Adolescent Health Domain

Annual Report Year 2022

According to the World Health Organization, adolescence is the phase of life between childhood and adulthood, from ages 10 to 19. This period is a unique stage of human development and an important time for laying the foundations of good health. Adolescents experience rapid physical, cognitive, and psychosocial growth. This affects how they feel, think, make decisions, and interact with the world around them. Despite being thought of as a healthy stage of life, there is significant death, illness, and injury in the adolescent years.[1] In the District of Columbia (DC) adolescents experience various health issues that affect their development mentally and physically.  Without effective prevention strategies, the level at which these experiences affect their lifestyle in adulthood is high.

 

In recent years, data has shown that poor mental health has become a significant cause for concern for adolescents in the District. According to the Youth Risk Behavior Survey (YRBS), DC high school students have increasingly reported feeling sad or hopeless (36.3% of students in 2021 compared to 25.5% in 2012), especially female students and those who identify as lesbian, gay, bisexual, transgender, or were unsure of their sexual identity.[2] Mental health and disorders were among the health indicators that worsened over the last few years, with approximately 16.32% of adolescents experiencing major depressive episodes (MDEs) on average from 2019-2020.[3] The most recent National Survey of Drug Use and Health conducted in 2021 estimated that 16.53% of adolescents 12-17 in DC experienced an MDE in the past year.[4] The COVID-19 pandemic negatively impacted youth mental health with the effects still felt in DC.

 

Additionally, adolescents in DC continue to experience multiple health challenges related to engaging in high-risk behaviors resulting in substance use, STD/STI transmission, and pregnancy. DC high school students were more likely to report using marijuana in the past 30 days and before the age of 13 than high school students nationally in the 2021 YRBS.[5] Additionally, 28.5% of high school students reported ever having sexual intercourse; 18% reported currently being sexually active; and 5.3% reported having sexual intercourse for the first time before the age of 13 years (higher than national figure of 3.2%). Further, amongst students who reported being sexually active, 18.3% of DC high school students reported not using any method to prevent pregnancy during last sexual intercourse compared to 13.7% of high school students in the US.4 An increase in the number of high school students who drank or used drugs before last sexual intercourse between 2019 and 2021 from 16.5% to 20.7% was also a concerning observation. Due to unsafe sexual practices, adolescents and youth have been disproportionately affected by STIs compared to other age groups in DC and were especially at-risk for gonorrhea and chlamydia infections. In 2021, one in five chlamydia cases were amongst adolescents aged 13-19 and 1 in 2 gonorrhea cases were under the age of 30. In 2021, the chlamydia case rate for the 13-17 age group was 1,570.3 per 100,000 and for the 18-19 age group 3,381.1 per 100,000; the gonorrhea case rate for the 13-17 age group was 483.7 per 100,000 and for the 18-19 age group 1,122 per 100,000. In 2021, there were 230 new HIV diagnoses, 0.4% of which were in the 13-17 age group, 3.5% in the 18-19 age group, and 9.6% in the 20-24 age group.[6] Moreover, the teen birth rate in DC was 15.6 births per 1000 females aged 15-19 years – nearly a 65% decrease between 2011-2020. However, DC birth rates for 15–17-years-olds were consistently higher than national rates for the same age group.[7]

 

Expanding adolescent access to healthcare is important to improve the population’s overall health and well-being. Approximately 70.5% of adolescents (aged 12-17) received a preventive check-up according to the 2020-2021 National Survey of Children’s Health.[8] Within the District, more accessible mental health services are a recognized community need and high priority, especially for adolescents. According to the Designated Health Professional Shortage Area (HPSA) Statistics as of March 2021 from HRSA’s Bureau of Health Workforce, 122,341,224, or approximately one-third of the U.S. population, lives in a designated Mental Health Professional Shortage Area, and only 27.2% of the mental health needs in these shortage areas have been met.[9]

 

In an effort to address the adverse health outcomes of adolescents, DC Health contributes to the Title V priorities by partnering with various community-based organizations that carry out evidence-based approaches and strategies. Through consistent programming and monitoring, DC Health provides quality services to combat the increasing risk factors seen within the adolescent health population. Below are program activities and results from fiscal year 2022.

 

Priority Area 1: Reducing grief and trauma-related symptoms among children and adolescents.

Traumatic experiences during childhood and adolescence have profound effects on psychosocial wellbeing and lifelong health throughout the lifespan. Children and adolescents who experience chronic and traumatic stress have lower educational achievement rates, increased likelihood of involvement with the criminal legal system, and significantly higher risks for mental and physical health problems. The NIH estimates that high doses of childhood trauma shorten life expectancy by an average of 20 years.[10] Children and adolescents in low-income Wards of DC are at increased health risk due to high rates of exposure to chronic stressors (e.g. community and domestic violence, racism, poverty, incarceration loss of parents/caregivers, etc.). In alignment with best practices to reduce grief and trauma-related symptoms DC Health is committed to increasing access to mental health and grief and trauma-informed care in school-based and community-based settings.

 Performance Measures:

• State Performance Measure (SPM) 3: Mental Health- Increase the percent of children and adolescents ages 3-17 with mental health needs who received counseling.

Objective 1: Increase the percent of adolescents ages 12 to 17 with mental health needs who received counseling from 59.1% to 65% by 2026

Strategies:

• Provide accessible mental health programs in school-based health centers and community-based organizations.
• Provide training for behavioral health professionals.

Activities:

DC Health strategically targeted adolescents by partnering with established community programs to expand their reach into schools and communities. Listed below are program overviews and FY22 accomplishments for the Wendt Center for Loss and Healing, the Pediatric Mental Health Care Access program, and Children’s National Hospital Resources and Education for Adolescents in Community Health program.

 

In FY22, Title V funded the Wendt Center for Loss & Healing’s Resilient Scholars Project-School/Community-Based Program (RSP-SB/CB) to provide high-quality, evidence-based mental health services through group or individual therapy to children/adolescents (ages 6-21 years) suffering from affective disorders resulting from trauma and/or traumatic loss in DC Public and Public Charter Schools and community programs located primarily in Wards 1, 4, 5, 6, 7 and 8.  The program maintained the following multifaceted goal for FY22: Increase access to effective mental health care through the provision of high-quality, evidence-based mental health services in community-based or virtual settings to low-income children (ages 6-21) exposed to trauma and grief, and through specialized training services informed by evidence-based practices that expand the capacity of members of the school workforce to effectively support trauma- and grief-impacted children. 

 

In FY22, the Wendt Center for Loss and Healing completed the following activities: 

 

• Provided accessible, effective, evidence-based mental health services at school/community partner sites in-person and/or via tele-therapy services.   
• Expanded the capacity of DC schools to meet the needs of trauma- and grief-impacted students through the development and provision of specialized training informed by evidence-based practices to school personnel. 
• Provided virtual or in-person therapy, individual (up to 15 sessions per individual) or group (10-12 sessions per group), using evidence-based interventions and techniques (CM-TF-CBT; Play Therapy; TCTSY) to children on the Wendt Center’s office-based waitlist. 
• Administered pre- and post-assessment measures to all children completing therapeutic services. 
•  

In FY22, the Wendt Center reached 141 low-income children and adolescents (ages 6-21) exposed to trauma and grief with effective high-quality evidence-based mental health services either in individual or group-based sessions. The Wendt Center partnered with nine DC public and public charter schools to reach a total of 93 children and adolescents in group or individual therapy. They also partnered with the Washington Nationals Youth Baseball Academy and Washington Jesuit Academy to serve 30 children and adolescents in group or individual therapy. Additionally, 18 children from the office-based waitlist were served in individual group therapy services (virtual or in-person).  

 

Pre- and post- assessment measures were administered to all children or adolescents who completed therapeutic services. Students referred for trauma-focused services completed the Structured Trauma-Related Experiences and Symptoms Screener (STRESS) Youth Self-Report, and those referred for grief-focused services, completed the Persistent Complex Bereavement Disorder (PCBD) Checklist Youth Version 1.0.  Students completed these tests prior to receiving services and then after to measure whether a reduction in symptoms of trauma or grief occurred. Table 1. illustrates the FY22 results of the trauma and grief therapy services provided by the Wendt Center.  

 

Table 1. Results of Trauma and Grief Therapy Sessions in School or Summer Settings across Students who Completed Assessments, FY22 

Type of Therapy	Reduction in Symptoms
Trauma focused-group therapy	59% reported a decrease in trauma-related symptoms (N=32)
Trauma focused-individual therapy	67% reported a decrease in trauma-related symptoms (N=6)
Grief-focused group therapy	68% reported a decrease in grief-related symptoms (N=41)
Grief focused-individual therapy	67% reported a decrease in grief-related symptoms.   (N=3)

 

The Wendt Center also worked to expand the capacity of DC schools to meet the needs of trauma- and grief-impacted students through the development and provision of specialized trainings informed by evidence-based practices to school personnel. In collaboration with the George Washington University (GWU) School of Public Health’s School-Based Community of Practice, the Wendt Center created and provided a two-day workshop informed by evidence-based practices on facilitating grief groups in schools to 83 school personnel. School personnel expressed significant interest in the training, and a formal partnership for FY23 was developed to continue the work stemming from successes. Additionally, in collaboration with the GWU Community of Practice, Wendt Center revised the Grief and Trauma Certification Program for school-based mental health professionals and completed the program with a cohort of eight school-based mental health professionals. The center also developed and published 3 tip sheets for school-based staff and school-based mental health professionals focused on ensuring that classrooms are grief- and trauma-informed, ways to incorporate this material into lesson plans, ways to support student regulation, and/or ways to tend to self. Ninety-three parents and caregivers were provided with supportive outreach to help them increase their knowledge of the symptoms and impact of trauma and grief and of how to effectively support their children and access appropriate resources. All parents or caregivers with children or adolescents enrolled in school-based or summer programming received a project manual and an electronic newsletter.  

 

In FY22, the Wendt Center experienced many successes, including many described above. The Wendt Center has increased access to effective mental health care through the provision of high-quality, evidence-based mental health services in community-based or virtual settings to 141 low-income children (ages 6-21) exposed to trauma and grief, and through specialized training services informed by evidence-based practices that expand the capacity of 160 members of the school workforce to effectively support trauma- and grief-impacted children. Training on grief and trauma has had success in building capacity across the District. Successful partnerships were facilitated with 9 schools (Anacostia High School, Columbia Heights Education Campus, DC Prep Anacostia Middle School Campus, Eastern High School, EL Haynes High School, Eliot Hine Middle School, Johnson Middle School, KIPP DC: College Preparatory, and Miner Elementary) and 2 community partners, and multiple new modalities were explored, including Culturally Modified TF-CBT and Trauma Sensitive Yoga (TCTSY). The potential to reach of students is maximized through the training offered to staff in the (9) DC Public and Charter Schools. It is estimated that the training of school staff has the potential to reach 5,010 students. [11]

 

The continued impact of the COVID-19 pandemic led to a decrease in student enrollment numbers for school-based therapy services both individual and group sessions. The effects of the COVID-19 pandemic have also caused challenges in carrying out meaningful outreach efforts with caregivers. Community-based organizations also expressed increased burnout and frequent turnover among staff which presented difficulties in partnering with local summer camps where the Wendt Center provides summer therapy services.

 

The Pediatric Mental Health Care Access (PMHCA) program uses the telehealth model which is a mechanism or strategy to execute the integration of behavioral health into pediatric primary care. The PMHCA program provides teleconsultation, training, technical assistance, and care coordination support services for pediatric primary care and other primary care providers to identify pediatric behavioral health conditions. Additionally, they assist with the diagnosis, treatment, and referral of children with specified conditions, contributing to Title V’s state performance measure (SPM) 3. 

 

In FY22, DC Health began implementing the Health Resource and Service Administration (HRSA) grant that expanded the DC’s Pediatric Mental Health Care Access (PMHCA) program. DC Health continued its interagency partnership with the District of Columbia Department of Behavioral Health (DBH) to implement the DC Mental Health Access in Pediatrics (DC MAP) program. DC MAP promotes improving behavioral health in the pediatric population by integrating behavioral health with pediatric primary care through consultation, training, and technical assistance. The telehealth expansion of existing pediatric mental health care access addresses timely detection, assessment, treatment, referral, and integration with Pediatric Primary Care Providers. 

 

The overall goal is to achieve a sustained reduction in barriers to mental health treatment and follow-up in DC and to increase the quality of telehealth mental health training and resources. The expansion of telehealth services to improve diagnostic accuracy with patients to allow for more rapid responses to critical mental health needs is being implemented and will be an ongoing process. Immediate and specific mental health training is also being facilitated for Pediatric Primary Care Providers to address mental health concerns with their patients. Additionally, DC MAP continues to provide community-based mental health resources for patients.   

 

DC MAP provides rapid assistance through telehealth services to alleviate barriers for patients who may feel uncomfortable meeting a new mental health provider or traveling to different sites to receive services. Implementation of telehealth consultation supports a more accurate evaluation of the clinical situation. It can bring awareness of acute concerns and demonstrate effective collaboration facilitated by the family's Pediatric Primary Care Provider to form a connection and build rapport with mental health providers. Psychoeducation can improve family follow-up with specialty care providers by providing telehealth consultation concerning diagnosis, prognosis, treatment options, and resources.  

School-based mental health services remain the ideal location for the pediatric population identified by their Pediatric Primary Care Provider as needing additional mental health support to receive services. The process for developing a referral system for patients identified by their Pediatric Primary Care Provider within the DC School-Based Health Center program will be implemented in FY23. A DC MAP mental health resource guide will be available to help providers, the pediatric population, and their families find support and services within schools and the surrounding communities.   

 

In support of program implementation, the DC MAP team tracked key performance measures via their online database, AdvancedMD. In FY22, the program served 892 individuals, including 882 children and youth (1-25 years), seven infants (under 1 year), and three pregnant women for whom providers contacted the pediatric mental health team for consultation or referral.  

 

In FY22, 176 providers formally enrolled with DC MAP to use consultation (teleconsultation or in-person) or care coordination support services; 83 providers were both enrolled and contacted the program for consultation (teleconsultation or in-person) or care coordination support services. In total, 935 consultations and referrals were provided to pediatric providers. Providers contacted the pediatric mental health team for consultation (teleconsultation or in-person) or care coordination support services for the following conditions most frequently: anxiety disorders, depressive disorders, and trauma and stressor-related disorders.  

 

In FY22, with support from Concert Health, nine total trainings were held on topics ranging from mental/behavioral health conditions to medications to practice improvement/systems change/quality improvement. Across sessions, 103 providers were trained. DC MAP also maintained partnerships with Help Me Grow, AmeriHealth, MedStar Family Choice, Virginia Mental Health Access Program, and Maryland Behavioral Health Integration in Pediatric Primary Care. 

 

In FY22, there were increases in provider consultation and enrollment each quarter. DC MAP maintained a successful partnership with Concert Health to provide training throughout the fiscal year. The main challenge was that families were not following through with scheduling appointments with the recommended mental health referral or outpatient provider. The DC MAP team continues to explore barriers and develop solutions to understand family motivation and how providers engage with families regarding recommendations.  

 

1. Through the Resources and Education for Adolescents in Community Health (Project REACH), Children's National Hospital has contributed to SPM3, increasing adolescent access to mental health resources in the District. To address the widening medical and psychosocial disparities in DC, Project REACH is a multipronged teen-friendly program facilitated through the primary care medical home to youth in DC ages 13-19. While the priority focus area is mental health including grief and trauma-informed care, Project REACH also promotes adolescent health by increasing access to other adolescent-friendly services and education (e.g., reproductive health care). This program focused on three main goals in FY22:  Expand and evaluate a teen-friendly social media campaign utilizing human-centered design to disseminate culturally appropriate information on general healthy behaviors, reproductive health, mental health, accessing resources, life skills, and other topics identified by youth for youth ages 13-19 years in Washington, DC. In May 2022 modified to: Service patients ages 13-21 through the mobile medical program (and when indicated CHCTHEARC), who reside in the District of Columbia (Discussed further below). 
2. Implement virtual evidence-based/evidence-informed group education for teens ages 13-19 years annually.  
3. Facilitate access to youth-friendly services through the primary care medical home for non-parenting and parenting teens ages 13-19 years by providing care coordination for reproductive health services, mental health services, and comprehensive health services. 

 

In FY22, Project REACH implemented several activities including, identifying teen-friendly community organizations for partnerships and identification of patient needs including teen friendly education, reproductive and mental health services, vaccines, and comprehensive well visits; mobile medical van community outreach; provided evidence-based weekly reproductive health educational sessions and bi-monthly mental health education sessions; and, facilitated continued access to youth-friendly services within primary care medical homes for non-parenting and parenting teens.

 

Due to issues achieving the intended reach with the social media campaign, Children’s National Project REACH pivoted to leveraging a mobile medical van to conduct community outreach and provide services to patients 13-21 in DC. In FY22, 251 teens received adolescent-friendly services via the mobile van. 28 youth-serving organizations were identified and 15 were contacted to explore partnerships and interest in hosting mobile van sessions. In support of the No Shots, No School initiative, Children’s partnered with 5 public charter schools to facilitate immunization events with the mobile van.  

 

Children’s National Project REACH program implemented evidence-based virtual group education for teens, including longitudinal educational series and routine reproductive and mental health sessions. Attendance and participant engagement was tracked by facilitators via attendance logs and surveys. For the longitudinal evidence-based series (Teen Steps of Success (SOS)), 14 teens participated, and two cohorts were conducted. Due to issues with retaining youth within the virtual platform for 20 weeks, the curriculum and activities were shortened to a 12-week duration for the second cohort. Additionally, 31 teens participated in reproductive health education sessions offered weekly; 13% scheduled a related healthcare visit as a result of attendance. Due to staffing limitations and priority setting for reproductive health education and comprehensive care, mental health sessions were paused during FY22 due to the shortage in mental health care professionals and difficulty in hiring and onboarding (but have since resumed in FY23).  

 

Children’s National Project REACH program also facilitated continued access to youth-friendly services within the primary care medical home for non-parenting and parenting teens (ages 13-19 years) through care coordination and closed loop referrals. Data were collected via a care coordinator referral tracking database. 169 youth patients received reproductive health care coordination and 141 youth patients received mental health care coordination. Additionally, 74 parenting teen patients had a reproductive referral or mental health referral tracked by a care coordinator with over 50% completed/attended a needed appointment within 45 days of referral. 

 

In FY22, Children’s National Project REACH program achieved the following successes:  

 

• The replacement of the social media campaign to the mobile medical van better met the needs of teens during the grant year and promising community engagement and partnerships occurred to expand the work in FY23. 
• Hiring and onboarding a seasoned reproductive health case manager lead to a successful round of quality improvements, improved data tracking, and formalized partnerships for future connection with mobile medical programs and fixed health centers.  

 

In FY22, Children’s National Project REACH program experienced challenges recruiting and maintaining engagement for teens throughout the longitudinal Teen SOS group. The project is now working to increase referrals to the program from fixed health sites and community partners. The program functioned without a full-time mental health provider for much of FY22, and the LICSW in charge of mental health care coordination also transitioned from the organization. In addition, the mobile medical unit required servicing in July 2022 delaying vaccine delivery efforts. The unit has since been repaired and is continuing service delivery.

 

Priority Area 2: Enhancing positive youth development for adolescents to decrease high-risk behaviors.

Data gathered from the YRBS indicate adolescents in DC continue to experience multiple health challenges related to engaging in high-risk behaviors resulting in substance use, STD/STI transmission, and pregnancy.  DC Health ensures that adolescent-friendly educational programs are available in schools and within the community to promote positive youth development to address these ongoing challenges.

Performance Measures:

• State Performance Measure (SPM)4: Teen Pregnancy Prevention – Live Births to teenagers ages 15 to 19. 
• SPM5: Increase the percentage of adolescent engagement through tailored adolescent health programs including a Youth Advisory Council and curriculum implementation.

 

Objective 2: Reduce births to teens ages 15 to 19 from 15.6% to 10.4% by 2026.

Objective 3: Increase the percentage of adolescents (aged 14-21) participating in the Youth Advisory Council by 300% by 2026

Strategies:

• Provide accessible pregnancy prevention programs within schools.
• Provide the youth with opportunities to become leaders and advocates within their community.

DC Health partners with reputable community-based organizations to engage youth through various curriculum-based learning opportunities. These sessions cover a wide array of topics specific to adolescents and promote positive youth development. Listed below are program overviews and FY22 accomplishments for Crittenton Services of Greater Washington, DC Health’s Youth Advisory Council, Healthy Babies Project Inc., and Men Can Stop Rape.

Activities:

 

In FY22, Title V staff continued to provide oversight to Crittenton Services of Greater Washington for the Teen Pregnancy Prevention (TPP) program. Crittenton programming empowers teen girls (grades 7-12) across Wards 5, 7, and 8 in DC to overcome obstacles, make positive choices, and achieve their goals through programs in schools. Crittenton implements the SNEAKERS program (primary prevention), which teaches healthy relationships with peers, dating partners, and parents; reproductive health, nutrition, and fitness; academic and career options and enrichment activities. Crittenton also implements The PEARLS program (secondary prevention), which enables pregnant and parenting teens to develop positive life and parenting skills and avoid subsequent teen birth. Aligning with the Centers for Disease Control and Prevention's Community-Wide TPP Initiative Framework, DC Health’s programming aims to engage youth early in preventive health and reproductive life planning through a multicomponent, community-wide approach, which contribute to state performance measure (SPM) 4.

 

In FY22, Crittenton Services of Greater Washington focused on the following goals:  

 

1. Teen Pregnancy Prevention Program participants will have enhanced knowledge regarding existing contraception methods and how to access them and will increase their use. 
2. SNEAKERS and PEARLS participants will hold positive attitudes toward healthy relationships, have post-secondary educational plans, and avoid pregnancy. 
3. SNEAKERS and PEARLS participants will develop essential life and leadership skills. 
4. Teen Pregnancy Prevention Program participants will develop a reproductive life plan based on their awareness and/or intent to become pregnant. [One Key Question] 
5. Crittenton will continuously learn from and improve program content and delivery. 

Activities of the program included registering and retaining SNEAKERS and PEARLS participants; delivery of program sessions and conducting focus groups with participants to assess knowledge of contraceptive methods before and after program participation.  

 

In FY22, Crittenton’ Services of Greater Washington registered 266 participants in SNEAKERS and PEARLS programming, of which 238 remained active throughout the school year. Crittenton completed 21 total cohorts (20 SNEAKERS cohorts and 1 PEARLS cohort), delivering 496 total sessions. At the conclusion of the program year, only one (1) SNEAKERS participant reported a primary pregnancy, and zero (0) PEARLS participants reported a secondary pregnancy. 

 

To evaluate programming, pre-tests were given to participants at the beginning of sessions and post-tests at the end. Across SNEAKERS and PEARLS groups, 209 registered participants completed pre-tests, and 167 registered participants completed post-tests. Table 2 lists outcomes from the SNEAKERS and PEARLS program. Outcomes were only included if participants completed both a pre-and post-test – sample sizes across program groups and grade levels varied. 

 

 

 

 

 

Table 2. SNEAKERS and PEARLS program outcomes, School Year 2021-2022  

Program Group	Grade Levels	Outcome
SNEAKERS and PEARLS	All	51.8% of participants demonstrated increased knowledge of contraception methods
SNEAKERS and PEARLS	All	42.6% of participants demonstrated increased knowledge of where to access conception methods
SNEAKERS and PEARLS	All	45% of sexually active participants increase the use of birth control and condoms
SNEAKERS and PEARLS	8-12 grades	43.8% of participants demonstrated increased knowledge regarding healthy relationships.  36% of participants reported increased confidence regarding healthy relationships
SNEAKERS	9-12 grades	29% of participants completed a grade-specific plan for post-secondary education
SNEAKERS	7-12 grades	100% of participants were promoted to the next grade or graduated from high school
SNEAKERS	7-8 grades	44.3% of participants demonstrated increased knowledge regarding planning and goal setting.   77.0% of participants reported increased confidence in their ability to set goals and take steps to achieve their goals
SNEAKERS	11-12 grades	82.4% of participants demonstrated increased knowledge on “adulting” skills
PEARLS	All	33% of participants demonstrated increased knowledge on parenting (cohort of 4)

 

In FY22, Crittenton administered the One Key Question (OKQ) survey to 160 SNEAKERS and PEARLS participants, providing 24 referrals to teen-friendly, qualified reproductive health care providers for all sexually active participants who responded yes or no and indicated no or inconsistent contraceptive use. Crittenton reviewed and discussed 22 participants’ plans.  

 

At the conclusion of 2021-2022 school year, the Crittenton team documented lessons learned to identify potential areas for program improvement. Crittenton held close-out meetings with schools and conducted structured discussions regarding program delivery, program outcomes, and school support, summarizing lessons learned and recommendations to update the curricula and train staff. Crittenton also revised its program delivery strategy and reporting policies and procedures to improve data capture and program outcomes. Crittenton held two (2) weeks of staff training focusing on Advancing Youth Development, Mental Health First Aid for Teens, Trauma Informed Care, and organizational policies and procedures. 

 

In FY22, the Crittenton Services of Greater Washington’s SNEAKERS and PEARLS program achieved the following: 

 

• Resumed in-person programming and continued to provide emotional support to program participants. 
• Registered 266 program participants. 
• Held an Annual Leadership Summit in person. 
• 100% of students reported they would be promoted to the next grade level. 
• 99.6% of students avoided primary pregnancy and secondary pregnancy. 

 

In FY22, Crittenton Services of Greater Washington’s SNEAKERS and PEARLS program experienced the following challenges and areas for improvement: 

 

• Group Registration issues due to delays in getting into some schools caused by criminal background check requirements. 
• At times, issues within the school environments (e.g., school lockdowns, school disruptions due to behavioral issues, school absenteeism) caused delays both in recruitment and program delivery. 
• COVID-19 outbreaks resulted in higher absentee rates and school cancellations of groups.  

In FY22, the DC Health Youth Advisory Council (YAC) continued to promote health and leadership skills among DC youth to empower the next generation of DC leaders and public health professionals and contribute to the work of the Maternal and Child Health Advisory Council and DC Health’s Community Health Administration. The YAC continued developing and implementing program activities in alignment with DC Health’s mission, the YAC Framework, and the tenants of Positive Youth Development (Relationships and Inclusion, Education, Health and Wellness, Leadership and Advocacy, and Employment and Entrepreneurship). This work contributed to SPM 5. 

 

In FY22, the DC Health YAC was comprised of DC youth, ages 14 to 21, who attended a DC Public or Public Charter High School and/or were enrolled in college or post-high school programs in the District. Weekly YAC sessions and workshops were held to train members on public health topics, discuss best practices that promote, maintain, and protect youth physical, social, and mental health, and request members’ perspectives on health guidance and messaging as needed. The group also discussed available adolescent health services and programs in DC and how to best address barriers or negative experiences with these services to promote youth utilization and advocate for youth-friendly adolescent health services to policymakers and providers. To build leadership and advocacy skills, YAC members were tasked with working on projects and presentations to address relevant health topics. Key activities included recruitment and convening of weekly sessions and workshops; planning and executing the YAC’s first virtual Youth Health Summit; and, partnering with various community-based organizations, local government agencies, and other DC Health programs to raise awareness around health-related priority areas, participate in weekly YAC sessions, and support the Youth Health Summit.

 

In FY22, DC Health released a Request for Applications (RFA) to increase the reach and scale up the YAC and its activities. The YAC grantee, The Young Women’s Project (YWP) is implementing the 2022-2023 Youth Advisory Council in partnership with DC Health. The YWP is a DC nonprofit that builds the leadership and power of all young people to transform DC institutions to expand rights and opportunities for DC youth. The partnership with YWP will assist DC Health in accomplishing strategic priorities by strengthening public and private partnerships and implementing data drive outcome -oriented program approaches. The partnership with the community- based grantee will also enable the YAC to support other Adolescent Health programs within DC Health and other youth programs and services in the District of Columbia. 

 

The total number of adolescents engaged and participating in the YAC is a key indicator used to track progress toward SPM5. In FY22, twenty-four (24) DC adolescents aged 14-21 were recruited and completed the pre-assessment for the YAC school year 2021-2022 cohort. Table 3 provides the demographic breakdown of the cohort.

 

Table 3. Youth Advisory Council Member Demographic, SY 2021-2022
Characteristic	Total YAC members	Percentage of Cohort
Age
15 years old	4	16.7%
16 years old	7	29.2%
17 years old	11	45.8%
19 years old	1	4.2%
20 years old	1	4.2%
Grade
10th	5	20.8%
11th	6	25%
12th	11	45.8%
Currently not in school	2	8.3%
Gender Identity
Female	21	87.5%
Male	3	12.5%
Race/Ethnicity
Black or African American	14	58.3%
White	4	16.7%
American Indian/Alaska Native	1	4.2%
Asian	1	4.2%
Indigenous		4.2%
Black of African/Trinidadian	1	4.2%
Asian, White	1	4.2%
Black or African America, White	1	4.2%
Sexual Orientation
Heterosexual	17	70.9%
Bisexual	3	12.5%
Pansexual	3	12.5
Prefer not specify	1	0.1%
School Type
DC Public School	17	71%
DC Public Charter Schools	5	21%
I am currently not in school	2	8%
Source: YAC pre-assessment responses, some minor differences reported in the post-assessment

 

In FY22, important evaluation components were built into the YAC programming. During the first YAC convening, a pre-assessment was disseminated to capture YAC member baseline demographics and knowledge. A post-assessment was then disseminated at the end of the cohort to capture knowledge change as a result of participation in YAC. Additionally, feedback forms were collected after each educational training session to capture member perspectives.  

 

An analysis was conducted to explore participant perspectives and knowledge change during the SY 2021-2022 cohort period. In FY22, 20 of the original 24 YAC members (~83%) were retained, measured by those who completed both the pre-assessment and post-assessment at the end of the cohort period. In general, when comparing pre-and post-assessment scores, YAC members reported increased capacity in the following areas:  the ability to advocate for issues affecting youth throughout DC, awareness of mental health resources and services available in DC, and understanding of the Positive Youth Development Approach and the YAC Framework. Additionally, YAC members reported increased confidence in their ability to: identify barriers that contribute to negative experiences for youth when trying to access adolescent health services, educate the community and advocate for policies and programs that improve health outcomes for District residents, and raise awareness and advocate for youth-friendly mental health and counseling services. The pre-and post-assessment results were used to understand which topics were successfully addressed in YAC educational programming and which ones may require additional focus or retailoring in future years. 

 

Session feedback forms were also reviewed and feedback from YAC members was reported. In FY22, 466 total forms were completed. Most YAC members (77%) indicated they would feel “comfortable” or “very comfortable” presenting on the session topic along with other YAC members and 95% felt the topic was either “extremely important” or “very important.” Overwhelmingly, members cited satisfaction with the programming, reporting an annual approval rating of 94 of 100 across all sessions. Results of the feedback forms were continually reviewed to ensure YAC members were deriving value from the routine educational sessions, incorporating feedback received in future lessons.   

 

On May 21, 2022, the DC Health Youth Advisory Council in collaboration with the Department of Behavioral Health and Metropolitan Police Department facilitated a virtual Youth Health Summit, focused on youth mental health, violence, and healthy behaviors targeting DC youth aged 14-21. One hundred and thirty-three 133 individuals registered for the Summit, including attendees, hosts, and presenters partnering from 8 organizations. Sixty-eight (68) individuals, including 29 attendees and 39 hosts/presenters, attended the Summit.  

 

A post-survey was disseminated at the end of the Youth Health Summit. Fifty percent (50%) of participants completed this survey, the majority being individuals who participated in the Summit as presenters or hosts in some capacity during the Summit. Of those who completed the post-Summit survey, the majority reported they would attend a Youth Health Summit in the future (85%) and were “extremely likely” or “likely” to recommend the Summit to a peer (85%). Overwhelmingly, they reported being “very satisfied” or “satisfied” with the quality and clarity of information provided; however, the majority felt less positively towards the technology platform used, which is a key lesson learned. The majority also reported gaining knowledge from the Summit and an interest in the public health field.

 

In FY22, the DC Health YAC members responded positively to programming within session feedback forms. They reported a 94 or 100 approval rating across all sessions and increased their knowledge of health topics when comparing pre-and post-assessments. Further, the YAC members were able to plan and facilitate their inaugural Youth Health Summit attended by over 60 participants who generally provided positive feedback regarding the event. 

 

In FY22, due to the ongoing COVID-19 pandemic, the DC Health YAC had to adapt to some challenges. The YAC continued to facilitate virtual meetings (as opposed to in-person meetings) to prevent disease spread and maintain participant and facilitator safety. At times, there were challenges in maintaining youth engagement. Moving forward, DC Health is partnering with the Young Women’s Project (YWP) to facilitate the YAC. YWP will ensure recruited YAC members are engaged and support the transition of the programming to a hybrid model, re-convening sessions in part back in person.  It was noted that YAC members felt financial competency was not addressed in FY22 programming, which will be covered in FY23 educational sessions and workshops. 

 

Healthy Babies Project Inc. (HBP) was funded by Title V and contributed to state performance measure 5 (SPM 5) in FY22. In FY22, the Healthy Babies’ Life Empowerment Program (LEP) was funded to equip vulnerable, low-income District adolescents (ages 12-17 in Wards 5,7, and 8) with evidence-based health education and life skills training to help them build stable lives. The priority area for this program is positive youth development. This program focused on the following goals in FY22:  

 

1. Utilizing the Sisters Informing Healing Leading Empowering (SIHLE), Making Proud Choices, and Real Essentials as evidence-based curricula, to reduce teen pregnancy/STIs among 750 District youth (ages 12-18) over the course of (5) years. 
2. Increase high school graduation/higher education attainment with retained program participants at 6 months post-program completion. 

 

In FY22, HBP completed the following activities: 

1. Engaged low-income District residents ages 12-18 in evidence based PYD health and life skills programming that provides continuous quality improvement, including the facilitation of workshops. 
2. Disseminated and evaluated pre-and post-assessments to measure knowledge change amongst participants. 
3. Engaged youth in routine booster session workshops that addressed life skills and career exploration elements to help improve high school completion rates. 

In FY22, HBP’s LEP engaged 215 low-income District residents ages 12-18 in evidence based PYD health and life skills programming. Pre-tests were administered at the beginning of the cohorts and post-tests at the end. Survey results measured sexual health and pregnancy prevention knowledge, contraceptive knowledge and confidence in usage, safe sexual behaviors, and risky sexual behaviors, and understanding of healthy relationships. In FY22, risky behaviors decreased amongst LEP participants by 22%, meaning youth who were engaging in unhealthy sexual behaviors (sex with multiple partners or sex without a condom) are now with one partner or using condoms correctly and consistently in their activity. The following were additional key results from the LEP post-tests: 

 

• 68% of youth understand abstinence is the only way to prevent pregnancy. 
• 85% know STDs require treatment for healing. 
• 89% understand that unsafe sexual behaviors, such as multiple partners increase risk for STD.  
• 85% have skills to manage healthy relationships and can access whether the relationship is healthy or not. 
• 82% of youth can communicate thoughts and feelings. 
• 86% feel confident accessing birth control methods. 

Additionally, in FY22, HBP hosted 25 booster sessions attended by a total of 105 participants. HBP Booster Sessions are monthly, interactive workshops that enrich vulnerable District youth in building healthy relationships, choosing a career path, and learning advocacy skills. Any District youth may attend, but most participants are LEP alumni. HBP launched its Booster Sessions as one way to reinforce and expand on the program’s content and is one way to help youth put LEP skills into practice, including personal safety, family planning, and communication skills. Additionally, 105 participants completed the One Key Question Survey and those who reported unhealthy behaviors received referrals to services such as birth control counseling or parenting classes. Within the LEP booster sessions, pre- and post-surveys were also administered to evaluate participants’ career knowledge and awareness. 73.9% of youth gained knowledge in career field entry strategies and 60% of youth enrolled in a long-term education program, career exploration program, or internship.

 

HBP worked with 12 community partners for recruitment and as special guests for booster session workshops, including Hoops for Youth, Royal Kids, RecFit, DYRS, Idea Public Charter School, CFSA, and Virginia School of Nursing.  4 peer facilitators and volunteers were also trained to deliver programming. 

 

In FY22, the Healthy Babies Project, the re-establishment of a relationship with the District of Columbia Public School (DCPS) assisted with the recruitment of new LEP graduates for the program. Conducting the LEP during the Summer Youth Employment program also led to increased recruitment. By the end of the program, more than 86% of participants reported a lack of interest in becoming pregnant within the next year, and 90% reported practicing safe sexual behaviors to reinforce their goals.

 

In FY22, HBP experienced challenges re-engaging you via in-person workshops and booster sessions. Many participants were engaged online but HBP is working to build participation rates for in-person workshops. One mechanism has been to encourage quarterly booster sessions instead of monthly sessions to allow additional time for engaging participants to boost attendance. Some issues with recruitment occurred during the reporting period related to retention throughout the school year (e.g., school absences, shortage of school supportive staff, and school disruptions).  

 

In FY22, Men Can Stop Rape (MCSP) was funded by Title V to continue the Women Inspiring Strength and Empowerment (WISE) and Men of Strength (MOST) Clubs in support of the positive youth development priority area. In FY22, MCSR utilized effective strategies to support the DC Department of Health’s state performance measure (SPM) 5, increasing adolescents' (aged 12-17) engagement in tailored programming on health and life skills topics. In FY22, MCSR focused on the following goals: 

 

1. To implement WISE and MOST Club programming that engages adolescents ages 12-17 at 14 school locations in weekly programming about health, life, and career skills topics.  
2. To engage WISE + MOST Club members in the development and implementation of Community Strength Projects that demonstrate their increased understanding of health, life, and career skills topics and share this learning with the broader community.  
3. To train professionals to implement WISE and MOST Club programming; become trainers in their own communities on the role of engaging men and boys in gender-based violence prevention; and develop bystander intervention and consent skills amongst youth-serving professionals and key stakeholders.  
4. To deepen the effectiveness and sustainability of programming that produces statistically significant changes in attitudes, behaviors, and relevant outcomes for adolescent health based on key indicators. 

In FY22, MCSR completed the following activities:  

 

1. Facilitated weekly WISE and MOST Club programs at 14 school locations for a minimum of 15 students per location, led by MCSR-trained facilitators and guided by MCSR's 22-session curriculum, which provides 1 hour per week of group mentoring that deepens, increases, and sustains their awareness and understanding of healthy, pro-social behaviors at the individual, relationship, community, and societal levels.   
2. Mentored youth in the development of tangible life and career skills that will help them successfully transition from high school into adulthood. 
3. Guided WISE + MOST Club Members in planning, implementing, and assessing Community Strength Projects.   
4. Provided professional development opportunities to youth-serving professionals seeking to engage youth in positive youth development programming via a minimum of two trainings and additional technical assistance hours as needed/requested. 
5. Tailored and implemented evaluation tools to track key indicators. 
6. Analyzed evaluation data to assess the impact of programming and to enhance program sustainability. 

In FY22, MCSR reached 865 students in clubs, Community Strength Projects, and other events (noting this is a duplicated count and at times, there was an overlap in student participation across activities). Sixteen schools were engaged in programming. MCSR mentored 313 youth in the development of tangible life and career skills that will help them successfully transition from high school into adulthood. Through partnerships with various collaborators at the local and federal levels, MCSR was able to provide students with professional development opportunities through their Healthy Masculinity Action Project (HMAP). MCSR, National Resource Center on Domestic Violence, Men Stopping Violence, Break the Cycle, Coach for America, Women of Color Network, and A CALL TO MEN – launched HMAP with the National Healthy Masculinity Summit. MCSR has continued to implement HMAP programming, sparking an international healthy masculinity movement, and setting a standard for building a new generation of male leaders who model strength without violence. Based on a public health approach, the desired outcomes of HMAP have been shaped by a logic model that serves as a guide for planning and assessment. All the components of MCSR’s HMAP together constitute a unified and comprehensive whole that positively engages boys and men in prevention at all levels of the social-ecological model. Seventeen meetings were facilitated with Current and Veteran WISE + MOST Club Leadership Committee members, which provided valuable ideas and insights for programming, organizational growth, and near-peer and intergenerational mentoring opportunities. Twenty students from WISE + MOST Club network were recruited to speak on a variety of panels and provide feedback as part of creative brainstorming sessions for MCSR Gaming Initiative. MCSR Gaming is MCSR’s esports league for MOST and WISE Club members. It was launched in response to members’ interest in the gaming industry and more opportunities to connect outside of their Clubs. MCSR Gaming provides a safe, supportive space for young people to connect with their peers. The league encourages members to bring the healthier, nonviolent norms established in the MOST and WISE Clubs into their competitive gameplay and supports their interest in the growing opportunities within the gaming industry, allowing them to connect gameplay to specific STEAM programs that they learn as a part of their participation in the MOST and WISE Clubs. 

 

In FY22, MCSR guided WISE + MOST Club Members in planning, implementing, and assessing five Community Strength Projects (CSP), including Domestic Violence Awareness Month School Meetings; Solutions Through Film Black History Month Film Festival; Sexual Assault Awareness Month 30 Days of Strength Morning announcements and Open Meetings; Project Me; MCSR Gaming STEM Stops. According to CSP attendance sheets, 748 students participated in events throughout the year.  

The Community Strength Projects translate the lessons of the MCSR curricula guiding MOST and WISE Clubs into inspired public action, as students in the MOST and WISE Clubs organize and become leaders in their schools and communities. Through intergenerational and near-peer mentoring, club members develop, execute, and evaluate their own youth-led initiatives. By sharing what they learn in their Clubs with the broader community, it is expanding their capacity as leaders and allows them to earn service-learning credits to fulfill graduation requirements along the way. 

 

In FY22, MCSR also hosted four Healthy Masculinity Training Institutes (HMTIs) to provide professional development opportunities to youth-serving professionals seeking to engage youth in positive youth development programming and additional technical assistance. Eighty-three professionals were trained and two received additional technical assistance.  

 

MCSR disseminated a pre-and post-test to WISE + MOST Club members, receiving a total of 150 surveys across nine DC public schools. Seventy- five male students were given pre-tests in October 2021 and then post-test in May 2022 after participating in seven months of MOST Club programming.

 

In FY22, MCSR achieved the following successes:  

 

• A return to in-person programming across all club locations and exceeding the 700-student goal. 
• The successful revamping and then distribution, collection, and evaluation of pre- and post-surveys. 
• Facilitation of multiple HMTIs and other training for professionals.  
• Provision of Club members with multiple opportunities to offer insights and feedback to both our programs as well as state and federal initiatives. 
• The successful implementation of the annual Solutions Through Film event for Black History Month and the successful execution of Project Me in June 2022. 

In FY22, occasional returns to virtual education to follow COVID protocols and the delay in DCPS clearances provided challenges in the first half of the school year. In the summer, staff shortage issues occurred, but have been resolved and further planning has been developed to prevent reoccurrence.

 

Priority Area 3: Improving access to healthcare among adolescents.

As noted above in our overview of adolescent health outcomes in the District, expanding adolescent access to healthcare is important to improve the population’s overall health and well-being.

 

Performance Measures:

• NPM11: Percent of children with and without special health care needs, ages 0 through 17, who have a medical home. 
• ESM11.1: Number of children and adolescents with and without special health care needs referred to a medical home.
• NPM12: Percent of adolescents with and without special health care needs, ages 12 through 17, who received services to prepare for the transition to adult health care.

Objective 4: Increase the proportion of adolescents 0 to 17 who have a medical home from 46.8% to 47.9% by 2026.

Objective 5: Increase the percentage of adolescents ages 12 to 17 who use transition planning services from 19.4% to 25% by 2026.

Strategies:

• Encourage and empower students to utilize their school-based health centers as their medical home.
• Empower and encourage adolescents to utilize school-based health centers as their gateway and guide into adult care.

DC Health’s School-Based Health Center Program (SBHC) provides the opportunity for youth to receive a full range of medical services in an adolescent-friendly environment. Outlined below is a program overview and FY22 accomplishments for the DC SBHC Program.

Activities:

Title V provides support for DC Health staff overseeing the locally funded School-Based Health Center Program (SBHC), which contributes to NPM 11 and ESM 11.1. The program aims to improve the physical, social, emotional, and behavioral health of students, as well as minimize the effects of poverty and other adverse childhood experiences, enabling students to thrive in the classroom and beyond. During FY22, DC Health continued to provide oversight to seven (7) SBHCs operated by four DC Health grantees – Children’s National Hospital, MedStar Health Research Institute, Mary’s Center, and Unity Health Care, Inc. – in seven DC Public high schools. SBHCs are open year-round and promote an adolescent-friendly approach due to evidence supporting the need for care to be accessible, equitable, acceptable, appropriate, comprehensive, effective, and efficient. Services provided by each School-Based Health Center include preventive and primary care, sexual and reproductive health care, oral health care, behavioral/mental health care, health education, and linkages/referrals: 

 

• Preventative and Primary Care services provided by the School-Based Health Centers consist of promoting and maintaining health through risk screenings, well-child examinations, and immunizations. School-Based Health Centers evaluate, diagnose, and treat students with chronic illnesses such as diabetes, asthma, and obesity.   
• Sexual and Reproductive health care and life planning services provided by School-Based Health Centers include counseling and provision for various contraceptives, including oral contraceptives, Depo-Provera injections, and long-acting reversible contraceptives (i.e., subdermal implants, intrauterine devices (IUDs). Also provided are sexually transmitted infection screening, counseling, and prenatal care services.   
• Behavioral/Mental Health Providers are on-site to provide mental health assessments, treatment, counseling, substance abuse intervention, and care coordination. DC Health partners with the DC Department of Behavioral Health to ensure that the behavioral health needs of students are met through the School-Based Health Center or Mental Health Providers in the community. Students needing specialty care, emergency care, or other services not provided by the School-Based Health Centers receive a referral.  
• Preventive oral health services are provided at certain sites. These services include oral health screenings, dental cleaning, topical fluoride treatments, oral health education, and counseling. 

 

 

In FY22, SBHCs completed 6082 total visits and reached 2284 total students (unduplicated). The breakdown of service utilization is listed in the tables below. SBHC operators continued to routinely report data to DC Health, including monthly narratives, quarterly data reports, and annual end of year reports.  

 

Table 4. FY 22 School-Based Health Centers Utilization by Service and School (Oct 1, 2022 – Sep 30th, 2022)
Service	Anacostia	Ballou	Cardozo	Coolidge	Dunbar	Roosevelt	Woodson
Total Visits	771	591	1572	722	864	740	822
Total number of students who visited SBHC	350	234	371	423	233	383	290
Well Child Visits	60	3	51	19	0	22	94
Mental/Behavioral Health Visits	176	53	1544	489	80	227	813
Sexual Health Visits	276	110	224	115	157	319	152
Immunizations administered	262	169	1087	370	84	665	255
Oral Health Visits	66	0	1139	0	0	158	578
Asthma Care Visits	46	40	36	11	47	94	45

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The SBHCs were instrumental in assisting with the Immunization Compliance policy for the 2022-2023 school year. During the summer of 2022, they served as mass immunization sites for students who attended schools in Washington, DC. During the 2021-2022 school year, they were able to increase immunization compliance at their respective schools, by immunizing students who needed their childhood vaccinations. 

 

Thirty-two percent (1924/6082=32%) of students who enrolled in the SBHCs elected them as their medical home. The SBHC’s do not capture data on the exact number of students who need to be referred to a medical home. However, all 7 SBHCs are operated by 4 organizations that have networks of medical care providers within DC. Any student who is seen at any of the SBHCs can be referred to providers in the community within our outside-of-the-community networks. 

 

In FY22, the SBHCs have been making strides to address gaps in services provided by the clinics. This includes providing additional immunization support and increasing the number of behavioral health, dental and reproductive health services offered at the SBHCs. Closing health services gaps in the SBHCs have resulted in an increase in utilization by students who are enrolled in the clinics.  

The SBHCs were able to increase immunization compliance at their schools. SBHC providers and staff contacted non-compliant students who were enrolled in the school to schedule and provide childhood and COVID-19 vaccinations. Students had the ability to fully enroll in the SBHC or enroll as one-time visits to receive necessary vaccinations and become compliant.  

 

DC Health has made access to adolescent-friendly reproductive health care a priority for FY22. As a result, the SBHC operators have diversified the types of birth control available to students and have taken steps to ensure that all forms of birth control are offered to students (including LARC). Some of the SBHC operators have also taken a public health approach to addressing reproductive health by hiring reproductive health specialists and health educators to provide health education to students in addition to medical care.  

 

To increase adolescent access to behavioral health services, the SBHC’s began a partnership with the Pediatric Mental Health Care Access (PMHCA) program to ensure that eligible students receive behavioral health services in a timely manner. The partnership involves the use of the DC MAP referral process for students who are unable to receive care directly from the schools and SBHCs.  

The SBHCs also began incorporating health education and health information dissemination to the whole student body through bulletin boards, tabling at school events, health seminars, and small group activities. 

 

Increasing overall SBHC enrollment is an area for improvement that the SBHCs and DC Health have been strategizing to improve over the past fiscal year. DC Health has set an overall goal that all SBHC’s should reach at least 50% of the students enrolled in the school. In FY22, three of the seven SBHC’s enrolled at least 50% of the students enrolled in the school. SBHC staff have increased their visibility in schools and DC overall through recruitment tables, informational meetings, and their assistance with the immunization compliance program.  

 

Staff turnover in some of the SBHCs has also been a challenge. Overall, the sites have been able to hire and maintain providers at the SBHCs. However, recruiting and sustaining key support staff has been difficult. 

 

• Introduce and articulate the impact of implementation of identified programs, initiatives, and partnerships (Narratives received in Microsoft Forms).

 

 

 

 

 

 

[1] World Health Organization. (n.d.). Adolescent health. World Health Organization. https://www.who.int/health-topics/adolescent-health#tab=tab_1

[2] 2021 DC YRBS Data Files. (2023). DC Office of the State Superintendent of Education. Accessed June 26, 2023 at https://osse.dc.gov/node/1635216

[3] Substance Abuse and Mental Health Services Administration. (2020). National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia).

[4] Substance Abuse and Mental Health Services Administration. (2021). 2021 NSDUH: Model-Based Estimated Prevalence for States. https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates

[5] CDC. Youth Risk Behavior Surveillance System (YRBSS). District of Columbia 2021 and United States 2021 Results. Retrieved June 26, 2023, from https://nccd.cdc.gov/Youthonline/App/Results.aspx?LID=DCB

[6] Annual Epidemiology & Surveillance Report: Data Through December 2021. District of Columbia Department of Health, HIV/AIDS, Hepatitis, STI, & TB Administration 2022. Accessed April 10, 2023 at https://dchealth.dc.gov/service/hiv-reports-and-publications

[7] Perinatal Health and Infant Mortality Report: 2019–2020 Report, 2017–2018 Supplemental Report. (2022). District of Columbia Department of Health.

[8] Child and Adolescent Health Measurement Initiative. 2020-2021 National Survey of Children’s Health (NSCH) data query. Data Resource Center for Child and Adolescent Health supported by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB). Retrieved June 26, 2023 from [www.childhealthdata.org].

[9] U.S. Department of Health & Human Services: Health Resources and Services Administration Bureau of Health Workforce (2021). Designated health professional shortage areas statistics: Second quarter of fiscal year 2021.

[10] Brown DW, Anda RF, Tiemeier H, Felitti VJ, Edwards VJ, Croft JB, Giles WH. Adverse childhood experiences and the risk of premature mortality. Am J Prev Med. 2009 Nov;37(5):389-96. doi: 10.1016/j.amepre.2009.06.021. PMID: 19840693.

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https://www.myschooldc.org/