State Performance Measure 03: Percent of Wisconsin adults who report that they “usually” or “always” get the social and emotional support that they need (Social Connections)

 

Due to environmental and social barriers, too many Wisconsinites are lacking meaningful social connection, which can lead to increased risk of adverse health outcomes. In Wisconsin, the number of adults and youth who feel socially connected has declined in recent years. In 2023, 18% (17/96) of local and Tribal health agencies chose to work on Social Connections as an objective.   

 

According to 2022 data from the CDC’s Behavioral Risk Factor Surveillance System (BRFSS), currently, 76.4 percent of adults report that they usually or always get the social and emotional support they need. In addition, 69.4 percent of adults report that they rarely or never feel socially isolated from others. According to the 2021 Wisconsin Youth Risk Behavior Survey, in Wisconsin, 60.8 percent of high school students agreed or strongly agreed that they belong at their school.

 

Measure	Data
Percent of Wisconsin adults who report that they “usually” or “always” get the social and emotional support that they need	76.4% (2022 Behavioral Risk Factor Surveillance System)

 

Supporting Measures

Measure	Data
Percent of adults report that they rarely or never feel socially isolated from others	69.4% (2022 Behavioral Risk Factor Surveillance System)
Percent of high school students agreed or strongly agreed that they belong at their school.	60.8% (2021 Wisconsin Youth Risk Behavior Survey)

 

Wisconsin’s Title V program aims to incorporate work addressing social connection and access to informal and formal resources throughout the national and state performance measure strategies. Activities include offering social connection as a project option for local and Tribal health Tribal agencies to address, providing expertise on social connections, continuing to review existing efforts, aligning with the work of other Wisconsin performance measure teams, and developing a tool to organize current and potential efforts by leveraging existing data sources.

 

In year three of Wisconsin’s Title V program working to advance Social Connections, 2023 marked the first year that local and Tribal health agencies could select this topic area to work on with their annual Title V funding.

 

There were two unsuccessful attempts in finding a statewide partner to provide social connection technical assistance, and as a result, the Title V staff took the lead and hosted quarterly learning community calls for participating agencies. It was an exciting year with many noted successes including building a quarterly reporting system, precepting two Title V MCH interns, and successfully providing technical assistance to 21 local health agencies. Agencies were asked to assess the need for social connections work, prioritize partnerships and community engagement and to develop an action plan to support social connections.

 

Organize current and potential social connection efforts throughout the state by leveraging existing data sources and by identifying new and innovative opportunities for data collection.

 

In 2023, the Title V team launched the new reporting instrument, “Title V MCH Objectives: Social Connections” among the local and Tribal health agencies that implement the Social Connections MCH Objective. There were not any Tribal health departments that selected this objective. The Alchemer database and template were utilized quarterly among the local health agencies in order to gather local-level data on their social connections related projects and activities. The data collected includes but is not limited to why local and Tribal health agencies chose the Social Connections MCH Objective, areas of focus for their work, activity progress, facilitators and barriers, their utilization of partnerships to advance their work, and how they are integrating health equity. The information collected through the new reporting instrument helps to inform state-level work to better understand and support the unique needs for social connection across Wisconsin communities.   

 

To further support the development of social connections work in Wisconsin, two interns from the Title V MCH Internship Program created a variety of data products informed by local and state-level social connections data in the summer of 2023. This included: 1) a report which highlighted the importance and public health impact of social connections and synthesized key findings from the quarterly data collected from the local health agencies; 2) opportunities or recommendations for future data collection strategies that could close gaps in currently collected data; and 3) a series of one-pagers based upon the report’s findings. These data products have been used internally to support programmatic decision-making as well as shared externally to support partners and grantees in their decision-making, project planning processes, and sustainability of their work.   

 

Strengthen collaboration and partnerships with Title V-funded programs and other programs and grant-funded projects doing similar work to increase knowledge and promote resource utilization and tools to support social connection.

 

Title V staff and other core team members met biweekly throughout the year to plan and collaborate on social connections. Multiple agencies focused their efforts on social connections including the Office of Children’s Mental Health, Wisconsin Prevention Board, and Wisconsin State Health Improvement Plan (SHIP). Collaborative social connection efforts included internal meetings and then highlighting work accomplished at required quarterly learning community calls.  Learning community calls focused on sharing local, state, and national resources and highlighting programs that would inspire local health agencies.

 

In the May 2023 learning community, the Office of Children’s Mental Health shared Social Connectedness of Youth – The One Thing, which focuses on youth and mental health wellness by prioritizing social connections. The Wisconsin Prevention Board also presented their work,  Connecting with Others - Five for Families. This program prioritizes parents and children building a network of social connections around them.  At the learning community call in August 2023, the Title V MCH Internship Program students summarized their data projects and gained feedback for final editing. Local health agencies have appreciated learning more about these state and national level efforts.

Work with local and Tribal health agencies to assess the need for improvement of social connections within their community.

 

Twenty-one agencies selected social connections to work on in their communities. The most common reason for this selection came from community health assessments (76.2%). Forty-seven percent of those agencies also prioritized social connections within their community health improvement plans. Focused areas of improvement included:

 

• Community connections: 19/21

 

• Community development: 2/21

 

• Environment: 2/21

 

• Neighborhood safety: 1/21

 

• Safe stable housing: 1/21

 

• Schools and childcare: 7/21

 

• Social isolation: 19/21

 

• Social support: 18/21

 

• Other: 1/21

 

Partnership building was identified as a key factor in this work. A high interest or alignment with partners, providers, community members and governmental departments was considered valuable by 47.6% of local health agencies, Partners included: community-based organizations 90% (19/21), schools or school districts  86% (18/21), other governmental  departments/ agencies 76% (16/21), health systems or health organizations 67% (14/21), coalitions 62% (13/21), faith-based organizations or churches 57%(12/21), and private businesses 57% (12/21). Sixty percent of local health agencies developed new partnerships in social connections work. Other contributors to social connection work were data related resources, having flexibility or a broad scope within the social connection’s objective, alignment with agency priorities, funding resources and staff interest. One agency shared the following success related to partnership building:

 

“In 2024, the collaborative group working on social connections will be using ARPA dollars to coordinate listening and community empowerment sessions, create campaign materials related to social connectedness, and award mini grants to organizations doing social connectedness work in their communities. We are excited to complete this work within the next year and make a visible impact on our community.”

 

Title V staff asked about barriers to social connections work within the quarterly reports. The top five barriers noted included staff capacity (38.1%), lack of funding resources (28.6%), partners’ staff capacity (23.8%), trust with the community (19%) and lack of culturally relevant resources in languages other than English (19%).

 

Local health agencies acknowledged the barriers and continued to work through them. Staff capacity continued to be an ongoing issue as well as trust with public health. One agency shared the following partnership building success story:

 

“We have expanded upon already established partnerships and have made new connections with community organizations and individuals.  The community events we participated with have provided opportunities for information sharing as well as generally increasing our community presence and making connections for people with public health resources.  We hope to continue to build off of these connections and assist with future events.  All events over the past year have had positive outcomes; some of the greatest positive connections were made at the Summer Activities event at the Ashland School District and also the Ashland Area Farmer's Market.  Both of these events were very well attended and facilitated connections with individuals we may have not otherwise reached.  We hope to continue to expand our events and outreach at future community events as well as build upon partnerships.  One such partnership we hope to expand upon is our work with Bay Area WIC; there is a plan to resume in-person visits for WIC and we hope to assist with this to expand public health connections and awareness of resources.  Staff are also working on obtaining CLC certification to provide evidence-based practice/education during these events.”

 

The Title V program continues to prioritize health equity with local health agencies reporting the following:

 

• Utilizing data to help inform equity and community engagement efforts 33.3% (7/21)

 

• Actively working to connect with community (e.g., attend community events) 28.6% (6/21)

 

• Centering priority populations that are experiencing inequities 23.8% (5/21)

 

• Participating in trainings or professional development opportunities related to health equity and/or community engagement 19% (4/21)

 

• Partnering with other organizations, agencies, or departments to better reach priority populations 19% (4/21)

 

• Including community in program planning and decision-making (e.g., have a community advisory board, community involvement in program planning or decision-making) 14.3% (3/21)

 

• Create culturally relevant materials (e.g., translated materials into languages other than English, incorporated specific cultural perspectives) 9.5% (2/21)

 

• Create accessible materials (e.g., utilized plain language approaches, considered differing abilities/needs) 4.8% (1/21)

 

• Focus on and addressing social determinants of health 4.8% (1/21)

 

• Hire staff that are representative of the community and populations that are experiencing inequities 4.8% (1/21)
• Hire staff that are able to communicate with clients in languages other than English 4.8% (1/21)

 

With health equity as a priority, one local health agency shares the following success story:

 

“The activity that we were the most excited about was the implementation of the Bi-lingual story time. Our data from our community health survey shows that Hispanic families do not feel as connected to our community. This allowed them to have a safe and equitable space that did not previously exist.   For our school partnership activities, we were able to fund ASCA course books for school counselors as well as restorative practice books for students. This is exciting for us because these are new resources.”

 

Additionally, another local health agency shared their success story working with resettled families:

 

“We are excited to provide an opportunity that will help form connections for women who are pregnant, post-partum and/or have young children. We've appreciated getting to know our community partners in an effort to better serve women who have recently resettled.  The idea of gathering around food and promoting a laid-back environment focused on talking with each other has been well received. The MCHD team continues to solicit feedback about the events and what could be done differently. Incorporating these suggestions will help strengthen and grow the program moving into 2024.”

 

Social connections was a theme for other Title V funded projects. Family engagement strategies integrated support for social connections. Public Health Madison Dane County implemented casual meetups for participants receiving home visitation and Medicaid Prenatal Care Coordination services. Contracted Community Consultants helped to plan an event at a library that included music, food, movement activities, a lullaby writing activity, and free books and book bags. A parent in the home visiting program stated she “got to meet a lot of amazing women” and was “so proud to be part of such an incredible community!” A Public Health staff member said, “My favorite moment was seeing all the connections taking place and hearing all these beautiful languages around me – French, Spanish, Russian, Ewe, Japanese, English!” The Community Consultants also planned a potluck lunch for Nurse Family Partnership participants serving on the Community Advisory Board.

 

Social connections were supported by Cia Siab, Inc., a community-based organization serving Hmong families. They convened groups of mothers with children of similar ages for focus groups and educational sessions. The program manager reported they are confident that their goal of helping participants connect to one another was exceeded based on stories the women shared of additional activities between them outside of the group sessions.  At the completion of the 8-week session, participants established a group chat to stay connected, requested a potluck to share food with one another, and planned monthly dinners on their own to continue the relationships that had been established.

 

State Performance Measure 04: Percent of performance measures with family, youth, and community engagement embedded into program and policies 

 

Identify roadblocks to engagement and address in future training opportunities.

 

In 2023, Title V staff engaged in important conversations regarding avenues to share gratitude to community members for their involvement with the Wisconsin Title V program. These conversations were pivotal in planning for the upcoming 2025 MCH Needs Assessment. From various policy and practice conversations, it was determined that community agencies that partner with the Title V program are in the best position to offer equitable reimbursement to residents who share feedback and insight into maternal-child health needs. The Title V Health Equity and Community Engagement Technical Assistance Provider, Smith Research and Consulting, is one community partner that encourages equitable practices. This organization offered equitable reimbursements to local partners who participated in community opportunities to provide helpful insights to the Title V program. Partnering with agencies that are currently supported by Title V to enhance community engagement at local levels is an evidenced-based practice that will continue to be implemented by the Title V program.

 

In addition to supporting reimbursement efforts, Smith Research and Consulting also provided training opportunities in 2023 to local health agencies about incorporating community engagement best practices into local efforts. Quarterly learning calls were an opportunity for agencies to hear about common challenges in embedding these practices into organizations and ways to be creative and prioritize such efforts. To increase state staff capacity to enhance community partnerships, Wisconsin Title V staff participated in the Bureau of Community Health Promotion’s Health Equity Work Group throughout 2023. This work group focused on health equity and community engagement capacity building for staff, and group members co-designing equity-centered projects to advance this work across the bureau, including work carried out by Title V.

 

Increase family, youth, and community member participation in maternal and child health efforts including but not limited to ongoing Needs Assessment activities.

 

The Title V program released a youth, caregiver and family engagement funding opportunity to support engagement in maternal and child health efforts. Starting in January 2023, three agencies were selected to receive $50,000 annually through the end of 2025.The three organizations identified were Public Health Madison and Dane County, Cia Siab, and Family Voices of Wisconsin.

 

Public Health Madison Dane County is a local health agency that hosts a Nurse Family Partnership Community Advisory Board with all members being participants and graduates of their Nurse Family Partnership home visiting program and Medicaid Prenatal Care Coordination services. Four program participants were hired as community consultants to plan and facilitate Nurse Family Partnership meetings, coordinate social gatherings to foster relationships and increase social connections, and provide input for a doula program for Nurse Family Partnership /Prenatal Care Coordination birthing people. Nurse Family Partnership and Prenatal Care Coordination participants were supported to attend educational sessions including Black Women’s Wellness Day, YWCA Racial Justice Summit, doula training, and Advocacy Day at the Capitol. 

 

Cia  Siab, Inc. is a nonprofit agency providing culturally and linguistically appropriate domestic violence/sexual assault services to the Hmoob (Hmong) community in La Crosse, Wisconsin. They convened two cohorts of pregnant and parenting people for 8-week sessions that included education, information on community resources, opportunities for social connections, and opportunities to inform program planning. Participants learned about resources available from Great Rivers 211 referral line, Planned Parenthood, Head Start, and Cia Siab’s youth programs and monthly rice pantry food giveaway. Participants engaged in group wellness and social activities and were introduced/re-introduced to the art of paj ntuab, traditional cloth embroidery. Social connections were made that extended beyond the group sessions. Feedback from participants led to adjustments in the curriculum for the next cohort.

 

Family Voices of Wisconsin is a nonprofit agency that supports advocacy efforts to include families with special health care needs in civic engagement opportunities. The Wisconsin Family Leadership Institute Foundations 2023 cohort took place in the spring. The Wisconsin Family Leadership Institute advanced 2023 cohort took place in the fall. Many participants also attended the advanced session. One hundred percent of participants reported feeling prepared to talk with leaders about issues that matter to them and find themselves speaking up more often since Wisconsin Family Leadership Institute. Half of the participants have already visited with decision-makers in Wisconsin, six months out from the institute. An on-demand training was created in 2023 and is currently available on the Family Voices of Wisconsin YouTube channel called “Speak Up – Finding Your Voice.” This serves as an introduction to advocacy for families that have a child with a recent diagnosis and offers suggestions about partnering with caring professionals.

 

Incorporate the Community Engagement Assessment Tool within local and Tribal health agencies, Children and Youth with Special Health Care Needs Network partners, adolescent health programs, and Reproductive Health Family Planning Programs.

 

Challenges remained for local agencies to implement the Community Engagement Assessment Tool in 2023 to support health equity efforts. Despite creating and disseminating several training modules for local staff, questions and confusion halted agencies’ efforts to make advancements toward incorporating health equity and community engagement into their Title V programs. Because of such challenges, the tool was removed as a requirement for 2024-2025, and instead, context-based personalized technical assistance is offered as an alternative. See the SPM 04 2025 cross-cutting systems building application section for more details on this approach.