Priority Area: Mental Health

NPM-9: Percent of adolescents, ages 12 through 17, who are bullied or who bully others

Annual Plan for FY23:

During FY23, the Violence Injury Prevention (VIPP), the Office of Maternal and Child Health (MCH), and the Healthy Environments Active Living (HEAL) Program, will continue to implement strategies to decrease bullying of adolescents in Utah by targeting known risk factors. Risk factors including individual and interpersonal risks for perpetrating violence include impulsiveness, youth substance use, antisocial or aggressive beliefs and attitudes, low levels of school achievement, weak connection to school, experiencing child abuse and neglect, exposure to violence in the home or community, involvement with delinquent peers or gangs, lack of appropriate supervision, parental substance abuse, and parental or caregiver use of harsh or inconsistent discipline.

Our strategies are intended to reduce the risk factors known to influence bullying behavior as well as other types of youth violence. Community factors, or social determinants of health, such as residential instability, crowded housing, poor economic growth or stability, unemployment, concentrated poverty, neighborhood violence and crime, lack of positive relationships among residents, and views that drug use and violence are acceptable behaviors can also contribute to bullying. Addressing social determinants of health is a primary approach to achieving health equity.

VIPP, MCH, and HEAL are committed to applying a healthy equity lens to all work through implementation of the Health Equity Framework. The effort will encompass the following:

1. Identify and prioritize health disparities through data and stakeholder feedback.
2. Identify structural and social determinants of health through data and stakeholder feedback.
3. Choose evidence-based or evidence informed health equity strategies to implement that include stakeholders with lived experience.
4. Implement strategic practices to advance health equity.
5. Use evaluation to improve the quality of the strategies being implemented. Building internal capacity and using the framework to guide strategic planning will ensure continuous quality improvement of these strategies.

Proposed Activities:

• Offer at least one virtual Teen Speak class per month to approximately 120 parents and youth-serving professionals. This evidence-based program utilizes motivational interviewing principles to support parents and trusted adults in improving communication skills and strengthening youth-adult relationships. Data suggests that teens who can identify a strong relationship with at least one trusted adult are less likely to use drugs or alcohol, engage in sexual activity, or attempt suicide.

• Increase the number of adolescents receiving a Bystander Intervention program through virtual implementation of training. Bullying is the unwanted, aggressive behavior among school-aged children that involves a real or perceived power imbalance. Passive bystanders provide the audience a bully craves and the silent acceptance that allows bullies to continue their hurtful behavior. A bystander to bullying is anyone who witnesses bullying either in person or in digital forms like social media, websites, text messages, gaming, and apps. When bullying occurs, bystanders are present 80 percent of the time. A bystander has the potential to make a positive difference in a bullying situation, particularly for the youth who is being bullied. Studies show, when youth who are bullied are defended and supported by their peers, they are less anxious and depressed. The Upstanding Program teaches children simple strategies for standing up to bullying that effectively removes, rather than provides, more peer attention.
• Increase the number of students who are active for at least 60 minutes a day, through a variety of options, throughout the school day. Physical activity has brain health benefits for school-aged children, including improved cognition (e.g., academic performance, memory) and reduced symptoms of depression. Regular physical activity in childhood and adolescence can also be important for promoting lifelong health and well-being and preventing risk factors for various health conditions like heart disease, obesity, and type 2 diabetes.
• Strengthen Household Economic Security through an uptick in Utah filings for the Earned Income Tax Credit (EITC) through a targeted awareness program. Strengthening household financial security through tax credits, such as the EITC, can help families increase their income while incentivizing work or offsetting the costs of child-rearing and help create home environments that promote healthy development. The evidence suggests that the EITC can lift families out of poverty.
• Increase the number of Utahns who have been trained in a suicide gatekeeper training.
• While the Question, Persuade, Refer (QPR) intervention was developed specifically to detect and respond to persons emitting suicide warning signs, QPR has also been more widely applied as a universal intervention for anyone who may be experiencing emotional distress. It has been suggested by independent researchers and federal leadership that originally funded and conducted QPR studies, that the QPR intervention could be useful in a much broader application, and not just for the detection of persons at risk for suicide.

State Priority Area: School Lunch

SPM-3: Percent of students enrolled in free or reduced price lunch programs

Annual Plan FY23:

Local Health Departments (LHDs) will continue to work with local education agencies (LEAs) and the child nutrition program to improve the Local Wellness Policy (LWP). LEAs are on a 5 year cycle to review the Child Nutrition Program Administrative Review. There are about 140 LEA sites that participate in this review. Each review lasts about 4 1/2 months. The LEA can help support the administrative review by evaluating the LWP and updating the requirements to the policy for each LEA.

Schools who have 50% free or reduced percentages will need to implement an alternative breakfast model by the end of the 2022-23 school year. LHDs will help promote, encourage, and provide technical assistance to schools who are required to implement breakfast. We will participate in community coalitions that support school meals such as breakfast and lunch. These could be Action for Healthy Kids, Utah Breakfast Expansion Team and Get Healthy Utah. Provide opportunities for educators, families, and communities to learn more about services and programs that support healthy school meals by participating in professional development opportunities and community activities. Continue to work with the child nutrition program to build services and programs that enhance the school meals programs.

• Provide training to LHD health educators on how to use WellSAT, a quantitative assessment tool to help improve school wellness policies. Increase the number of LHDs that provide support to LEA local wellness policies. Coordinate with the Utah State Board of Education Child Nutrition Specialist to help support the LEA’s wellness policy section during the Child Nutrition Programs administrative review.
• Collaborate with the State Board of Education Child Nutrition Program to help educate families that meet the qualifications for free and reduced school meals to apply for services. Work with other state agencies to help simplify this process.
• Ensure that schools who are required to implement an alternative breakfast model during the 22-23 school year have the tools and resources to do so successfully. Educate LHDs about Start Smart.

The following NPM/SPMs are addressed in the Child Domain section.

NPM-13.2: Percent of children, ages 1 through 17, who had a preventive dental visit in the past year.

SPM-2: Percent of family members who live in the household that ate a meal together 4 or more days per week.