At the start of this grant cycle, workgroup members participated in meetings and activities related to the MCH Needs Assessment process. Beginning in March 2020 workgroup members became actively involved in the Department of Health’s COVID responses. Despite these alternative job responsibilities, the adolescent workgroups continued addressing strategies on the current state action plans. The results of these efforts are described below.
During our 2015 MCH Needs Assessment three (3) state priority needs were identified that were inclusive of the adolescent population:
- Improve and assure appropriate access to health services that are focused on families, women, infants, adolescents, and CYSHCN
- Provide positive child and youth development to reduce morbidity and mortality (intentional/unintentional injuries; dietary habits; tobacco use, alcohol use, other drug utilization)
- Promote oral health for all populations
Under the National Performance/Domain framework, 1 National Performance Measure was chosen, and the objectives, strategies, and activities are identified within the State Action Plan framework. In addition to the National Performance Measure activities there are other adolescent efforts that MCH team members support to assist in addressing adolescent health priority needs. Efforts included:
- Suicide Prevention: partnered with Helpline Center to offer youth suicide prevention education throughout the state. The Helpline Center provides a 24/7 statewide crisis line, teen crisis texting support, Youth Mental Health First Aid training, teen Mental Health First Aid training, Suicide Prevention Training for primary care providers and training for high school faculty on teen suicide prevention/intervention.
- Suicide Prevention: partnered with Department of Social Services BeThe1SD campaign and promoted suicide prevention to youth councils throughout SD. Each youth council developed their own suicide prevention activity for their council/community. Guidance and resources such as posters, brochures, referral cards, and wrist keychains to promote the National Suicide Prevention Lifeline were provided to each youth council.
- Adolescent Injury Prevention: partnered with SD Office of Public Safety to disseminate and promote an injury prevention toolkit to reduce child and adolescent injury. The toolkit provides education on car seat guidelines and encourages seatbelt use. The importance of seatbelt usage was also promoted via social media posts, infographics, phone holders, and window clings. New materials were developed to target parents and youth on injury prevention including an infographic that discussed what parents could do to help prevent teen car accidents in South Dakota and a phone silicone card holder that displayed the message “Someone Needs you. Buckle up. Drivesafesd.com. These materials were disseminated to local community health clinic, non-profits that serve youth and schools.
- Immunization Programs: DOH’s Disease Intervention Specialists visit all enrolled vaccination clinics across the state annually to review immunization coverage rates and provide technical assistance on how to improve coverage rates. The Immunization Program sends enrolled clinics a letter with their coverage rates, the state coverage rates, and the national rates three times a year. This serves as a reminder to keep working on improving immunization coverage.
The Office of Child and Family Services’ community health nurses (OCFS) conduct an audit of all incoming Kindergarten and 6th grade student immunization records to ensure they meet the states minimum immunization requirements for school entry. The OCFS works directly with the schools to check every student’s record. If a child is not up to date, the school is informed that the student needs additional immunizations. School-based clinics for influenza vaccine, adolescent Tdap, Meningococcal, and HPV vaccine are conducted by Community Health Nurses. Nurses also travel to Hutterite colonies to provide on-site vaccination clinics and promote/provide adolescent vaccines to this often vaccine hesitant population.
At the end of this reporting period the MCH Impact Team workgroup members assigned to each national or state performance measure were asked to complete a data collection form. The data collection form was a checklist of the strategies that the program was to address during the grant year. The workgroup members rated the degree to which the strategies were implemented, and the percentage of completion is included as the ESM for each measure. In addition to this assessment for each measure, data was reported to provide a quantitative context for each strategy. This ESM process allowed us to better report progress to date on all strategies. Data collection form can be found at the link below:
https://doh.sd.gov/documents/MCH/2020/DetailSheet_NPM10_FY20.pdf
DOH Strategic Plan Goal 1: Improve the quality, accessibility, and effective use of health care
National Performance Measure 10: Percent of adolescents, ages 12 through 17, with a preventive medical visit in the past year.
Data Statement:
In 2019, 78.2% of adolescents in South Dakota ages 12 through 17 received a preventive medical visit in the past year. There was a working change to the NSCH in 2018 that did not allow 2018 data to be provided or compared with other years of data.
The 2019 rate surpassed the 2020 target of 70.9% and was higher than the 2016-2017 rate of 68.5%. The change from the base year rate of 72.1% was not significant. South Dakota ranks 29th nationally.
The full-length South Dakota MCH Annual Data Summary can be found here:
https://doh.sd.gov/documents/MCH/2022_SDMCH_DataSummary.pdf
The annual data summary this year looks ahead to the emerging priorities from the 2020 Statewide Needs Assessment and focuses on injury prevention and healthy relationships for adolescents. It does not cover data trends relating to NPM 10.
State Objective 1:
By June 30, 2020, increase the immunization rate (%) for the >1 dose of meningococcal vaccine for adolescents 13-17 years of age from 74.5% (2017) to 75.7% (NIS)
State Objective 1 Data Statement:
South Dakota exceeded the 2020 target of 75.7% and there has been a significant increase between 2015 and 2019 in the immunization rate for >1 meningococcal vaccine among adolescents 13-17 years of age. The rate increased from 55.5% in 2015 to 86.2% in 2019. Despite this improvement, in 2019 South Dakota was ranked 36th nationally for meningococcal vaccine rate among adolescents and the U.S. rate was 88.9%.
State Objective 2:
By June 30, 2020, increase the percent of adolescents (14-18 years of age) who smoke that enroll in the Quit Line from 0.43% (2018) to 0.50% (QuitLine and YRBS)
State Objective 2 Data Statement:
South Dakota did not meet the 2020 goal of 0.50% of adolescents who smoke enrolling in the Quit Line. The 2020 data showed 0.39% of adolescents who smoked enrolled in the Quit Line. This was compared to a rate of 0.43% in 2018 and 0.61% in 2019. However, it should be noted that 2015 YRBS data was used in the 2015-2018 estimates, while 2019 YRBS data was used for the 2019-2020 estimates.
Strategies:
10.1. Partner with state and non-state agencies to promote yearly well adolescent preventive medical visits
- Partnered with DSS Medicaid to begin updating well-child letters. Medicaid well-child letters are sent out to participants annually to encourage participation and educate on annual well visits requirements. Medicaid Letter were broken down by the follow age groups, 0 to 3 years old, 4 to 9 years old, 10 to 12 years old and 13 + years old.
Medicaid Infographics can be found here:
- Partnered with SD Medicaid to obtain data specific to the number of adolescent preventive medical visits completed yearly. Medicaid data was reported as follows:
AWC-CH: Adolescent Well-Care Visits
- 2017 Reported Rate was 32%
- 2018 Reported Rate was 32%
- 2019 Reported Rate was 32%
- 2019 national average was 50.6%
IMA-CH: Immunization coverage for Adolescents
- 2017 – Calculated but not reported
- 2018 – 34% (without DOH SDIIS data) 57% (with DOH SDIIS data). Medicaid is looking at utilizing data from the South Dakota Immunization Information System (SDIIS) in the future
- 2019- 62.50% (with SDIIS data)
- 2019 National average 78.6%
- Collaborated with SD Dept of Health Medical Consultant, Dr. Poppinga, on key planning areas for adolescent health strategies.
- MCH Adolescent Coordinator continued to correspond with SD’s only adolescent health specialist, Dr. Barondeau, to discuss what current adolescent health topics he is focusing on and to gather a greater understanding of resources that could be utilized in a medical provider office.
Challenges:
- Meeting with outside partners were limited during this reporting period due to response needed for the COVID pandemic.
10.2. Identify and implement ways to promote yearly adolescent visit
- SD DOH of Health created social media post educating on the importance of making Adolescent Health and Adolescent Well Visits a priority during COVID. Some example of posts are:
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Adolescent Health The adolescent years are critical for teens’ current and future health. Good health enables #adolescents to learn and grow. https://www.hhs.gov/ash/oah/facts-and-stats/picture-of-adolescent-health/index.html |
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Adolescent Health As adolescents grow and change, they may face issues like maintaining healthy relationships, developing positive mental and physical health, and avoiding substance use. Learn more about #AdolescentDevelopment: https://www.hhs.gov/ash/oah/adolescent-development/index.html |
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- Continued partnering with SD Family Planning program and local non-profits to distribute a flier entitled “Adolescent Health Check Up”.
- The DOH Community Health Offices continued to display laminated “Adolescent Health Check Up” fliers and distributed fliers to clients.
- Created a tab for “youth and young adults” on the South Dakota Department of health website. Developed a sub-tab of “Adolescent Well Visits” and linked 10 informational sites with Adolescent well visit resources for youth and parents of youth.
- ‘Well-Child Visits Do Double Duty” Magazine Ad was published in South Dakota Medical Journal in August and September 2020.
Challenge: Promoting yearly well visits directly to adolescents or through adolescent peer to peer sharing/educating.
10.3. Encourage individual and family engagement.
- New Adolescent Health Platform - Cõr Health + Wellbeing launched at the end of 2019 on Facebook and Instagram. Cõr Health + Wellbeing was created to provide health and wellness support to South Dakota youth, young adults, and parents. Our goal is to break down those hard-to-talk-about topics like stress, depression, suicide, STDs, and reproductive health and provide talking points, strategies, and tips for making those conversations less awkward. Cõr is about giving youth, young adults and parents the tools they need to make positive decisions and take responsibility for their ongoing health and wellbeing.. Can be found:www.facebook.com/corhealthsd and www.instagram.com/corhealthsd.
Key areas addressed during this reporting period:
- Preventative Visits/Physical Health:
- Mental Health:
- Motor Vehicle Injury Prevention –
- Applied for a new grant through FYSB for a Competitive Sexual Risk Avoidance Education (CSRAE) Grant – received that grant September 30th, 2020. Funding will give MCH and SRAE a chance to work together in creating a Youth Action Council for the new priorities of Healthy Relationship and Suicide Prevention.
10.4. Target messaging regarding tobacco cessation coaching for adolescents
- The SD Tobacco Control Program has been educating providers, parents, youth and young adults about the dangers of e-cigarettes through a social media campaign and print ads in SD Medical Journals and parenting magazines. The campaign focuses on the harms to youth, pregnant women, non-tobacco using adults and how to talk to adolescent about e-cigs and JUULing.
- An educational webinar on e-cigarettes and vaping is available for educators and students, which could be used in classrooms, at teacher in-services or PTA meetings. Since November 2018 the webinar has been viewed 352 times. To view:
https://www.youtube.com/watch?v=RMWJOk70PIo&feature=youtu.be
- The South Dakota QuitLine is available for any SD tobacco users age 13 and older (including those who vape) to assist with quitting. Individuals can enroll by calling 1-866-737-8487 or at SDQuitLine.com. SD Tobacco Control Program broadcasted an ad entitled “What happens when you call?” which educated users on what would happen when they reach out to the SD QuitLine.
- OCFS field staff helped disseminate information on the following SD Tobacco Control Programs to agencies serving youth and schools.
1) Teens Against Tobacco Use (TATU) is a tobacco prevention program (which includes e-cigarettes) designed to help teens teach younger children about the hazards of tobacco use and the benefits of making healthy choices,
2) Life Skills training and curriculum for schools is a proven, highly effective, substance abuse prevention program. Life Skills has recently added an e-cigarette component to the curriculum,
3) Catch My Breath E-Cigarette & JUUL Prevention Program, which is available for free to any elementary, middle or high school.
Challenge: Staying current with vaping products; especially those targeted to youth.
10.5. Promote 6th grade vaccination requirements
- Provided the Department of Education 6th grade vaccination requirement information to distribute statewide to local school districts.
- Partnered with Medicaid to promote adolescent vaccinations by sending reminder cards to Medicaid enrolled
- Presented to Department of Education and providers on vaccinations during COVID
- Data from the 2018 and 2019 National Immunization Survey for adolescents (13-17 years old) shows an increase in vaccinations among South Dakota youth.
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2018 |
2019 |
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1 or more Tdap |
86.6% |
90% |
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1 or more MCV4 |
85.3% |
86.2% |
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Up to date on HPV |
49.5% |
61.2% |
- SD DOH of Health created social media post educating parents and youth on the importance of adolescent vaccines.
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Adolescent Vaccines What #vaccines do #adolescents need? Starting at age 11 or 12, the CDC recommends the Meningococcal, HPV, Tdap, and Influenza vaccines for almost all children. https://www.hhs.gov/ash/oah/adolescent-development/physical-health-and-nutrition/vaccines/what-vaccines-do-adolescents-need/index.html |
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Challenge: Vaccine hesitation from families.
ESMs
The degree to which the South Dakota Title V program has implemented evidence-based or informed strategies to increase the percent of adolescents with an annual preventive medical visit.
79% completion of identified strategies.
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