NPM #7 Injury Hospitalization – Reduce intentional and unintentional injuries among children and adolescents

Please note that some of the strategies and activities listed below impact both the Child and Adolescent Health domains. To avoid duplication, the information will only be listed in this domain, for which it is anticipated to have a larger impact, but it should be noted that some strategies and activities may address a wider age range.

The Bureau of Community Health and Wellness (BCHW) serves as the state lead for Safe Kids Worldwide and provides funding for 10 Safe Kids Coalitions. The coalitions reach 60 counties to provide unintentional injury prevention services to children (0-19 years old). The coalitions are led by local public health agencies (LPHAs), non-profit entities, and local hospital systems. They work to increase knowledge, attitudes, and skills to address priorities such as teen driver safety, sports safety, medication safety, fire safety, and water safety. The coalitions offer a broad array of educational activities such as the National Safety Council’s Defensive Driving Course (DDC). DDC increases parent and child awareness and knowledge on injury prevention priorities. Teens ages 14 and up are encouraged to take the DDC and learn state and local traffic laws, distracted driving prevention, and safe driving practices. A Drivers Education Program is also offered to better prepare youth for driving. The program is taught by certified National Safety Council instructors. The complete program consists of six modules, each module has been created to increase in complexity as students master each driving skill. In order to pass this course and receive their certificate of completion, Students must pass all six modules to receive a completion certificate. Additional injury prevention activities include: participating in health and safety fairs, providing education through school and community events, hosting drug take back events, conducting media campaigns that incorporate prevention messages, and working with policymakers to address gaps in policies that could prevent injuries. The coalitions work closely with law enforcement officers, fire fighters and paramedics, medical professionals, educators, parents, businesses, community agencies, public policy makers, and, most importantly, adolescents, to reinforce teen driver safety. The Department of Health and Senior Services (DHSS) will host quarterly conference calls and offer a one-day workshop for all coalitions to gain knowledge of evidence-based interventions and network with other coalitions.

The Injury Prevention Program will continue to build program capacity and partner with Safe Kids coalitions to provide programs, identify gaps in current services, and increase the number of partners that support injury prevention programs. The Injury Prevention Program will continue to collaborate with TEL-LINK and Text4baby to provide information and resources about car seats and seat belts. The Injury Prevention Program will promote ThinkFirst Missouri traffic safety programs, which include group presentations delivered in schools, worksites, and community settings. Presentations feature compelling testimonies from Voices for Injury Prevention (VIP) speakers. Having sustained a brain or spinal cord injury from a motor vehicle crash, VIP speakers present serious yet motivational messages about the consequences of life-altering injuries and encourage audiences to take personal responsibility and make safer choices. A new traffic safety program, ThinkFirst for Kids, has been developed. ThinkFirst for Kids Missouri will partner with Safe Kids Columbia to develop and present on passenger and pedestrian safety, bike safety, ATV safety, water and fire safety in schools and community settings. Presentations will be tailored to accommodate the needs and size of the audience and reach approximately 1,000 children and families.  Presentations will be flexible to fit the needs of the community and may be presented at after school programs, classrooms, school assemblies, or other settings where K-8th graders gather. The program will also incorporate the MODOT Smart Riders program for elementary-aged students. Family engagement will also be a priority for Safe Kids coalitions, and coalitions will continue to incorporate families into coalition activities. DHSS will provide technical assistance to further that effort.

The Injury Prevention Program will continue to coordinate the Missouri Injury and Violence Prevention Advisory Committee (MIVPAC), which provides expertise and guidance to the Injury Prevention Program and establishes injury prevention as a state priority. The Committee consists of representative members from state agencies, local and regional government agencies, non-governmental bodies, and community members. Many Title V funded programs from DHSS participate on the committee, such as MCH Services Program, Adolescent Health Program (AHP), and Genetics & Healthy Childhood Program. The Committee’s goal is to reduce the morbidity and mortality of children (0 -19 years) due to injuries and violence. MIVPAC will continue implementing the strategic plan, which includes strategies to promote partnerships and collaboration to improve injury prevention efforts and promote MIVPAC as the resource for best-practice recommendations to address injury and violence prevention.

The MCH Services Program will continue contracts with 23 LPHAs that identified the reduction of intentional and unintentional injuries among adolescents as the Priority Health Issue in their FFY 2022-2026 MCH work plans. The Program will continue to support LPHA efforts to prevent and reduce injury related to:

• Fire and water safety;
  • The Hickory County Health Department is working with the Sea Tow Foundation’s Life Jacket Loaner Program to implement life jacket loaner stations in state parks that have water access points. The first loaner station will be implemented by the end of FFY2023 and will be located at the Hermitage Campground Boat Ramp. Those participating in water activities may borrow the life jackets at no cost and are asked to return them when they are finished. The Camden County Health Department is working on a similar program.
  • The Hickory County Health Department is also working to increase awareness of water safety initiatives among local businesses and partners. They will provide updates in the Chamber of Commerce newsletter and the Lake Area Vacation Guide. Recent updates have included information on the Wear It Campaign addressing life jacket education as well as the Sober Skipper Program. Plans to increase individual knowledge and skills around water safety are underway; boat rentals/marinas and campgrounds will include life jacket safety education with each rental.
  • The Camden County Health Department partners with the Missouri State Highway Patrol-Water Patrol Division to provide water safety education to preschool and school-aged children and adolescents.
• Motor vehicle safety/accidents;

• The Sullivan County Health Department continues to partner with Think First Missouri to bring the ThinkFirst for Teens School Assembly Program to schools. The Program is offered free of charge and provides a high-impact injury prevention message from a VIP Speaker. The Green City R-1 School District hosted this assembly and 50 high school students were in attendance.  In addition, the health department is partnering with medical providers as well as the Division of Motor Vehicle in the county to provide them with Safe Driving Bags that include the following:  CDCs Parents are the Key to Safe Driving, GDL System Planning Guide, Eight Danger Zones for Teens Behind the Wheel, AAP Parent-Teen Driving Agreement, Passport to Safe Driving, First Impact Zoom Schedule, and promotional materials provided by MODOT.
• The Moniteau County Health Department will continue to provide education and safe driving resources to those who come to the health department to get a birth certificate for the purpose of obtaining a permit/driver license. Since March of 2023, the health department has provided five parents and new teen drivers with education and resources.

• Child abuse and neglect;
  • The MCH Services Program, in partnership with MO KidsFirst, will continue to offer and/or support and promote partner offerings of the Stewards of Children training for LPHAs and other community partners. The Stewards of Children framework teaches how to prevent, recognize, and react responsibly to child sexual abuse. The framework is built on the foundation of The 5 Steps to Protecting Children and uses real people and their stories to show how to protect children. It is available in English and Spanish.

• The Schuyler, Putnam, and Clark County health departments are working with organizations serving youth to determine if they have child-adult contact policies and if not, helping them to develop policies and provide staff trainings.  In addition, these health departments plan to host Parent Café’s in their local communities. Parent Cafés are structured, small group conversations, to facilitate transformation and healing within families, build community, develop peer-to-peer relationships, and engage parents as partners in programs that serve them. Participants of café’s often report reduction in stress, improvements in their well-being and enhanced support networks.

• Violence
  • The Kansas City (KC) Health Department will work with the KC Blueprint for Violence Prevention and Healthy Communities. KC Blueprint was developed by the Violence Free Kansas City Committee, a citywide multisector collective impact effort of public and private entities with the mission to ensure that violence prevention and deterrence efforts are coordinated and rooted in public health and community resilience approaches. The goal of the KC Blueprint is to reduce incidence of violence and trauma affecting youth and families and ultimately heal the city together. (KCBlueprint, 2020)
• Lead poisoning
  • The Johnson County Health Department continues to work with local child care providers to develop lead testing policies and provide on-site lead testing for children along with education and referral to resources. Child care providers that develop policies and practices will be recognized by the health department with a “seal of greatness”.

Young Children Specific

The Child Care Health Consultation (CCHC) Program will continue to provide consultations and trainings for child care providers and health promotion for children in child care on a variety of injury prevention topics to promote safe child care environments, encourage healthy and safe behaviors, and prevent injuries in children. Consultations for child care providers will assist in the assessment of healthy and safe environments using evidence-based tools, development and review of policies, implementation of health and safety procedures, promoting active supervision, and utilizing safe and developmentally appropriate equipment in the indoor and outdoor environments of the child care facility. Training and health promotion topics will include, but not be limited to: abuse and neglect, mandated reporting, behavioral health, emergency preparedness, CPR/First Aid, active supervision, medication administration, poisoning prevention, lead poisoning prevention, fire safety, gun safety, injury prevention, motor vehicle and car seat safety, playground safety, safe sleep, stranger safety, water safety, and sun safety. Health promotions will continue to provide children in child care with meaningful experiences regarding health and safety and injury prevention that can be implemented in their lives outside of their child care programs, and provide educational materials for parents/guardians. All CCHC Program services will continue to be inclusive and promote family engagement in safe and healthy behaviors.

Safe Kids coalitions will address priorities including child passenger safety, bicycle/helmet safety, crib safety, TV and furniture tip-over, pedestrian safety, poisoning, water, home safety, and other areas based on community needs. The coalitions will offer a broad array of activities including: providing cribs and car seats, offering parent education, conducting car seat checks, facilitating training for certification of child passenger safety technicians (CPST), conducting prevention media campaigns, and working with policy makers to address gaps in policies that could prevent injuries.

The DHSS Injury Prevention Program Manager will continue to: represent District 5 (Central District) on the MO Child Passenger Safety Advisory Committee, maintain regular contact with all CPSTs/inspection stations in the district to provide resources, mentor new CPST, be the main point of contact when the Department of Transportation, orders car seats for the area inspection stations, recruit new inspection stations, and attending CPS Advisory Committee meetings. The MCH Director will continue to participate on the Missouri Brain Injury Advisory Council, MIVPAC, and the MO Council for Adolescent and School Health (CASH). The MCH Director, Injury Prevention Program Manager, MCH Program Manager, and MCH District Nurse Consultants will continue to serve on statewide and regional safety coalitions, such as the Missouri Coalition for Roadway Safety state and regional coalitions and the Occupant Safety Subcommittee, and partner with safety advocates to prevent intentional and unintentional injuries.

The violence prevention team in the Office on Women’s Health (OWH) will leverage the Rape Prevention and Education Grant to promote shared risk and protective factors for violence prevention to prevent teen dating violence, sexual violence, and harassment among the middle school population in the state.