Towards achieving Vermont’s new performance measure regarding childhood physical activity: we are planning the following strategies:

• Ongoing Title V funding in support of the Physical Activity and Nutrition Director in the Department’s Division of Health Promotion and Disease Prevention
• Broadly promote the 3-4-50 initiative to early care and learning settings and schools to promote physical activity within the context of the school day and to parents and communities beyond the school day. 3-4-50 is the Health Department’s cross-sector initiative to engage individuals, worksites, schools, cities and towns and faith-based communities in better understand the overwhelming impact of chronic disease and inspire them to take action to change
• Include nutrition and physical activity standards in our early care and learning quality rating system: Vermont’s Quality Improvement and Rating System (QRIS)/Step Ahead Recognition System (STARS), which is currently under revision
• Working with Vermont’s early care professional development system (Northern Lights) to increase professional development opportunities in physical activity and nutrition for early care and learning providers

• Broadly promote the use of Vermont’s FitWIC: materials for parents and their preschoolers. FitWIC Activities will help foster child health and development through active physical play
  Promote the implementation of the 10 schools who have new and improved school wellness policies and increase the number of schools willing to work on their wellness policies
• Provide increase parent education through provider offices about the importance of physical activities in schools and how to advocate for that or how to find out what is already happening in schools
• Increase distribution of AAP policy statement Crucial Role of Recess

In the coming year, we plan to promote utilization of Help Me Grow (HMG) Vermont by health care providers, human services partners, and consumers/caregivers. Trainings, community outreach and family engagement via HMG system partners will continue to increase awareness of the HMG centralized call/contact center as a resource for providers and families. We have redesigned our HelpMeGrowVT.org website and now host a family access portal to the Ages and Stages Questionnaires (ASQ) online screening system. In addition to families accessing ASQ tools online, we plan to pilot hosting the ASQ family access online system for several partners including a pediatric practice, early care and learning sites, and our Children’s Integrated Services coordinators.

We will promote and increase use of our statewide Universal Developmental Screening (UDS) protocol, including use of the UDS registry, and offer continued training and technical assistance on developmental and behavioral screening tools for health care and early care and learning providers. Our regional MCH coordinators are teaming up with Building Bright Futures coordinators and our early childhood philanthropic partner, Let’s Grow Kids, to focus efforts on engaging both health care and community providers in use of the UDS registry for improved cross-sector collaboration and early identification. With support from Let’s Grow Kids, HMG will host a Brooks ASQ Train the Trainer session to increase the number of ASQ trainers in Vermont in order provide needed training to multiple provider groups including: health care, early care and learning, and community providers, Head Start/Early Head Start programs, Pre-Kindergarten programs, and school districts. We will coordinate UDS activities with Vermont’s ACOs and the Blueprint to leverage health reform and enhanced payment opportunities. We plan to engage health reform stakeholders in use of the UDS registry data and in planning enhancements.

Together with HMG system partners, we plan to standardize high-quality training on developmental promotion, referral and connection to needed services, including use of the UDS registry, as a foundational component of Vermont’s professional development system for all childcare providers. Specifically working with our Let’s Grow Kids partners, we plan to develop a developmental screening training course (e.g. webinars with coaching and mentoring component) for inclusion in VT Northern Lights professional development system. Additionally, we plan to embed health promotion practices into Vermont’s QRIS/STARS system. We will continue to provide leadership for coordinated, cross-sector efforts between medical homes and early childhood settings to improve developmental screening rates, reduce screening duplication and streamline the process for families, align cross-sector Child Find efforts, and improve collaboration and communication around referrals and timely linkage to resources.
 

The Vermont HMG team is currently receiving technical assistance from the FrameWorks Institute to examine, refine, and target messaging regarding early childhood development, resilience, and other key concepts to further promote our work. The FrameWorks Institute is a nonprofit think tank that advances the mission-driven sector’s capacity to frame the public discourse about social and scientific issues. FrameWorks designs, conducts, and publishes multi-method, multi-disciplinary framing research to prepare experts and advocates to expand their constituencies, to build public will, and to further public understanding. Vermont is excitedly investigating how to further this work.

In the coming year, Vermont Title V has several proposed strategies aimed at reducing childhood injury:

• Provide public health leadership in the prevention and approach to child maltreatment
  • Support statewide implementation of evidence-based home visiting programs that have demonstrated effect in improving parenting practices
  • MCH Coordinators at the District Office level serve as members of local Child Protection Teams
  • MCH leadership serves on the Vermont Citizen’s Advisory Board (VCAB) to examine policies, practices, and procedures of the Vermont’s child protection agency, and provide for public outreach and comment to assess the impact of current procedure and practice on Vermont children and families
  • MCH leadership serves on Vermont’s Child Fatality Review Team and works with this team to update data gathering, assessment, and review procedures.
  • MCH Coordinators at the local level coordinate with the Department for Children and Families to improve the health status of children in state custody (Fostering Healthy Families)
  • Vermont contracts with a Child Safe Physician to provide medical leadership and case-specific consultation for community efforts and coordination around child abuse and neglect and trauma response
• Contribute to farm health injury prevention though participation on Vermont’s Farm Health Task Force
• Organize and implement trainings for MCH home visitors on child home safety with a specific emphasis on rural and farm related injury prevention

In the coming year, Vermont has several planned strategies aimed at improving the oral health of children:

• Vermont MCH supports a portion of the salary of the Oral Health Director in the Health Department’s chronic disease division; this funding supports programmatic planning as it relates to the MCH population.
• MCH staff and the Oral Health Director will work with Communications and Vermont Oral Health Advisory Panel partners to promote Vermont’s new oral health periodicity schedule: current best practice guidance to pediatricians, family medicine providers, dentists, and families.
• Provide oversight to the 802Smiles Network of School Dental Programs to help to ensure that every child has access to preventive, restorative and continuous care in a dental office
• Regional MCH Coordinators in district offices work in tandem with co-located public health dental hygienists to assess the local dental health landscape and share resource availability with health care providers and community partners.
• MCH Coordinators and PHDHs provide outreach to pediatricians regarding: a) oral health education and referral to a dental home; and 2) fluoride varnish application.

Vermont continues its commitment to promoting protective factors and resiliency among Vermont’s families and leveraging Title V activities to do so. Planned strategies include:

• Continuing to incorporate the Strengthening Families framework into all relevant work, with an emphasis on preventing and mitigating the impact of toxic stress and with special attention to the inclusion of Strengthening Families into the release of Bright Futures 4th edition.
• Our full-time coordinator of Adolescent Sexual and Reproductive Health oversees the Division’s PREP program and other adolescent sexual and reproductive health related efforts. This staff member is now one of 30 certified trainers in the state in the Youth Thrive Framework, which grew out of the Strengthening Families model. Youth Thrive utilizes the most current science on adolescent brain development, trauma, and resilience. Regional communities of practice will be formed in Vermont to support local implementation of the Youth Thrive Framework.
• With HMG system partners, MCH coordinators in district offices will continue to provide HMG Child Health Provider Outreach and training to child health providers and community partners to increase use of the HMG centralized call/contact center and use of the developmental screening registry.
• Promote and expand Help Me Grow Vermont to promote optimal child development by enhancing protective factors. Research indicates that referrals to Help Me Grow and subsequent linkages to community-based programs and services enhance protective factors, and perhaps even mitigate risk factors. Even among families with differing needs, HMG support to families and their connection to programs and services has been shown to enhance parents’ perceptions of family functioning relevant to protective factors. This positive shift in parents’ attitudes, knowledge, and behaviors contributes to engaged and educated parents better equipped to meet their children’s needs and foster healthy development (Hughes, 2016).

• Currently underway, evaluation of the HMG VT system includes survey results of family and community outreach trainings and impact on strengthening protective factors. Additionally, those families accessing the HMG contact center are surveyed on follow up calls and asked to respond to two or three protective factors questions, when applicable: 1) I am able to access services if I need it; 2) I have a better understanding of services for me and/or my child; 3) I have a better understanding of my child’s development and information that will impact my child’s wellbeing.
• The HMG VT contact center will continue to utilize and refine strategies developed while participating in a Help Me Grow National Center Protective Factor Evaluation Pilot to explore the enhancement of the Strengthening Families Protective Factors through HMG telephone care coordination. HMG contact center staff continue to refine and develop protective factors strategies to use during telephone conversations with families.

• We will continue to educate providers and community partners on the impact of Adverse Childhood Experiences and mitigating strategies by:

• Presenting epidemiological data to a variety of professional audiences on ACEs
• Participating in state and local community planning sessions to address trauma in health care, schools, and communities

• We will support the Vermont Family Based Approach whose long-term goal is to help the well remain illness free, prevent at-risk children from developing psychiatric illness, and intervene comprehensively on behalf of children and families challenged by emotional or behavioral disorders

Please note: Only those strategies the link with national and state performance measures are identified in the Action Plan Table for this section.