaign to promote health care transition awareness to youth and parents/caregivers. Six video ads (three each in English and Spanish) were displayed on social media. Twitter resulted in 95,903 media impressions. Facebook had 110,832 media impressions, 11,709 views, 68% watching the videos, and 3% engaged users. DP Video created refreshed health care transition animated messaging with the intention of increasing the number of young people viewing and taking action. The same group of adolescents recruited for the well-visit campaign review, provided input about its relatability. Plans were made to boost two new messages for youth/young adults on social media during the next funded period. The content in English and Spanish contains video descriptors for individuals who are visually impaired.
Title V MCH Program shared all operational DP Video created social media content with funded partners and outside agencies. This allowed businesses to place the messages on agency Facebook and Twitter platforms. Additionally, staff shared an inclusive animated video What is Health Care Transition? with groups focused on serving children and youth with and without special health care needs. This resource, created by Got Transition, was a joint effort using young adult input. The Title V MCH Program downloaded English and Spanish materials housed inside Got Transition for adolescents and young adults, and parents and caregivers and imported Quick Response (QR) codes into the health care transition materials. Glossy color printed handouts were printed and disseminated to partners and at community events.
Project ECHO Health Care Transition Series
The Title V MCH Program funded health care transition efforts with Nevada Center for Excellence in Disabilities (NCED) within the College of Education at University of Nevada, Reno (UNR). NCED serves as Nevada's University Center for Excellence in Developmental Disabilities (UCEDD). The six-session provider Project Extension for Community Healthcare Outcomes (ECHO) series used Got Transition evidence-driven strategies to improve access of information about transitioning from pediatric into the adult health care system. The presentations were conducted by subject-matter experts from the National Alliance to Advance Adolescent Health, Family Voices, and Nevada Legal Services. Attendees learned best practices from the Got Transition six core elements of health care transition, related resources, and participated in case-based discussions. Seventy-two providers from various healthcare disciplines represented eight counties with five from rural regions. A survey was used to collect data on the impact of the series. Thirty-two participants (44%) completed the survey and of those 87% reported they would incorporate health care transition into their practice.
Public Health Clinic Wellness
Twelve public health clinics were awarded Title V MCH Program funding to promote adolescent health and wellness. These entities included Carson City Health and Human Services (CCHHS) in Northern Nevada and 11 nursing clinics within DPBH Community Health Services (CHS) providing services in rural Nevada counties. Staff used standards of care from national agencies to enhance service quality. Nurses were trained in person-first inclusive language, culturally competent care, and adolescent-friendly medical environments. Education and counseling were conducted to the individual based on age and life circumstances.
The 12 public health clinics and Title V MCH Program share commitments to enhance the quality of adolescent visits and increase the number of youth and their families receiving health care transition information. Starter Guides and Spark Trainings (Adolescent Health Initiative) were used to develop nurses’ awareness about adolescent-friendly clinic environments. Clinic staff reviewed principles from Six-Core Elements of Health Care Transition (Got Transition) to aid in educating young people and their parents/caregivers about the steps necessary to transition from pediatric to adult health care.
Through clinical settings and community events, staff informed about benefits of being adequately insured, value of annual well-visits, health care transition awareness, reproductive and sexual health, immunizations, depression, intimate partner violence prevention, tobacco/nicotine cessation, and healthy eating habits. Approximately 400 adolescents and/or adult caregivers were reached at community events. Title V MCH Program staff provided clinics with materials for dissemination. These included Does Your Teen Need Health Coverage? informing about the value of well-visits and how to apply for insurance, education on health care transition for youth and young adults as well as parents and caregivers (Got Transition), MHP, and Nevada 211.
Immunizations were administered during clinic visits and community vaccine events. Additionally, all clinics conducted reminder telephone calls for delayed adolescent age-appropriate vaccinations.
During clinic visits, adolescents were screened for risk behaviors, including nutrition and weight management, depression, sexual coercion, alcohol, drug, and tobacco/nicotine use. Nurses encouraged youth to include family in discussions regarding sexual decisions
CCHHS provided wellness screenings and education to 155 adolescents. Racial/ethnic groups served were primarily Non-Hispanic White (52%), followed by Hispanic (43%), and the remaining identifying as other racial groups (5%). Most were female (92%), and the remaining were male (8%) since none identified as other gender. Referrals were provided to users of alcohol (23%), those experiencing depression (20%), users of nicotine/tobacco (17%) substances (2%), and youth affected by intimate partner violence (2%).
The clinic implemented youth-friendly electronic risk assessments, Rapid Adolescent Prevention Screening (RAAPS) and Adolescent Counseling Technologies (ACT). RAAPS and ACT used during well-visits identify behaviors contributing to adolescent morbidity, mortality, and social problems. RAAPS and ACT are intended to strengthen CCHHS’ appeal as an adolescent/young adult-centered medical home. Other aims were to gather more reliable risk responses, provide nurses with prompts for scripts to discuss behaviors, and develop a database comparing one visit to another, to identify highest risk activities in Carson City, and to monitor community changes. RAAPS and ACT became fully integrated into the clinic electronic health record (EHR) system in late August 2022.
Furthermore, CCHHS promoted adolescent focused health and wellness messages through printouts, clinic digital signages and social media campaigns. Does Your Teen Need Health Coverage?, highlighting the value of well-visits, was given to 180 adolescents or adults with teens, with 156 youth and or their adult providers being provided with materials on how to transition from pediatric into the adult health care system. Individuals driving by or walking into the building could view the promotional campaigns on the signage. Facebook campaigns promoted well-visits and health care transition. Adolescent well-visit social media messages reached 10,623 people with 3% engaged users. Health care transition Facebook posts touched 2,044 individuals with 0.6% engaged users.
CHS provided adolescent wellness screenings and education. Referrals were made for youth using alcohol and substances, experiencing depression, and experiencing intimate partner violence. Data from the 11 DPBH rural public health clinics is not being reported due to its unreliability. Challenges involved data from first quarter EHR no longer being available, unexpected delays for startup of new EHR, data collected without an EHR was not dependable, and new system setup initially lacked infrastructure to conform with Title V MCH report needs. A subject matter expert resolved the challenges allowing the next funded period to contain reliable data.
Trauma-Informed Yoga
The Title V MCH Program continued funding Urban Lotus Project (ULP) to provide yoga and mindful meditation to disproportionally affected youth, including those living with special health care needs. ULP offers Trauma-Informed Yoga for Youth to help adolescents impacted by a lifetime prevalence of adverse childhood experiences (ACEs), heightened by COVID-19. This yoga practice helps increase physical activity, provide resilience, support mindfulness, combat obesity and chronic disease, enhance wellness, and helps mitigate other harmful public health outcomes
The trauma-informed yoga practice provides movement activity, at no cost, in a safe environment to young people experiencing disadvantages. ULP provided inclusive environments and practiced cultural humility to ensure teachers nurture each student's strengths, interests, and talents and honor beliefs, customs, and values.
ULP served adolescents at 14 different venues including drop-in youth centers, residential substance and mental health treatment facilities, and youth-serving community organizations. As many as 805 individuals participated in 291 yoga classes. Most students attended multiple yoga classes resulting in at least 1,704 pupil exposures. ULP shared its trauma-informed approach and yoga's science and benefits to several organizations. These discussions allowed agencies to learn the value of the yoga practice to help youth heal from the disruptions, social isolation, and losses experienced by COVID-19. Of the 2,791 pupil exposures, 61.4% were adolescents, 37.8% young adults (ages 18-25 y.o.) and 1.15% children ages 5-11 y.o.).
ULP’s success is showcased as a promising practice inside the AMCHP MCH Innovation Database allowing for the specialized yoga and mindfulness instruction to be replicated. AMCHP awarded Replication Project Implementation funds to a Nashville, Tennessee yoga organization. Small World Yoga (SWY) received technical assistance from ULP and Title V MCH Program on how to expand their trauma-informed program to adolescents. Discussions included authentic youth engagement, trauma-informed principles, health equity, cultural humility, and intersectionality when building systems for engaging youth into organizations and community projects. Additionally, AMCHP provided guidance to ULP and Title V MCH Program to better coach SWY towards a successful replication.
Participation in replication benefited SYW, ULP, and the Title V MCH Program. Nevada state staff provided evidence-based success principles such as Plan-Do-Study-Act cycles, value of evaluation surveys, and sustainability principles to enhance SWY’s level of success. SWY, ULP and Title V MCH Program all gained credibility from local, state, and national colleagues about the value of trauma-informed yoga practices and became encouraged about its best-practice potential down the road. Furthermore, the article by SWY inside the AMCHP Pulse Newsletter, How Trauma-Informed Yoga is Healing a Generation, was shared with youth-serving agencies across the nation.
Trauma-Informed Yoga Success Story
Student Responses to Yoga Exposure through ULP included:
- “I have learned that I am capable of letting all my worries go”- Male age 16
- “The classes have helped me to be calm and stay in the moment. I really like it.” - Non-binary age, 15
- “ULP yoga classes have made me feel more confident” – Female age, 14
- “I feel I can finally take up space.” - Female age, 15
- “ULP classes help me to be able to just sit and process” - Female age 15
- “Since taking these classes I will begin to take a slower approach to negative situations” - Non-binary age, 15
Collaboration with Youth-Serving Agencies
Participation in the National Network of State Adolescent Health Coordinators (NNSAHC), bi-monthly calls with Region IX states, and quarterly calls with Regions VII, IX, and X allowed for resource sharing and engagement with other states. Calls focused on how best to serve adolescents, state policies to include youth in the workforce, challenges and solutions faced by the pandemic, and state program successes. Attendance at several adolescent-focused conferences and webinars and sharing highlights with funded partners and youth-serving agencies across the state occurred.
Information was shared with Title V MCH Program funded partners and DPBH adolescent-focused programs about upcoming webinars and training, round-table discussions, community events, new publications, and youth-focused materials. Adolescent-focused health information was disseminated through the MCH Coalition and PCO e-newsletters. Topics included but were not limited to emotional and behavioral health, tips to deal with isolation and uncertainty during the pandemic, adolescent-centered care, and health care transition from pediatric to adult care.
The Title V MCH Director and AHWP Coordinator served on the Youth Advisory Council through the NVPCA Healthy Tomorrows Partnership for Children Program (HTPCP) grant. The HTPCP project collaborated with Title V MCH Program to improve adolescent well-visits rates in Federally Qualified Health Centers (FQHCs). Social media content created using Title V MCH Program funding was posted on FQHC Facebook pages. Topics included the value of adolescent well-visits, health care transition awareness, youth engagement in physical activity, and adolescent emotional well-being.
Title V MCH Program served on Nevada’s state team of the National Comprehensive School Mental Health Collaborative Improvement and Innovation Network (CoIIN) led by Nevada Department of Education (NDE). This partially funded HRSA Maternal Child Health Bureau project focused on promoting a positive school climate, social-emotional learning, and mental health and well-being while reducing the prevalence and severity of mental illness.
MCAH participated in the Leadership Exchange for Adolescent Health Promotion (LEAHP) learning collaborative, with the goal to develop state action plans in support of school adolescent health. Priority areas explored included systematic approaches to sexual health education, accessible reproductive health services, and creation of safe and supportive environments for students at school and home. Information was shared by subject matter experts and goals were set to develop a policy brief outlining successful policies from other states to help Nevada develop its systems.
Youth Engagement
Title V MCH Program attended webinars and conferences to learn best practices of authentic youth engagement for potential future planning and implementation. Handouts and PowerPoint presentations from webinars and meetings were shared with MCAH, Nevada youth-serving agencies, including youth advisory councils such as Healthy Young NV and the Nevada chapter of Youth Motivating Others through Voices of Experience (M.O.V.E.).
Pregnant and Parenting Teens
MCAH partners with agencies serving pregnant and parenting teens through work conducted by Nevada Home Visiting (NHV), Maternal and Infant Program, Title V MCH Program, Account for Family Planning, and Personal Responsibility Education Program (PREP). The NHV Program serves young adult families to improve health outcomes, promote breastfeeding, increase developmental screening, and reduce teen pregnancy and substance use.
Trauma-Informed Approaches
The 2019 Nevada Youth Risk Behavioral Survey (YRBS) Middle and High School Adverse Childhood Experiences (ACE) Special Reports reveal the following differences in ACE scores: females were more likely to report two or more ACEs than males; children qualifying for free or reduced lunches were more likely to report one ACE score or higher; students identifying as gay, lesbian, or bisexual were more likely to report higher ACE scores than those identifying as heterosexual, and as the number of ACEs increased so did the likelihood of participating in violence, experiencing victimization, sexual and physical dating violence, as well as suicidal ideation. The percentage of middle schoolers with three or more ACES who reported feeling sad or hopeless almost every day was 292% higher than the percentage of middle schoolers with no ACES (67.8% vs. 17.3%). There was a 237% difference between students reporting 3 or more ACES and those reporting none (67% vs 19.9%) for high schoolers. This indicates the need for prevention and intervention strategies targeting ACEs to reduce mental health consequences into adulthood. Current statewide efforts address ACEs through building resiliency, using trauma-informed approaches, and providing social and emotional support services to children and their families.
NDE, Division of Child and Family Services, several mental health consortia, Title V MCH Program, and community agencies collaborated on policy improvements, and systems-building projects to address ACEs. MCAH within Rape Prevention and Education (RPE), PREP, and Sexual Risk Avoidance Education (SRAE) attended conferences and webinars to understand how trauma affects the developing adolescent brain in healthy decision-making and to learn what it means to be trauma-informed with adolescent patients. Resources were shared with youth-serving agencies and youth advisory councils to enhance their understanding of trauma-informed principles and how to best engage with youth impacted by ACEs.
As applicable, funded partners were requested to promote the DPBH awarded Nevada Resilience Project helping families and individuals experiencing struggles and challenges. Bilingual ambassadors provided education, information, counseling, and resource navigation over the phone, through text and video chat, and face-to-face while promoting resilience, healthy coping, and empowerment. Additionally, state staff shared the Nevada 211 Youth app helping young people locate services and resources such as health care, crisis support, employment services, food pantry locations, and emergency housing programs.
Suicide Prevention
While the 2020 Needs Assessment did not list teen suicide as a priority, behavioral health encompasses mental health concerns such as suicide. Strategic partnerships continued to advance public policy around stigma reduction, mandatory training for most school districts, and training for staff and parents.
Overall, National Vital Statistics Survey (NVVS) data show adolescent suicide rate for ages 15-19 y.o. per 100,000 in Nevada was 15.1 from 2019-2021, higher than the corresponding U.S. rate of 10.6 per 100,000.
The percent change in Nevada’s adolescent suicide rate for ages 15-19 from 2007-2009 to 2019-2021 is 132%. The graph below illustrates the trends for Nevada and the US.
Data Source: Federally Available Data, National Vital Statistics Survey (NVSS)
In Nevada, the adolescent suicide rate is highest for Non-Hispanic Asian (29.1 per 100,000), followed by Non-Hispanic Black (19.1), Non-Hispanic White (18.9), Non-Hispanic Black (14.4), and Hispanic (11). Compared to the United States, Nevada sees a disproportionately higher adolescent suicide rate for adolescents residing in Non-Metro areas. The graph below shows the breakdown:
Data Source: Federally Available Data, National Vital Statistics Survey (NVSS)
The 2021 Nevada YRBSS contains data from students in 6th through 12th grade in regular public, charter, and alternative schools. Students self-report behaviors in six areas of health-related to morbidity and mortality. The Emotional Health section contains eight questions to measure mental health risks. The table below outlines the responses from the major areas of concern related to suicide.
|
2021 Nevada Youth Behavior Health Survey: Emotional Health Questions |
Middle School Students |
High School Students |
|
Percentage of students who seriously considered attempting suicide during the 12 months before the survey |
20.0% |
22.4% |
|
Percentage of students who made a plan about how they would attempt suicide during the 12 months before the survey |
13.3% |
21.6% |
|
Percentage of students who attempted suicide during the 12 months before the survey |
7.6% |
12.3% |
|
Percentage of students who attempted suicide that resulted in an injury, poisoning, overdose that had to be treated by a doctor or nurse during the 12 months before the survey |
N/A |
3.9% |
Sexual and Gender Minority Report
The 2019 Nevada High School YRBS Sexual and Gender (SGM) Minority report found students identifying as SGM had increased risk burdens across six different categories compared to non-SGM students. These risk behavior categories were violence-related behaviors, adverse childhood experiences, emotional health, substance use, sexual behaviors, and resiliency factors. Title V MCH will continue to consider the increased risk of adolescents identifying as SGM in future programming.
State Teen Pregnancy Prevention (TPP) Programs
While Title V MCH Program funds do not directly support TPP Program efforts, the staff worked closely with SRAE and PREP on cross-cutting efforts to enhance positive youth development, reach youth who live in higher risk settings, prevent teen pregnancy, and to avert relationship violence by supporting healthy relationship education. Allowing for learning best practices and sharing resources, SRAE and PREP participated in meetings, webinars, and email exchanges through national youth reproductive health technical assistance agencies, AFP, LEAHP, and NNSAHC.
Funded and community partners had access to several documents such as bilingual data factsheets highlighting national, state, and county-specific statistics on teen pregnancy. Additionally, Title V MCH Program recommended materials were made available, informing about the value of well-visits and how to apply for insurance, education on health care transition, Nevada Tobacco Quitline, MHP, and Nevada 211
TPP Program awarded DP Video Productions funds to promote youth emotional wellness through a six-month social media campaign. Eight messages and videos (four each in English and Spanish) informed adolescents ages 10-19 y.o. and their parents/caregivers how to obtain resources through the Nevada Resilience Project, a program of Nevada 211. The posts ran from October 2022 through May 2023.
Sexual Risk Avoidance Education Program
SRAE transitioned back to in-person education in schools and community-based settings. The program operated in northern and rural Nevada reaching 273 youth ages 10-19 y.o., an increase from COVID-19 hybrid in-person and online sessions.
Priority enrollment was given to adolescents experiencing homelessness, in foster care or with other disproportionate risks. Participants were recruited through CCHHS, Family Resource Center of Northeastern Nevada-Elko, (FRCNEN), NyE Communities Coalition, and local partnerships.
SRAE continues to build partnerships to reduce teen pregnancies and births through evidence-based curricula providing an inclusive, non-stigmatizing environment addressing the social, psychological, and health gains realized by abstaining from sexual activity.
The curricula, Promoting Health Among Teens! -Abstinence-Only (PHAT! -AO and Teen Outreach Program (TOP) used theoretical frameworks focused on positive youth development principles. Topics covered included healthy decision-making, engagement in healthy relationships, and peer group development for positive social values and norms. The curricula were designed to reduce teen pregnancy by teaching sexual responsibility through accountable sexual behavior decision-making, encouraging respect among themselves and others, increasing effective life management skills, and the importance of developing a positive self-image. The activities helped participants feel comfortable practicing abstinence, address concerns about the training, and provide strategies for overcoming obstacles through community service-learning projects.
Personal Responsibility Education Program
PREP transitioned back to in-person learning in schools and community-based settings. The program operated in southern, northern, and rural Nevada reaching 661 youth ages 13-19 y.o., an increase from the pandemic generated hybrid in-person and online sessions.
PREP served youth who were disproportionally affected such as those experiencing homelessness, sexual and gender minorities (SGM), individuals in foster care, and juvenile justice-involved youth. Five PREP funded partners (NVPCA, NyECC, FRCNEN, CCHHS, and The Center) taught comprehensive sex education using several evidence-based curriculums specifically geared towards the youth presenting at each agency such as, Making Proud Choices (MPC), Seventeen Days, Positive Prevention Plus, and Reducing the Risk with the lesbian, gay, bisexual, transgender, and queer (LGBTQ) supplemental adaptation.
The curricula taught confidence and skills to reduce STIs, HIV/AIDS, and pregnancy through abstinence and increased condom use when choosing to have sex and reduce alcohol-related sexual risk behavior. The courses contain culturally based interventions to reduce HIV/AIDS sexual risk among Hispanic youth. Each funded partner plays an active role bringing innovative projects into their local communities (e.g., support groups serving SGM communities). The curricula empower teen parents through social-emotional learning skills for healthy relationships and self-care for a successful future.
TPP Program Success Story
Shared by SRAE Program staff member:
“On the first day of spring class for the Promoting Health Among Teens- Abstinence Only Program, a young tween entered the room shy and demure. She was very quiet and uncomfortable. She didn’t know the other youth in attendance (they were siblings and cousins) and very boisterous. Mom hung around until it was time for class to begin, and when she was ready to leave the youth was hesitant of staying and wanting to leave with her, but mom insisted that she try it out for the day; so, she stayed. By the end of the four-hour day she was smiling and conversing with the rest of the group. The second day she entered the room ready to work. When we concluded with the program, this youth asked if her little sister could attend this class the next time we have one; we’d replied “Of course!”.
We’ve scheduled our summer session and this youth’s mom called and asked if she could sign up both girls. She stated that her daughter wanted to attend the other class we offered, PREP, and since her eldest daughter enjoyed it so much, and she also recommended that her sister attend, mom wanted to sign the youngest up for Abstinence Only class.”
Teen Pregnancy and Repeat Teen Birth Rates
In 2021, according to NVSS, the US teen birth rate was 15.1 births per 1,000 females aged 15–19 y.o., a decrease from 16.8 in 2020. The teen birth rate in Nevada has decreased 65.68% from 2009.
Data Source: Federally Available Data, National Vital Statistics Survey (NVSS)
Racial/ethnic and geographic disparities exist in Nevada. Teen birth rates are higher among Non-Hispanic Black (27.2 per 1,000), Hispanic (18.8), Non-Hispanic American Indian/Alaska Native (18.5) compared to Non-Hispanic Multiple Race (14.7), Non-Hispanic Native Hawaiian/Pacific Islander (15), Non-Hispanic White (8.8), and Non-Hispanic Asian (3). Teens living in non-metro areas face a disproportionately higher birth rate (17.7) than their urban counterparts in small/medium metro (14.7) and large metro areas (14.8).
The maps below illustrate Nevada’s teen pregnancy rate and repeat teen birth rate by mother’s residence zip code. Figure 1 reports on teen pregnancy rates and figure 2 informs on repeat teen birth rates.
Figure 1 Figure 2
Data Source: Nevada Department of Health and Human Services, Nevada Birth Registry and State Demographic Data, Office of Analytics
Teen birth rates have decreased considerably in both rural and urban counties (2018-2022) in a side by side comparison The map below illustrates Nevada’s teen birth rate by county, showing the reduction in rates between 2018 and 2020.
Data Source: Nevada Department of Health and Human Services, Nevada Birth Registry and State Demographic Data, Office of Analytics
Accomplishments of Adolescent Health and Wellness Program
Title V MCH Program successfully promoted public health approaches to protect, promote, and improve adolescent physical, behavioral, emotional, and mental health statewide using a health equity lens. Best practices were shared with funded agencies and community members on how to serve adolescents through promoting yearly well-visits and health care transition education.
CCHHS implemented youth-friendly electronic risk assessments RAAPS and ACT to identify behaviors contributing to adolescent morbidity, mortality, and social problems. This will help strengthen the appeal of CCHHS as an adolescent/young adult-centered medical home, increase collection of reliable risk responses, and develop a database to monitor individual and community changes overtime.
Title V MCH Program moved forward on securing a long-term goal for locally sourced youth-created content on the topics of well-visits and health care transition. Plans were solidified with Immunize Nevada for YAC members to create social media content and print materials promoting the value of yearly well-visits and the steps necessary to transition into the adult health care system.
AMCHP awarding Replication Project Implementation funds to an out-of-state yoga organization helped ULP grain credibility among their partners. This award provided the Nashville, Tennessee yoga agency technical assistance from ULP and Title V MCH Program on adolescent trauma-informed practices and evidence-based success principles. This partnership resulted in conversations about authentic youth engagement, trauma-informed principles, health equity, cultural humility, and intersectionality when building systems for engaging youth into organizations and community projects.
Adolescent Health Data
NPM 10 - Percent of adolescents, ages 12 through 17, with a preventive medical visit in the past year
According to the 2020-2021 NSCH, 58.5% of adolescents ages 12 through 17 had a preventive medical visit in the past year. This is significantly below the national average of 69.6%. Nevada ranks last out of the 50 states and D.C. for this measure.
NPM 12- Percent of adolescents without special health care needs, ages 12 through 17, who received services to prepare for the transitions to adult health care
The percent of adolescents without special health care needs who received services to prepare for the transitions to adult health care had been slightly increasing every year in Nevada, from 9.4% in 2016 to 13.5% in 2018-2019 (NSCH). However, the percentage decreased in 2019-2020 to 10.6% and continued to decline to 8.3% from 2020-2021. Nevada is significantly below the national average of 16%, and ranks last out of the 50 states and D.C.
NOM 23 - Teen birth rate, ages 15 through 19, per 1,000 females
According to NVSS data, Nevada’s teen birth rate has steadily been decreasing from 44 per 1,000 in 2009 to 15.1 per 1,000 in 2021. This represents a 65.7% decrease. Nevada is above the national average of 13.9 per 1,000 and ranks near the bottom at 30th out of the 50 states and D.C.
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