Adolescent Health Domain

FY21 Application

 

 

The FY21 workplan for the Adolescent Health Domain includes the following performance measures:

 

1. Injury Hospitalization
2. Pregnancy Intention
3. Oral Health
4. Transition

 

Madeline (Maddie) Kapur, MSW, MPH (Adolescent Health Coordinator) currently serves as the Title V Adolescent Health Domain Lead.

 

Title V-funded efforts for adolescent health will be implemented by the Injury and Violence Prevention Program, Reproductive Health Unit, Dental Program, School Health Program. These entities and their proposed activities for the upcoming grant period are detailed below.

 

 

I. Injury & Violence Prevention Program

 

The Injury and Violence Prevention (IVP) Program is led by Lisa Wooten, MPH,

BSN, RN (Injury and Violence Prevention Program Supervisor). A detailed overview is provided within the Child Health Domain application.

 

Reduction of suicide deaths is a continuing priority across populations and particularly for adolescents. However, death statistics vastly underestimate the burden of intentional self-harm injuries in youth. Following publication of the National Strategy for Suicide Prevention in 2001, the Virginia Commission on Youth (a joint commission of the Virginia General Assembly) published the Youth Suicide Prevention Plan, and amended the Code of Virginia §32.1-73.7 to designate the Virginia Department of Health (VDH) as the lead agency for youth suicide prevention in the Commonwealth.  

 

In 2003, the Joint Commission on Health Care directed Virginia’s Secretary of Health and Human Resources to lead a cross-government effort to formulate a comprehensive plan for suicide prevention across the life span. This effort produced the Suicide Prevention Across the Life Span Plan for the Commonwealth (Senate Document 17, 2004). The plan recommended a series of important actions to be taken in leadership and infrastructure development, surveillance, public awareness, and intervention. Following publication of the 2004 plan, the Virginia Department of Behavioral Health and Developmental Services (DBHDS) was designated in the Code of Virginia as the lead agency for suicide prevention across the lifespan in Virginia (with VDH remaining the lead for youth suicide prevention).  

 

Since its designation, VDH has continued to work collaboratively to employ evidence-based interventions in preventing youth suicide in Virginia with a variety of federal, state and local partners, including Virginia’s Health Resources and Services Administration Maternal Child Block Grant Title V team.

 

Snapshot of Program Accomplishments

 

The IVP Program Youth Suicide Prevention Program employs a public health approach focusing on policy and systems change to implement statewide strategies targeting youth attending Virginia public schools and youth attending Virginia colleges. The program provides training and resources to reduce the risk for suicide for at risk youth by building capacity to respond to students in need of mental health services, and promote training for clinical staff and students in distress following a suicide related crisis. The program supports the development of partnerships with community mental health organizations and provide best practice training in identifying and responding to students, faculty, staff and administration. Title V-funded and non-funded IVPP staff continue to lead these programs.

 

Budget Update

 

IVPP leverages Title V funds, along with state revenue funds and other federal funds, to oversee the development, implementation, and evaluation of various statewide injury prevention programs. Efforts focused on capacity-building (particularly regarding staffing), sustaining and expanding service delivery, and policy.

 

Equity Considerations

 

Disparities are widespread across Virginia’s landscape as it relates to suicide risk, inclusive of gender, race, sexual orientation, occupation, geographical (rural vs urban), maternal status, and military versus civilian status. According to the Centers for Disease Control and Prevention Preventing Suicide: A Technical Package for Policy, Programs, and Practices, the current evidence suggests that identifying people at risk of suicide and the continued provision of treatment and support for individuals can positively impact suicide and its associated risk factors (Direct language). It is crucial to build a community and safety net around youth at risk for suicide. Gatekeepers, or individuals in a community who have face-to-face contact with large numbers of community members as part of their usual routine, such as healthcare providers, counselors, faculty, coaches, ministers, youth workers, parents, or law enforcement, are in a unique position to connect with suicidal individuals and respond with necessary support for disparate and vulnerable populations.

 

Suicidal thoughts and behaviors vary by race and ethnicity among youth. Addressing burden through an equity lens is expected to improve the health of children and youth of color at risk for suicide.

 

Emerging Issues

 

Adverse childhood experiences (ACEs) are of increasing interest. Virginia’s Behavioral Risk Factor Surveillance System (BRFSS), a population health survey on health behaviors of adults aged 18 years and older, reported that in 2018, 15.4% of participants responded ‘yes’ to four or more ACEs. Persons who experienced four or more ACEs also reflected higher rates of poor or fair health status (22.0%) and binge drinking (21.3%). Out of all BRFSS respondents who completed the survey in 2018, 32.5% experienced verbal abuse, 27.0% divorce, 26.1% household substance abuse, 16.9% household depression, 16.4% household physical abuse, 16.1% physical abuse, 12.8% sexual abuse, and 7.8% household incarceration (VDH Division of Population Health Data, 2020).

 

Consumer/Family Engagement & Partnership

 

Community engagement is critical to reducing risk of self-harm and suicide.  The presence of increasing resources for treatment alone has not been shown to be a sole effective intervention without community engagement.

 

 

FY21 Action Plan Overview: Mental Health

 

 

According to the Virginia MCH LiveStories, the percentage of  high school youth who were bullied on school property decreased from 21.9% in 2013 to 15.7% in 2017 (Virginia Youth Survey). However, the percentage of middle school students who were bullied on school property remained stable at approximately 43%. Seven percent of high school youth reported electronically bullying someone, and the percentage increased with age with 10.3% of students 18 or older reporting electronic bullying. According to data from the Department of Behavioral Health and Developmental Services (DBHDS), the most common mental health diagnosis among adolescents is a mood disorder, followed by anxiety disorders, substance use disorders, behavioral disorders, and psychotic disorders.  All categories of disorders increased in prevalence from 2016 to 2017.

 

According to the Virginia Youth Survey, the number of high school youth that felt sad or hopeless almost every day for two weeks in a row so that they stopped doing usual activities increased by 15.7% between 2011 and 2017. High school females were approximately twice as likely to report feeling sad and all suicide-related behaviors. According to the self-reported data from the Virginia Youth Survey a notable trend across all mental health and suicide-related behaviors is that once students begin reporting depression or suicidal thoughts, they were more likely to report the next stage of suicidal ideation or attempt. In 2017, among students who reported that they seriously considered attempting suicide: 82.0% reported having felt sad, empty, hopeless, angry, or anxious, 67.5% made a plan about how they would attempt suicide, 40.8% attempted suicide, 24.9% were physically hurt by someone they were dating or going out with in the past 12 months, 36.2% were bullied on school property, 29.2% were bullied electronically,  and only 54.2% had at least one adult that they can talk to if they have a problem.

 

Strategy: Provide suicide prevention trainings to professionals interacting with youth and adolescents.

Domain: Adolescent

 

 

IVPP will continue its partnership with James Madison University and PRS to deliver gatekeeper and Suicide 2 Hope trainings statewide. Healthcare providers will continue to receive Recognizing and Responding to Suicide Risk trainings as gatekeepers in communities. 

 

 

Strategy: Provide suicide prevention trainings to professionals interacting with youth and adolescents.

Domain: Adolescent

 

 

IVP Program will partner with the Title V team to complete a needs/asset assessment and evaluation specific to interagency adolescent mental health activities, to include key accomplishments, identification of community-based organizations poised to serve as strategic partners, and assessment of 3-5 strategic needs. This work will align with the Suicide Prevention Plan for the Commonwealth of Virginia as constructed by the IVP Program and the Virginia Department of Behavioral Health and Developmental Services.

 

 

II. Adolescent Health Program

 

The Adolescent Health Program is led by Madeline Kapur, MPH, MSW (Adolescent Health Coordinator). The Resource Mothers Program is led by Consuelo Staton, MEd. (State Resource Mothers Coordinator) and serves pregnant and parenting teens. Both program managers report to the Reproductive Health Unit Supervisor, Emily Yeatts, MPH, MSW.

 

The goal of the Virginia Department of Health’s Adolescent Health Program is to ensure that Virginia adolescents have access to the information and resources they need to optimize their reproductive lives and health. The program has a number of current and upcoming initiatives that build toward this goal.

 

One key initiative currently underway is the funding of positive youth development programs throughout the Commonwealth. The Reproductive Health Unit is using Title V State SRAE funds to support two evidence-based positive youth development programs: Teen Outreach Program (TOP) and Project AIM. Five sites throughout the state – four in southwest Virginia and one on the coast – receive these funds and use them to serve youth. Both TOP and Project AIM have documented evidence of decreasing sexually risky behavior and delaying sexual initiation. Teens that participate in TOP, additionally, have fewer pregnancies, fewer suspensions and improved academics. Sites began implementation in October 2018; long-term, VDH anticipates seeing lower rates of teen pregnancy and teen birth in the areas that the SRAE program is serving. While COVID-19 impacted programming in FY20, Virginia SRAE sites were still able to begin programming with almost 1500 young people and complete programming with 500.

 

The Adolescent Health Program expanded its reach in FY20 by funding the comprehensive sexual education curriculum Get Real. Get Real is an evidence-based, LGBTQ-inclusive comprehensive sexual education curriculum for middle and high school youth developed by the Planned Parenthood League of Massachusetts. The curriculum addresses topics such as healthy relationships, communication skills, puberty, reproduction, sexual identity, abstinence, refusal skills and contraception. VDH funds three sub-recipients to implement Get Real in communities with some of the overall highest teen pregnancy rates as well as some of the highest racial and ethnic disparities in teen pregnancy rates in the state. Sub-recipients began receiving funding on July 1, 2020, and most have either just begun program implementation or are in the planning stages. By June 30, 2021, the three sub-recipients combined aim to serve 6,700 young people.

 

VDH partnered with the American Sexual Health Association to launch BrdsNBz, a free and anonymous sexual health text line, in September 2019. This service has greatly increased the reach of the Adolescent Health Program, providing teens that VDH may not otherwise reach with vital sexual health information, particularly during the COVID-19 pandemic. Usage of this service has steadily increased since its launch, and the Adolescent Health Program recently funded a mass postcard mailing to Virginia households in order to continue raising awareness about the service.

 

The Adolescent Health Program is currently in the process of hiring two Youth Advisors, young people who will provide their expertise on VDH’s public health programs and initiatives. The Youth Advisors will split their time between providing input on existing programs and initiatives and developing and managing a statewide structure for infusing youth voice and leadership into public health programs in the state.

 

Virginia’s current Family Life Education (sexual health education) standards fall woefully below what young people need. The recent Title V Needs Assessment demonstrated that young people want sex education that is comprehensive and LGBTQ+ inclusive, and Virginia is currently falling short. The Adolescent Health Program, in conjunction with the policy arm of the Office of Family Health Services and the Virginia Department of Education, aims to advocate to change the Code of Virginia to include a requirement that sex education be comprehensive, evidence-based, medically accurate, LGBTQ+ inclusive and required. Once the policy is amended, the Adolescent Health Program will work with the Virginia Department of Education to create standards that are consistent with public health best practices in sex education.

 

The results of the Title V Needs Assessment emphasize the need for additional interventions that address substance use, mental health, bullying and teen suicide. The Adolescent Health Coordinator, along with the new Youth Advisors, will work with the Department of Health Promotion and the Regional Tobacco Cessation Teams to develop an organized response to teen vaping in Virginia. The Adolescent Health Coordinator will also sit on the Title V Child/Adolescent Mental Health Workgroup, which will partner with the Virginia Department of Behavioral Health to address access to mental health services and the Virginia Department of Education to address bullying. In order to increase community agency, the Adolescent Health Program will provide mini-grants to schools, community organizations or groups of youth that want to address one of these issues (substance use, mental health, bullying or teen suicide) in their communities. The Adolescent Health Program will provide suggestions and technical assistance, but communities will ultimately decide what interventions they think will be most effective.

 

Snapshot of Program Accomplishments

 

• The Adolescent Health program launched BrdsNBz, a free and anonymous sexual health text line for teens. Usage is steadily increasing, and service is safely providing valuable sexual health information to young people during the pandemic.
• The Adolescent Health Program began funding three sub-recipients to implement Get Real, a comprehensive and LGBTQ+ inclusive sex education curriculum, in areas of the state with the highest teen pregnancy rates and/or racial and ethnic disparities in teen pregnancy rates. Between the three sub-recipients, 6,700 young people will participate in year one of the program.
• VDH’s Adolescent Health Program collaborated with the Office of Family Health Services, the Office of Epidemiology, the Office of Communications and 14 young leaders to develop a COVID-19 social media campaign for young people, which can be downloaded for viewing here.
• The Adolescent Health Program continued to leverage SRAE funds to support positive youth development programs throughout the Commonwealth. While COVID-19 interrupted programming this year, the SRAE still managed to begin programming with 1,500 young people and complete programming with 500.

 

Budget Update

 

Beginning in FY20, Title V monies began supporting two adolescent health initiatives discussed earlier in the application: Get Real and BrdsNBz. In FY21, Title V monies will be used to pay the part-time wage of Youth Advisors, fund the regional youth advisory structure, and provide mini-grants to communities in order to improve adolescent mental health.

 

Challenges & Barriers

 

The COVID-19 pandemic has presented challenges to both current and future Title V Adolescent Health initiatives. In-person programming for young people halted in March of 2020. The Youth Advisor hiring process was put on hold as VDH’s human resources staff members had to focus on hiring thousands of contract tracers. In order to continue to provide information, resources and support to young people, the Adolescent Health program focused on further promoting the BrdsNBz sexual health text line, creating and disseminating a COVID-19 social media campaign for young people and adapting ongoing projects to fit the current environment. Currently, the program is working with sub-recipients to adapt programming to a virtual setting (some are still in the planning stages, while others have begun implementing virtually), and is currently hiring for the two Youth Advisor positions.

 

Consumer/Family Engagement & Partnership

 

The Adolescent Health Program is currently in the process of hiring two Youth Advisors at the Virginia Department of Health’s Central Office. Youth Advisors will provide feedback on existing programs and develop and manage a statewide youth advisory structure. These efforts are detailed in the Cross-Cutting Domain application. In the meantime, the Adolescent Health Program elicits feedback from young people that participate in programs through post survey questions, and then will support sub-recipients in making programmatic changes based on youth feedback. Additionally, the Adolescent Health Program received feedback from 14 young leaders via survey on its recent COVID-19 social media campaign for teens.

 

 

FY21 Action Plan Overview: Reproductive Justice & Support

 

 

Teen pregnancy rates declined remarkably in Virginia between 2012 (32.1 per 1,000 females age 15 to 19 years) and 2018 (19.1 per 1,000), but differences exist among race/ethnicity and regions within the state. Hispanic and non-Hispanic Black teens had the highest teen pregnancy rates in 2018 at 34.6 per 1,000 and 28.9 per 1,000 respectfully. The Eastern (24.0), Southwest (23.7), and Central (21.9) regions had rates higher than the state rate.

 

Strategy: Implement evidence-based comprehensive sexual education in areas of the state with disproportionately high rates of teen pregnancy and low access to sexual health information.

Domain: Adolescent

 

 

In FY21, the Adolescent Health Program will begin a number of projects that further reproductive justice and amplify youth voice in Virginia.

 

For the first time in recent memory, VDH is funding a comprehensive sexual education program: Get Real. VDH selected Get Real based on its evidence base and because it is fully inclusive of LGBTQ sexuality and identity. The Get Real initiative promotes health equity by prioritizing the funding of agencies in communities with disproportionately high rates of teen pregnancy and/or racial and ethnic disparities in teen pregnancy.

 

About Get Real

 

Get Real is a comprehensive sexual education curriculum for middle and high school youth developed by the Planned Parenthood League of Massachusetts. The middle school program consists of nine lessons each in 6th, 7th and 8th grades. The high school program consists of eleven lessons that are designed to be taught in either 9th or 10th grade. The curriculum addresses topics such as healthy relationships, communication skills, puberty, reproduction, sexual identity, abstinence, refusal skills and contraception. The program also includes a focus on social and emotional learning as well as homework that promotes parental engagement.

Get Real is on The Department of Health and Human Service’s list of evidence-based programs. Research published in 2014 showed that middle school girls and boys who received the curriculum were 15% and 16% less likely to engage in sex compared to their peers who did not receive Get Real. The family engagement component of the program had a long-term impact on middle school boys; boys who completed the Get Real take-home activities in the 6th grade were more likely to delay sex in the 8th grade. While there is currently no published research evaluating the effectiveness of the high school curriculum, the curriculum is evidence-informed based on widely evaluated best practices in comprehensive sexual education.

 

VDH leverages Title V funds to implement Get Real in communities across Virginia that have disproportionately high rates of teen pregnancy and/or stark racial and ethnic disparities in teen pregnancy. VDH currently funds program implementation across three sub-recipients: The Virginia League for Planned Parenthood, Eastern Virginia Medical School and Planned Parenthood South Atlantic. Between these three sub-recipients, VDH funds Get Real in some of the highest need areas of the state. While the 2018 overall teen pregnancy rate among 10-19 year olds in Virginia is 9.8 per 1,000, areas funded by this initiative, such as Roanoke, Richmond and Petersburg, have the highest overall teen pregnancy rates in the state (46 per 1,000, 35 per 1,000 and 82 per 1,000, respectively). Furthermore, these areas also have some of the highest racial and ethnic disparities in the state; for example, the teen pregnancy rate among Hispanic/Latinx teens in Richmond it is 81 per 1,000, and in Roanoke is 79 per 1,000.

 

Funding for these three agencies began on July 1, 2020. Sub-recipients are largely implementing the program virtually, and are either in the program planning stages or have just begun serving young people. Between the three sub-recipients, VDH anticipates serving 6,700 this year.

 

 

Strategy: Advocate for policy change that requires sex education in Virginia to be medically accurate, comprehensive, inclusive and required.

Domain: Adolescent

 

 

 

Strategy: Fund BrdsNBz, a free sexual health informational text line for teens operated by the American Sexual Health Association, statewide in Virginia.

Domain: Adolescent

 

 

During FY20, VDH began funding a confidential sexual health text line for teens: BrdsNBz. While the Adolescent Health Program is growing, there are still many communities, populations and geographic areas that VDH does not reach or serve. Texting is a relatively low-cost intervention that provides access to sexual health information to young people in communities that VDH does not reach with its other sexual health programming.

 

About BrdsNBz

 

According to the BrdsNBz website, 9 out of 10 teens with a cell phone use text messaging. Teens are constantly using their phones; teen girls send an average of 40 texts per day, and older teen girls send an average of 50 texts per day. By meeting teens where they are, BrdsNBz provides a low-barrier, anonymous way for Virginia adolescents to get sexual health information. The BrdsNBz text line will help to prevent adolescent unintended pregnancy and increase effective contraceptive use by providing accurate and complete sexual health information to Virginia youth.

 

BrdsNBz usage is steadily increasing. After a slow winter, the number of messages the line received increased five-fold between April and May, and ASHA has consistently received approximately 45 messages per month since then. VDH is working closely with ASHA to continue to advertise the text line to young people and increase awareness and usage.

 

 

FY21 Action Plan Overview: Mental Health

 

Objective: By June 30, 2025, decrease the rate of hospitalization for non-fatal injury per 100,000 children ages 10 to 19 from 182.6 (HCUP - State Inpatient Databases (SID) 2015) to 124.79.

 

Strategy: Empower communities to address mental health issues that impact young people.

Domain: Adolescent

 

 

Virginia’s Title V Needs Assessment clearly demonstrated the need for more support around adolescent mental health in Virginia. At the same time, VDH - particularly the Title V team - is making a concerted effort to put more power in the hands of Virginia communities. As a result, the Adolescent Health Program will focus primarily on empowering young people and communities with mini-grants that allow community members to implement the public health interventions that they think are needed to improve adolescent mental health in their schools and neighborhoods.

 

While these mini-grants will serve to empower young people and solve mental health issues on a community level, there are some barriers to adolescent mental health that are at the structural and policy level. Therefore, VDH staff will also convene with other VDH staff, staff at the Virginia Department of Education and the Department of Behavioral Health Services and community stakeholders in order to determine what policies or statewide structures can be improved in order to positively impact adolescent mental health.

 

 

III. Dental Health Program

 

The Division of Prevention and Health Promotion’s Dental Health Program is led by Tonya McRae Adiches, RDH (Dental Health Programs Manager).

 

JoAnn Wells, BSHS, RDH, serves as the Maternal, Infant, and Adolescent Oral Health Consultant.

 

The Dental Health Program is detailed within the Women’s Health application.

 

 

FY21 Action Plan Overview: Oral Health

 

 

According to the National Survey of Children’s Health (2017-2018) 88.2% of adolescents 12-17 years in Virginia had a preventive dental visit. Overall, 82.4% of children, ages 1 through 17, had a preventive dental visit in Virginia.

 

 

IV. School Health Program

 

The VDH School Health Nurse Consultant (Joanna Pitts, BSN, RN, NCSN, CNOR) partners and collaborates closely with the Virginia Department of Education (DOE) School Nurse Consultant to serve elementary to high school aged children enrolled in public, private and parochial schools in the Commonwealth. The program aims to provide technical assistance and professional development training opportunities to school systems, particularly to school-based medical professionals, and families, and also to develop and update certain guidelines relevant to mandated services noted in the Code of Virginia.

 

Snapshot of Program Accomplishments

• VDH filled the vacant School Health Nurse Consultant position in May 2020.
• Since that time, Ms. Pitts has been immersed in the COVID-19 agency response and providing technical assistance to school nurses across the state. In collaboration with her counterpart at DOE, they hold weekly Zoom meetings, averaging over 250 participants, and maintain two Padlet sites as a resource for school nurses: COVID 19 Resources for VA School Nurses and Back to School, Information for School Nurses.
• The following programmatic documents have been reviewed and updated and set to be released late 2020/early 2021:
  • The 1999 School Health Guidelines. These guidelines will be available in print and digitally on VDH’s school health website.
  • The Commonwealth of Virginia School Entrance Health Form. This form will also be available in Spanish for the first time.
  • Guidelines for Managing Asthma in Schools.  Although VDH provided much consultation, the Virginia DOE houses this document.
• Ms. Pitts also serves on ImmunizeVA workgroups, Virginia’s statewide coalition aiming to improve vaccination coverage across the Commonwealth. She also created guidelines for Medical Reserve Corp volunteers, enabling them to assist in vaccination clinics occurring in school settings this past summer. At least five large immunization clinics occurred between June – August 2020.

 

 

FY21 Application Overview: Strong Systems of Care for All Children

 

 

According to the National Survey of Children’s Health (2017-2018) only 11.6% of adolescents age 12-17 years received services necessary to make transitions to adult health care.

 

Strategy: Maintain data capacity for school health immunization data.

Domain: Adolescent

 

 

School nurses recognize the importance of each student having a medical home and healthcare transition services, as supported by the American Academy of Pediatrics, American Academy of Family Physicians and American College of Physicians. In the ongoing provision for technical assistance and training opportunities, the VDH School Health Program promotes medical home and transition professional development opportunities related to medical home and transition for Virginia school-based medical professionals.

 

Critical to understanding the scope of medical home, transition services, select chronic health conditions, school health personnel staffing, and student clinic visits and disposition is the school health uniform data set survey. The VDH School Health Nurse Consultant works collaboratively with the VDOE School Nurse Consultant who administers the uniform data set survey. VDH maintains an agreement with DOE to analyze school health data that is collected from school systems across the Commonwealth.  Currently, 75% of schools are reporting into this system. Those that are not are attributing this to lack of school nurses in the school system. There are efforts, legislatively, to mandate all school systems to report data into current system.

 

There is no race/ethnicity data collected relevant to immunizations available, so it is difficult to ascertain if and where disparities may lie within the state. The VDH School Health Nurse Consultant will continue to partner with DOE and work with the VDH Division of Immunization, Immunize VA, and MCH Epidemiologist to plan for the expansion of this data collection.

 

Evidenced-based/Informed Strategy Measure: Percentage of Virginia schools reporting into the VDOE school health data system

 

Strategy: Expand and empower school nurse workforce.

Domain: Adolescent

 

 

The pandemic further strengthened the need for a school nurse to be in every school building in order to implement public health strategies, assess impact and to provide education and training to school personnel, students and families. It became very apparent early that the school nurse needed to be a vital member of school teams planning for re-opening during the COVID-19 pandemic. VDH and DOE will collaborate with the Virginia Association of School Nurses (VASN) on these policy initiatives and to promote educational opportunities and technical assistance.

 

Consumer/Family Engagement & Partnership

 

The VDH School Health Nurse Consultant collaborated with Jeannine Uzel, Director of Public Health Nursing, VDH Division of Immunization, local health departments, area schools, and with the Virginia DOE to increase access to vaccines, particularly for our underserved population. The team developed guidance and parental notification methods for area school divisions. Efforts were focused on reaching out to the student population that required additional immunizations prior to the start of the new school year. The resources we provided have been successfully used by area schools to advertise and perform drive thru immunization clinics for their school families.

 

The VDH School Health Nurse Consultant encouraged school nurses to participate in community contact tracing efforts. Currently, area school nurses have completed contact training courses and are currently working with their local health departments, serving as contact tracers, with the goal of reducing the impact of COVID-19 in their school community.

 

Emerging Issues

 

COVID-19 will continue to challenge the school health system: physically, mentally and socially. Both the VDH and DOE school health nurse consultants will continue to provide technical assistance and support in the coming year. 

 

With the pandemic, immunization rates have decreased across the board and in every age group.  Initially, the CDC recommended prioritizing vaccines for children under 24 months of age. This guidance resulted in a decline in the administration of vaccines for children older than 24 months and adults. As of May 31, 2020 vaccines entered in the Virginia Immunization Information System (VIIS) were 23% lower compared to previous years, but in June, vaccine orders increased in Virginia. Getting these rates to pre-pandemic levels will be challenging and will require intense outreach and education strategies to be in place.

 

 

Adolescent Health Work Detailed in Other Sections

 

Note that following strategies are detailed in the Women’s/Maternal application and are thus not repeated:

 

Reproductive Justice & Support

• Work with stakeholders to remove policy, financial, and training barriers to contraceptive access (Reproductive Health Unit; Domain: Women’s/Maternal, Adolescent)
• Explore opportunities for providing support to families seeking fertility services and families experiencing miscarriage (Reproductive Health Unit; Domain: Women’s/Maternal)

 

Priority: Oral Health

• Maintain and expand existing MCH-focused dental education programs to improve oral health for individuals across the lifespan, to include advising on oral health integration in primary care settings, education for home visitors, school-aged oral health education, and emerging needs of adolescents (Domains: Women/Maternal, Child, Adolescent)
• Sustain network of 5 regional Oral Health Alliances and distribute mini-grants for implementation of systems change and data-sharing initiatives to improve the oral health of all Virginians, with emphasis on pregnant women, and children and adolescents aged 1-17 (Domains: Women/Maternal, Child, Adolescent)
• Convene statewide groups focused on targeted oral health issues (e.g. Water Equity Taskforce, Early Dental Home workgroup, Future of Oral Health workgroup), facilitate collaboration and workplan development, and provide leadership and oversight to guide initiatives (Domains: Women/Maternal, Child, Adolescent)