Priority: Optimize Children’s Physical and Oral Health
Performance Measure (NPM): Percent of children, ages 6 through 11, who are physically active at least 60 minutes per day.
Strategy: Increase the number of schools and early care and education sites that receive support and targeted outreach to improve policies and meet best practices for increasing physical activity opportunities for youth they serve
Current Efforts
During FY23 the Maine CDC continued to track progress on the evidence-based strategy measure (ESM) to identify the number of school administrative units, early childhood education (ECE), and after school/out of school (OOS) programs that meet best practices and highest standards for physical activity. Ongoing work with partners for data collection included reviewing Let’s Go! annual survey data, childcare licensing lists, Go Nutrition and Physical Activity Self-Assessment for Child Care (GO NAPSACC) registration and activity data. Maine DOE continued to partner with Maine CDC to coordinate available and relevant data.
During the last year Maine CDC and partners (Maine Roads to Quality (MRTQ), Medical Care Development (MCD) Global Health and Healthy Kids Healthy Future (HKHF), WinterKids, and Let’s Go!) provided training and access to resources for Schools and ECE providers to support these settings in meeting higher standards and best practices for physical activity. Activities and outcomes include:
- Let’s Go! utilized the updated “Let’s Go! Guide to Success” environmental assessment tool with all registered school, OOS, and ECE programs to assess opportunities to support registered sites in increasing physical activity. Let’s Go! updated resources and tools to align with national recommendations, created new tools, resources and trainings that align with the updated Let’s Go! Guide to Success. Let’s Go! launched the new Let’s Go! Learning online platform in September 2022. This platform allows registered sites to access the updated Let’s Go! Self-Assessment tool as well as a variety of on-demand trainings focused on healthy eating and physical activity. Replacing both the Let’s Go! Guide to Success and Let’s Go! Annual Survey, the updated Let’s Go! Self-Assessment aligns with national recommendations of best practice for healthy eating and physical activity and is both age and setting specific. Since September, 137 ECE programs and 75 schools have completed the Self-Assessment. Over the past six months 234 educators received training and technical assistance. In October 2022, Let’s Go! held their annual schools symposium, “Building a Positive School Culture: Innovative Strategies to Connect Physical Activity and Mental Health” with strategies to boost student and staff mental health, resilience, and connection; provision of tangible tools to increase classroom physical activity and community connections; and opportunities to bring learning outside and be inspired by Maine examples. The conference was virtual but well attended with 149 attendees and representation from 67 schools.
- MRTQ and MCD Global Health’s HKHF partnered to train ECE providers as peer-to-peer physical activity trainers and hold communities of practice learning collaboratives.
- MCD Global Health HKHF convened three quarterly Physical Activity Learning Sessions Master Trainer Cadre sessions and increased the number of trainers in the state from seven to 10; three of these trainers are ECE providers.
- MRTQ, Maine CDC and MCD Global Health’s HKHF supported over 200 ECE providers to receive education in the newly released Outdoor Learning Environments (OLE) by providing incentives for sites to attend Maine Association of the Education of Young Children’s Annual Conference training on OLE.
- WinterKids’ Program developed a self-paced eLearning training module using their existing Learn Outside Guide Elementary Edition training curriculum and materials. The Learn Outside Guide will make this training and curriculum easier to access for elementary teachers to integrate fun, outdoor activities into their winter lessons while at the same time meeting education standards. The guide features over 40 lessons covering six subjects (Art, Health, Language Arts, Mathematics, Science and Social Studies), and meeting Common Core Standards where applicable. The second version of the module is currently under review by WinterKids, and the training module is anticipated to launch in late spring or early summer. Additional work conducted this year included updating the existing portal MoveLearnExplore.org and hosting the online Guide to Outdoor Active Learning Preschool Edition (GOAL PreK) for ease of access for the new training module(s). To date 213 early childhood educators have registered, and 145 have completed the GOAL PreK Online Training Module, which provides educators with one (1) contact hour listed on their certificate of completion.
- Maine’s Quality Rating System revision went live in March 2023. The revisions added PA and Nutrition threads to the existing system. This addition is supported with a requirement for assessment of current practices for physical activity and nutrition (PAN). The Maine DHHS Office of Child and Family Services oversees these requirements and Maine CDC has been part of the Quality Rating and Improvement System (QRIS) Revisions workgroup that will now become the QRIS Implementation Support Committee. Moving forward, data from GO NAPSACC and other assessments will be used to monitor improvements in practice and policies. In addition, the PAN in ECE Coalition (co-convened by Maine CDC) will work to coordinate training opportunities and resources that support ECE sites in this content area.
Maine CDC and Maine DOE worked together to provide training and technical assistance to K-12 educators to increase efficacy and support implementation of best practices in physical activity. Activities and outcomes include:
- Sponsored Keynote speaker at the Annual Maine Association for Health, Physical Education, Recreation and Dance conference. The focus was the relationship and importance of physical activity to student wellbeing and academic achievement. There were over 400 in attendance, 397 were participants.
- Provided seven school PE/Health classrooms with Heartrate Monitoring classroom kits that have supporting educational and instructional components. The kits accommodate up to 25 students for each cohort.
- Over 200 educators received classroom curriculum to support and promote PA in classrooms Ready, Set ,Go.
- Sponsored nine individual classroom or PE teachers to attend the annual conference.
- Provided 224 fitness trackers to 14 school districts to support PA classroom initiatives.
FY24 Plan
Strategy: Increase the number of schools and early care and education sites that receive support and targeted outreach to improve policies and meet best practices for increasing physical activity opportunities for youth they serve
Plans for FY24 include supporting new partners working with ECE’s and Schools. In January 2023 Maine CDC launched Maine Prevention Network (MPN). This initiative replaced former funding that supported portions of Let’s Go! work. This is a statewide effort that includes supports for improving PA in schools and ECE’s but also expands into community efforts such as increasing access to trails, encouraging Safe Routes to Schools and other opportunities. Maine CDC will support the local Healthy Eating Active Living (HEAL) partners in provision of technical (TA), training, and educational opportunities as appropriate. Many of the funded partners were part of the work with Let’s Go! We continue to collaborate with Let’s Go! as a key partner in this work.
Maine CDC and partners are planning a statewide ECE PA Symposium, scheduled for the end of July 2023. National, regional, and local experts will provide training, hands on experience and resources designed to support ECE providers in skill development and best practices. Maine CDC and Maine DOE will work to identify training opportunities for educators.
Let’s Go! is continuing to offer access to training and online technical assistance, the MPN HEAL coordinators identified PA training and TA in their service areas and plan on supporting schools and ECE’s with continuing to make progress in increasing access to developmentally appropriate PA. Some strategies include working to provide PAL’s trainings and utilizing GO NAPSACC assessment and modules to encourage improvements at ECE sites. School based interventions include Story Walks and walking classroom strategies.
Maine CDC, MRTQ and PAN in ECE will be promoting and recruiting for online training education on Outdoor Learning Environment Modules and ongoing access to WinterKids Elementary and ECE modules. Supporting ongoing Physical Activity Learning Sessions trainings and coordinating with the existing cadre of trainers will continue, looking to increase the number of ECE’s that have access to the training and receive recognition will be key to the success of these strategies.
WinterKids will work with Maine CDC and partners to promote new resources to educators and provide support to increase the number of sites that complete and participate in this program to increase physical activity through this interactive curriculum and training resources.
Maine is seeking additional funding to support the focus for improving PA before, during and after school. The Maine CDC applied for a State Physical Activity and Nutrition (SPAN) Grant. SPAN awards will be announced in August 2023. Maine’s focus will be on improving standards, practices, and policies for sites including ECE’s and community, afterschool programs and connected recreation programming as well as work to increase statewide implementation of Safe Routes to School.
This funding opportunity will exponentially impact our work and Maine is hopeful that we will be successful in securing the additional resources.
Performance Measure: Percent of children, ages 1 through 17, who had a preventive dental visit in the past year.
Current Efforts
Strategy: Maintain support for the School Oral Health Program consultants and administrators
The School Oral Health Program (SOHP) is collaborating with Medical Care Development to develop an on-line/virtual (hybrid) training for non-dental paraprofessionals. The goal is to offer an 8-hour training to interested nurses and other medical staff as well as community health workers. The training includes such topics as infection control, dental anatomy and tooth recognition. Through an expanded workforce we can offer SOHP services to more schools resulting in a greater impact on decreasing childhood caries.
The Oral Health Navigator training was launched in December 2022. To date, six (6) individuals have successfully completed the training. The SOHP Program Manager continues to provide support to existing field consultants and program administrators through the annual clinical training and as needed throughout the year.
The Maine SOPH continues to grow the oral health workforce. In addition to the online training for onboarding new consultants, we have created an online education program for students (and adults) to learn more about oral health. Through the Children’s Oral Health E-Learning Platform (COHELP), launched February 1, 2023, we can provide educational support to school nurses and teachers to educate on oral health. This program meets the Maine DOE requirements for health and personal hygiene. Students navigate their way through video gamification, learning about good oral health habits, making smart nutritional choices, safety, sports related dental injuries, and self-esteem regarding oral health. The COHELP program is free and can be played as often as desired https://cohelp.mcd.org/ . The SOHP has tracked 577 users to date and nine different countries. COHELP can be played in the classroom or at home from any device connected to the internet.
Strategy: Provide support and supplies for updated PPE requirements post COVID-19
The need for PPE is decreasing as the pandemic becomes more manageable. Level 1 surgical masks, gloves and eye protection will be offered to all field consultants. The SOHP will continue to follow the federal CDC guidance, Occupational Safety and Health Administration, Organization for Safety, Asepsis and Prevention and the Maine DOE for PPE protocol.
FY24 Plan
Strategy: Maintain support for the School Oral Health Program consultants and administrators
The SOHP will continue to hold an annual clinical training for all hygienists and nurses working within the program. Daily support is given to all school administrators, nurses, consultants and health clinics throughout the school year.
The SOHP Manager will attend the Maine Association of School Nurses, Maine New School Nurse Orientation and Maine Nurses Summer Institute to assist schools and nursing staff in any capacity regarding oral health.
Strategy: Provide support and supplies for updated PPE requirements post COVID-19
The FY24 focus on this strategy is to provide support through training of field consultants and school staff. We will continue to provide essential PPE for working in schools.
Priority: Ensure early detection and intervention for developmental delay
Performance Measure: NPM 6 - Percent of children, ages 9 through 35 months, who received a developmental screening using a parent-completed screening tool in the past year.
Current Efforts
During FY23, The Maine WIC program continued to collaborate with community partners to increase referrals for children to health care providers and Child Development Services for developmental screening. Maine WIC hosted an annual Lunch and Learn for WIC, Public Health Nursing, and Head Start staff to review developmental screening tools use and function.
Maine Families home visitors continue to complete the Ages and Stages Questionnaire (ASQ), and ASQ Social Emotional (ASQ-SE) screenings with families at regular intervals. Family visitors complete ASQs, at a minimum, at 2, 4, 6, 9, 12, 18, 24, 30, and 36 months. Family visitors complete ASQ-SEs at a minimum of three times within the first three years of the child’s life. Family visitors worked with local child development services and other specialists to offer referrals for families as indicated by a screening result.
Public health nurses (PHN) provide infant physical assessments at each home visit, which includes an assessment of the child’s development. PHN’s perform physical assessments appropriate for age/condition and document the results in the pediatric physical assessment tool. PHNs monitor children for their ability to express needs. They monitor the child for attainment of developmental tasks expected for age as well as monitor the child’s response to stimulating/nurturing activities. Public health nurses refer to appropriate providers if any assessments are determined to be outside of normal limits.
More than half of the homes in Maine get drinking water from private, residential wells (https://data.mainepublichealth.gov/tracking/data-topics/privatewells). The WIC program, in conjunction with the Well Water program, issues well water test kits to WIC families that have a well at their residence. Regular testing can ensure that bacteria, arsenic, uranium and other harmful chemicals are not in the water that WIC families consume.
Other Efforts
Maine partnered with 211 Maine to make Maine the 29th state to join the national Help Me Grow network in FY22. This free service launched in November 2022 and available for children up to eight years of age and their families, aims to improve access to early developmental screening, diagnostic, and treatment services and referrals to early intervention services. Any parent, including those expecting a child, caregiver, or child health provider can call or email 211 and the Help Me Grow team will listen and link them to services addressing a broad range of needs, including health care, quality early learning experiences, and healthy nutrition. Help Me Grow Maine also provides follow-up support to help ensure successful connections to services.
Other goals of Help Me Grow include helping families use existing programs throughout the state; facilitating long-range planning by identifying gaps in services; and collaborating with community partners in early childhood and child health fields.
In conjunction with the Learn the Signs Act Early tool, WIC staff began making referrals to Help Me Grow for the ASQ.
FY24 Plan
Strategy: Work with community partners to collaborate and increase referrals for developmental screenings
During FY24, The Maine WIC program will continue to refer participants to needed healthcare and Child Development Services. The Maine WIC program will hold a Lunch and Learn, based on child developmental screenings, annually in January. The Maine WIC program will refer participants to Help Me Grow if an ASQ is needed. If funded, the Maine WIC program will continue to provide well water test kits to WIC families. The Maine WIC program will continue to use the Learn the Signs Act Early screening tool.
Maine Families home visitors will continue to complete the ASQ, and ASQ-SE screenings with families at regular intervals. Family visitors will complete ASQs, at a minimum, at 2, 4, 6, 9, 12, 18, 24, 30, and 36 months. Family visitors will work with local child development services and other specialists to offer referrals for families as indicated by a screening result.
Public health nurses will provide infant physical assessments at each home visit, which includes an assessment of the child’s development. PHNs monitor children for their ability to express needs, monitor the child for attainment of developmental tasks expected for age as well as monitor the child’s response to stimulating/nurturing activities. Public health nurses will refer to appropriate providers if any assessments are determined to be outside of normal limits.
Priority: Optimize Children’s Physical and Oral Health
State Performance Measure: Percent of children, ages 19-35 months, who have completed the combined 7-vaccine series (4:3:1:3*:3:1:4)
Current Efforts
Strategy: Ensure children have access to the required immunizations according to the schedule
During FY23 the Maine Immunization Program (MIP) continued collaborating with both the Maine AAP to promote childhood/adolescent vaccines and the Maine DOE to ensure superintendents, school nurses, and parents were informed of changes related to Public Law (PL) 154 (eliminating non-medical exemptions to vaccine requirements for school attendance) and the importance of immunization.
MIP continued to focus on and enroll new providers, worked with these providers to educate on the importance of all vaccines and encouraged them to become vaccines for children (VFC) providers.
MIP continued its partnership with PHN to offer childhood vaccines at all Maine Department of Health and Human Services (Maine DHHS) offices across the state. There are currently six (6) of eight sites offering all Advisory Committee on Immunization Practices recommended immunizations. In addition, PHN continued to offer both influenza and COVID-19 vaccine clinics.
The MIP educated hospital organizations, clinics, and private practices enrolled in the VFC program to conduct reminder/recall to bring their children up to date on their vaccinations. MIP educated during immunization quality improvement for providers (IQIP) visits, demonstrating how to run reports and implementing strategies for increasing vaccination efforts. The MIP educated during VFC site visits of this important Maine Immunization Information System functionality and ensured an article was written in one of our quarterly newsletters.
MIP continued to provide all immunization rate information to the general public and constituents through our website. Immunization rates posted included: quarterly rates for 24-35 month old children and 13 year old adolescents at both the county and statewide levels; annual school assessment rates for both required vaccines and exemption rates at the individual school, county, and statewide levels; annual healthcare worker assessment of required vaccines at the facility, county, and statewide levels; annual childcare facility rates at the county and statewide levels; and annual college assessment at the facility, county, and statewide levels. This information provides both transparency and the opportunity for individuals to make informed decisions about where to seek services.
FY24 Plan
Strategy: Ensure children have access to the required immunizations according to the schedule
During FY24 the MIP will continue collaborating with both the Maine AAP to promote childhood/adolescent vaccines and the Maine DOE to ensure superintendents, school nurses, and parents are informed of changes related to PL 154 and the importance of immunization.
MIP will continue to target and enroll new providers, work with these providers to educate on the importance of all vaccines and encourage them to become VFC providers.
MIP will continue its partnership with PHN to offer childhood vaccines at all Maine DHHS offices across the state. There are currently six (6) of eight sites offering all Advisory Committee on Immunization Practices recommended immunizations. In addition, PHN will continue to offer both influenza and COVID-19 vaccine clinics.
The MIP will educate hospital organizations, clinics, and private practices enrolled in the VFC program to conduct reminder/recall to bring their children up to date on their vaccinations. MIP will educate during IQIP visits, demonstrating how to run reports, implementing strategies for increasing vaccination efforts. The MIP will educate during VFC site visits of this important Maine Immunization Information System functionality and ensure an article is written in one of our quarterly newsletters.
MIP will continue to provide all immunization rate information to the general public and constituents through our website. Immunization rates posted will include: quarterly rates for 24-35 month old children and 13 year old adolescents at both the county and statewide levels; annual school assessment rates for both required vaccines and exemption rates at the individual school, county, and statewide levels; annual healthcare worker assessment of required vaccines at the facility, county, and statewide levels; annual childcare facility rates at the county and statewide levels; and annual college assessment at the facility, county, and statewide levels. This information provides both transparency and the opportunity for individuals to make informed decisions about where to seek services.
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