NPM 7: Rate of hospitalization for non-fatal injury per 100,000 children, ages 10 through 19.

 

The FY20 Needs Assessment, as in previous years, highlighted the need to prioritize injury prevention among adolescents, which the Centers for Disease Control and Prevention (CDC) defines as youth ages 10-18 and young adults ages 19-24. Based on National Performance Measures from the United States Department of Health and Human Services and state inpatient databases, Texas has had a consistently lower rate of adolescent hospitalization for injury than the rest of the U.S. However, unintentional injury has been, and continues to be, the leading cause of death among youth and young adults as well as the leading cause of non-fatal injury.

 

CDC Web-based Injury Statistics Query and Reporting System (WISQARS) data from 2018 shows that 16.5% of all injuries reported to the trauma system in Texas are of youth and young adults from falls and motor vehicle traffic accidents, which are both categorized as unintentional, non-fatal injuries.

 

A framework that proactively promotes protective factors in young people is Positive Youth Development (PYD). Maternal and Child Health (MCH) uses PYD as the foundation for engaging and serving youth in MCH strategies and initiatives. PYD involves youth as active agents, people that can improve their life by taking action on their own behavior, and engages every element of the community.

 

MCH funds several organizations to implement injury and violence prevention efforts to address NPM 7 including Texas A&M University (TAMU), Texas Juvenile Justice Department (TJJD), the Office of Attorney General (OAG) with a CDC grant, and the Texas Department of Family and Protective Services (DFPS).

 

To address injury prevention in FY22, TAMU will continue to administer the Texas Youth Action Network (TYAN) and expand on PYD work across the state. MCH began funding TYAN in FY18, building on the success of the Texas Healthy Adolescent Initiative from 2010-2018. TYAN promotes youth engagement and Youth-Adult Partnerships (YAPs) as effective strategies to improve youth-serving programs and organizations. TYAN’s program engagement includes developing online resources for a general audience, conference presentations for youth-serving professionals, and online tools and advanced structured learning opportunities for interested individuals. TYAN also provides customized training and technical assistance to organizations willing to undertake a two-year commitment as a TYAN community partner. Community partners are organizations that formally join TYAN to create or expand YAPs in their community. TYAN provides training, technical assistance, and grant funding to community partners to help them establish or expand YAPs in their organization. TYAN will continue to implement these strategies during FY22.

 

TYAN will engage and recruit at least 16 organizations to be a part of the community partner learning cohorts in FY22. After changing their approach in FY20, TYAN exceeded recruitment expectations. Thus, in FY22, TYAN plans to approach engagement and recruitment of the community partners using the same strategies of exhibiting at conferences, networking through social media, referrals from Public Health Regions (PHRs) and current community partners, and appropriate communication with youth-serving organizations.

 

TYAN will continue evaluating the community partner YAPs in FY22. Effective YAPs have practices that provide youth opportunities to explore, take chances, safely learn from mistakes, and celebrate successes while being guided by caring, connected adults. In turn, youth have better resiliency-related positive youth development outcomes in areas like self-confidence, life skills, and core values and they are prepared to make better choices at all stages of life. TYAN collects evaluation data to measure the processes and assess the extent to which community partners are achieving the intended outcomes of the PYD framework within their YAPs. Adult and youth members are asked to report on PYD-related behaviors before and after joining their YAP.

 

Knowing the importance of PYD and YAPs as a protective factor for injury prevention, TYAN will continue promoting these activities through the TYAN website, e-newsletters, and social media in FY22. All levels of program engagement involve the promotion of PYD and YAP, but this activity will be measured through online interactions with TYAN using the number of website visitors, number of social media followers, and the number of email subscribers. In FY22, TYAN will continue to disseminate a monthly newsletter to their subscribers, update their website with any new resources, announcements, and opportunities, and engage with followers through their social media posts.

 

In FY22, TYAN plans to continue disseminating adolescent health-focused online tools such as the Organizational Readiness Assessment for Youth- Adult Partnerships (ORAYAP) and Youth Development Training Series (YDTS) as well as the creation of an adolescent health data dashboard. The ORAYAP and YDTS were created in FY19. The ORAYAP is an assessment tool designed for youth-serving professionals to rate their organization’s capacity to engage young people. Through the ORAYAP, organizations can assess their current youth engagement and identify areas of improvement to be a more youth-centered organization.

 

In FY20, TYAN funded a market research study that found that adolescent health champions and youth-serving organizations need data tools and information on health metrics to inform their programming. To address this gap, TYAN is developing an adolescent health dashboard in FY22. The dashboard will be a publicly available tool that showcases data at the county, regional, and state level. This activity will allow youth-serving professionals and stakeholders to access the best available adolescent health data in one location.

 

Another NPM 7 activity from TYAN includes presenting at youth-focused conferences throughout FY22. Conference presentations are intended to serve as a mechanism to spread awareness of TYAN and increase knowledge around PYD and YAPs. TYAN staff presented at two conferences in FY20 and three in FY21 due to COVID-19 canceling opportunities. TYAN instead sought out ways to connect with individuals and organizations virtually but found that, although virtual options give more flexibility, in-person conferences allow for deeper interactions between attendees and TYAN. In FY22, TYAN will try to attend at least four conferences to engage with youth-serving professionals and to identify opportunities with other youth-centered organizations.

 

Additionally, in FY20, MCH and TYAN identified a need to create a “training library” for PHRs on topics related to adolescent health. The library will be a source for PHRs to have access to updated trainings, research and materials to provide to the community as well as train internal staff. Since PHRs are considered the health experts within their communities, staff need to be as well-informed as possible on health issues, have access to evidence-based resources, and disseminate that information across the communities they serve.

 

MCH and TYAN will maintain efforts in FY22 to be up to date on emerging trends in adolescent health, integration of social-emotional learning, awareness of PYD, strategies to engage adolescents, connecting youth to PYD programs, and responding to adolescent health needs amidst COVID-19.

 

MCH has funded TJJD on a year-to-year basis since FY19 to create healthier environments for youth ages 12-18 living in residential facilities by increasing quality, positive activity opportunities. The COVID-19 pandemic resulted in increased stress, anxiety, and other mental health concerns among youth due to change in routines, break in continuity of learning, and health care, and loss of safety. To provide better support to youth in their residential facilities, TJJD identified the need to focus more on mental health regulation and established several calming rooms, spaces providing a supportive and relaxing environment, throughout their juvenile residential facilities in FY21. To support this shift, TJJD will use Title V funds to purchase sensory and calming supplies and equipment in FY22. The supplies and equipment may include items such as weighted blankets and stuffed animals, calming toys with tactile sensory such as fidget tools, and activity kits for calming rooms and education spaces. MCH and TJJD expect to see increased participation of PYD activities as well as a decrease in self-reported risky behaviors. To measure success and reach of the activities, TJJD will send data on youth’s participation in PYD activities, number of activities that support PYD (e.g., team building and youth group meetings), and self-reported metrics on PYD measures. MCH will meet with TJJD at least twice in FY22 to discuss TJJD youth needs and plan progress.

 

In FY22, MCH will continue to represent Texas as the Principal Investigator for the CDC’s Rape Prevention and Education (RPE) grant. Year three of the five-year funding cycle began in February 2021. RPE addresses sexual violence, one of the main causes of intentional injury among adolescents and is correlated to suicide ideation and suicide. The activity is another example of MCH efforts to increase the number of programs using youth voice and approaching youth education with a PYD lens. RPE also provides an opportunity to engage 18 rape crisis centers on sexual violence prevention efforts through PYD. MCH contracts with OAG to implement community-based activities focused on PYD, healthy relationships, and the prevention of sexual violence. MCH works with OAG, Texas Association Against Sexual Assault, (TAASA), Texas A&M Health Science Center (TAMHSC), and local rape crisis centers to implement primary prevention strategies to reduce sexual violence. TAASA serves as the state sexual assault coalition and TAMU is the external evaluator.

 

During FY22, MCH, OAG, TAASA, and TAMHSC will provide technical assistance and training to 18 rape crisis centers implementing evidence-based and evidence-informed strategies as well as evaluate their efforts. Additionally, the state partners will meet twice a month as part of the Primary Prevention Programming Steering Committee. Ongoing activities include reviewing and improving the action plan, discussing effective implementation of the primary prevention focus areas, and tracking and evaluating the number of activities and participants that attend activities that the 18 RPE-funded sites host as part of their funding. The activities include educational seminars, training programs for professionals, and community-wide workshop topics on subjects such as primary prevention, consent, bystander intervention, PYD, and youth voice. RPE aims to end sexual violence by preventing it from happening, and, as with most primary prevention efforts, takes time to see the long-term outcomes. However, MCH and OAG track short-term outputs and outcomes of youth and adult reach through the RPE programming.

 

RPE was awarded two supplemental awards from the CDC for FY20 and FY21 related to COVID-19. The first award focused on the impact of the pandemic on implementation sites and the second award focused on supporting additional FY20 and FY21 activities. The additional funding supported training and technical assistance for the 18 RPE-funded rape crisis centers to adapt their primary prevention strategies for the virtual sphere as well as the development of two guidebooks. One guidebook focuses on adapting curriculum-based and community-level prevention programming to online implementation while the other guidebook focuses on keeping online trainings spaces engaging. Even though the supplemental funding ended in January 2021, RPE will continue using the guidebooks in FY22.

 

MCH will continue to fund Texas Department of Family Protective Services (DFPS). Since FY19, MCH has funded the Prevention and Early Intervention program at DFPS to create child- or adolescent-focused videos in English and Spanish. In FY21 and FY22, the videos will focus on youth and young adults. The topics are agreed upon by both agencies to align with their health priorities. In FY21, the topic focused on what it means to be a teen in the age of social media, the burden of social media on youth mental health, and associated risk such as disruption of proper mental functions and increased loneliness. This topic is especially timely amidst the pandemic. COVID-19 may affect the approach for focus groups and capturing footage, but DFPS is mitigating this issue with a more virtually friendly approach. The topic for FY22 has yet to be determined, but most likely will align with NPM 7. Success of this activity is measured using the reach of the video through tracking metrics by DFPS. MCH hopes to see an increase in parental awareness of issues affecting youth and young adults.

 

Due to the fiscal impact of COVID-19 on Texas’ budget, all state agencies were asked to reduce their general revenue budget by 5%. After a thorough review of agency activities to protect core public health programs and key agency priorities, DSHS made the difficult decision to suspend the Medical Child Abuse Resources and Education System (MedCARES) Grant Program. MedCARES mainly focused on supporting direct client medical services, which does not align with DSHS’s core public health mission or current guidance from HRSA’s Maternal and Child Health Bureau around funding such services. MCH will conduct contract closeout procedures in FY22 and collaborate with Office of Injury Prevention (OIP) to identify supplemental injury prevention activities.

 

To address injury prevention and promote PYD, MCH leads Texas’ efforts to support Child Fatality Review Teams (CFRTs), host adolescent health quarterly meetings, update adolescent health webpages, and disseminate adolescent health messaging through the agency’s e-newsletter platform Granicus.

 

MCH will update DSHS adolescent health and CFRT websites, support regional activities, and develop education and resources for interested stakeholders. MCH will also promote webinars and technical assistance tools for injury prevention stakeholders and interested CFRT team members.

 

In FY22, MCH will continue providing technical assistance to local CFRT teams to increase quality and quantity of deaths reviewed and increase the number of counties covered by local CFRTs. MCH will work to determine the impact of the COVID-19 pandemic on local team operations by conducting a survey and will assist local teams as needed to reinstate local child fatality review.

 

The goal of the state CFRT is to provide review team coverage for all 254 Texas counties and increase the percentage of deaths reviewed. According to Texas’ 2020 CFRT Report, local and regional CFRTs cover 211 of the 254 Texas counties resulting in 94% of Texas children residing in a county where child deaths are reviewed. MCH and PHRs will continue supporting the goal to cover all 254 Texas counties and will help where needed. PHR staff facilitate many of the CFRT teams. In FY22, the short-term goal will be to add or reinstate five more counties involved in CFRT activities.

 

CFRT staff will work to streamline the steps in death review facilitation. Electronic death certificates are currently delivered within six months of death. Local teams will continue to be trained to use an expedited review process for natural deaths to help teams prioritize reviews. Further, MCH will create one technical assistance training webinar related to death certificate distribution, child death review, and death review data entry in FY22. These process changes allow teams to gain timely access to data. Continuing education opportunities for local CFRTs will focus on improving the CFRT process in communities and address preventable deaths in Texas. This will require:

• Ongoing assessment of data needs, gaps, and opportunities;
• Continuous refinement of review tools, data systems, and training to aid in the reviews; and
• Review of pilot funding strategies to help in completion of data entry.

Resources will also include information on best practices in injury prevention programming. Located within the MCH Unit, the OIP continues to identify additional avenues to train medical examiners and justices of the peace.

 

The Adolescent Health Quarterly Meeting has been an ongoing activity since 2015. This group, with membership of more than 70 youth-serving professionals in Texas, shares information and updates about current projects and allows for potential opportunities for collaboration and coordination. FY20 saw the frequency of the group meeting decrease because of shifted priorities amidst COVID-19 and staff vacancies. In FY22, MCH plans to focus on injury prevention and reduction during at least one meeting with a potential presentation to members on up-to-date efforts and data on reducing injury among youth and young adults. This meeting is a health promotion and collaborative-based activity guided by evidence-based strategies and approaches informed by CDC technical packages.

 

MCH oversees 11 adolescent health-related webpages on the DSHS website. The webpages aim to increase knowledge about adolescent health-specific topics and PYD efforts as well as serve as a connecting opportunity to resources. Webpages include up-to-date adolescent health information, important phone numbers, resources, and related sites for adolescents and parents. In FY22, MCH plans to collaborate with OIP to include adolescent-specific injury prevention information on their webpage and link that information on the adolescent health webpage. The COVID-19 pandemic has shifted priorities for web content in FY21 and webpages will become more of a priority for FY22.

 

Another MCH activity supporting efforts to promote adolescent health, PYD, and the importance of youth participation in PYD programs is Granicus. Granicus delivers updates to subscribed users. At the start of FY21, the adolescent health distribution list had 10,281 subscribers. MCH will promote evidence-based strategies on injury prevention and reduction through intentional, targeted messaging by distributing messaging on injury prevention through adolescent health’s Granicus at least three times throughout FY22 on protective and risk factors associated with injury prevention and reduction. The COVID-19 pandemic saw the isolation of (and potential lack of supportive environments for) youths and young adults affecting the risk for poor mental health - a concern for youth-serving professionals. Thus, MCH will continue to focus on targeted health promotion messaging on injury prevention and reduction.

 

To educate Texans on injury prevention and reduction, MCH supports the Texas PHRs, Texas Health Steps – Online Provider Education (THS-OPE), and Friday Beat.

 

MCH will support PHR staff in their endeavors to address unintentional injury and injury prevention in their communities. The PHRs focus on region-specific topics and activities. PHR staff plan to complete the following activities related to human and sex trafficking prevention in FY22:

• PHR 1 will conduct individual, parent, or guardian outreach by having educational resources available in the lobby or patient rooms on awareness and education on domestic minor sex trafficking prevention. Staff will provide awareness and education to health care providers or agencies who provide services to adolescents on domestic minor sex trafficking prevention by recognizing, referring, and reporting that someone might be trafficked.
• PHR 4/5N will promote child injury prevention related to human sex trafficking. Staff will conduct, track, and monitor the number of presentations, trainings, outreach events conducted regarding human sex trafficking prevention and awareness, location of events, number of participants, key partners, number of participants who can identify (3) grooming techniques used by human traffickers, and (3) characteristics of at-risk populations.
• PHR 7 will educate communities to recognize, report, and prevent human trafficking by continuing to use the Shared Hope Presentation, and will use a pre- and post-test to evaluate participants’ understanding of the presentation. Education is planned for county judges, community centers, tattoo parlors, churches, libraries, schools, and hospital staff in Lampasas, Coryell, Burnet, Llano, Blanco, Robertson and Burleson counties. Each participant will receive a folder with print out material, cell phone pocket holders, and pens with the human trafficking hotline number on them for quick, accurate, and discretely provided referral information to anyone seeking information and resources about human trafficking including victims seeking to leave their captors. DSHS staff in these counties will continue to attend the Central Texas roundtable meetings as well as conferences and seminars to stay abreast of the latest trends related to human trafficking.
• PHR 9/10 will raise awareness of human trafficking prevention in the community. Staff will collaborate with and convene local partners in the fight against human trafficking. Staff will partner with coalitions or other interested partners in educating the local community to include parents and children. Staff will develop a clinic process for identifying and referring identified human trafficking victims and individuals at risk to appropriate services.

 

PHR staff plan to complete the following activities related to motor and vehicle safety in FY22:

• PHR 7 will continue to partner with Texas Trails, Education and Motorized Management (TXTEAMM), AgriLife, and 4H to assist in safety awareness activities such as distributing handouts and TxDOT approved helmets and providing technical support. Staff plan to reach out to schools in those counties where all-terrain vehicle (ATV) rates are the highest to offer the safety awareness class at their school health fairs and at other events as requested by their community. They also plan to reach out to “Helmets of Love”, a nonprofit organization that provides helmets to youth for bikes and All Terrain Vehicles (ATVs).
• Staff in PHR 8 will promote adolescent vehicle safety including having their field office team participate in one school or community event planning committee and provides technical assistance around evidence-based strategies for preventing motor vehicle crashes, give one presentation using evidence-based curriculum around motor vehicle safety per year, and provide adolescent injury prevention education, support, or community resources to at least one audience of CFRT members, commissioners, lawmakers, parents, educators, or providers.

 

Regional staff plan to complete the following activities related to suicide prevention in FY22:

• PHR 2/3 will assist school districts, in non-local health department counties, in obtaining resources on evidence-based suicide prevention programs, such as the Signs of Suicide (SOS) curriculum, through the local mental health authority or other available resources.
• PHR 4/5N will provide education and guidance to Save A Life Today (SALT) Coalition for suicide prevention outreach. Education and guidance may include sharing conference proceedings, research data, or prevention-related news and updates, with the intent that core group members will disseminate the information in their own counties.
• PHR 6/5S will partner with independent school districts or other organizations to provide suicide prevention trainings and to provide technical assistance with their suicide prevention policy or procedures reviews.
• PHR 9/10 will work with independent school districts, local coalitions, CFRTs, and other local partners to reduce the number of suicides and bullying by promoting evidence based PYD, suicide, and bullying prevention programs in middle and high school. Staff will survey school policies and identify gaps.
• PHR 11 will conduct five ASK About Suicide to Save a Life trainings to help equip their communities with gatekeeper skills. The goal of the trainings is to provide education regarding tools and resources available for suicide prevention.

 

Education will continue to be provided through THS-OPE Modules related to injury prevention and reduction for health care providers, teachers, regional staff, and other relevant youth-serving professionals. MCH will provide subject matter expertise for module reviews in FY22. Topics related to injury prevention include but are not limited to: Preventing Unintentional Injury, Interpersonal Youth Violence, Promoting Adolescent Health, and High-Risk Behaviors in Young People: Screening and Intervention. Additionally, the THS-OPE modules will be promoted and disseminated through Adolescent Health webpages, listservs, and Granicus. Success for this activity is measured in the number of learners completing each module as well as the reach from the various dissemination efforts.

 

Dissemination of and support for DSHS’ Friday Beat, a weekly e-newsletter that is sent to over 7,900 school health stakeholders every Friday, will continue in FY22. The Friday Beat is developed based on CDC’s Whole School, Whole Community, Whole Child approach for their health-related topic information distribution to school nurses and other youth-serving professionals. In FY22, MCH will recommend the importance of topics related to NPM 7 to the school health staff. Additionally, MCH will continue to meet with school health staff on a quarterly basis to discuss collaboration opportunities and priorities.

 

In FY22, MCH will participate in national- and state-level activities such as the Children and Youth Behavioral Health Subcommittee (CYBHS), the National Network of State Adolescent Health Coordinators (NNSAHC), the Texas Medical Home Learning Collaborative, and the Transition to Adult Learning Collaborative to provide subject matter expertise and incorporate successful and evidence-based strategies in the adolescent health domain.

 

MCH will support the CYBHS as it relates to injury prevention, particularly in preventive mental and behavioral health strategies, community-based service systems, care coordination, and family-driven and youth-centered approaches. CYBHS is a subgroup of the Behavioral Health Advisory Committee, which serves as the primary advisory voice to Texas Health and Human Services Commission (HHSC) for issues related to mental health and substance use. The CYBHS provides recommendations on children and youth behavioral health topics and serves as the advisory body for the Texas System of Care, an HHSC framework to provide a spectrum of accessible, responsive, and effective services and supports. MCH will represent DSHS on the CYBHS during FY22 by attending quarterly subcommittee meetings, providing subject matter expertise, and collaborating on cross-sector initiatives.

 

MCH will continue to participate in the National Network of State Adolescent Health Coordinators (NNSAHC) on a bi-monthly basis during FY22. NNSAHC provides a space for collaboration and sharing of evidence-based practices and tips on any barriers or successes faced while implementing youth and young adult programs.

 

SPM 2: To reduce the prevalence of overweight and obesity in Texas children ages 10-21.

Amidst the COVID-19 pandemic, CDC reported strong and consistent evidence that shows children with underlying medical conditions such as overweight and obesity are at increased risk for severe illness compared to children without underlying medical conditions. This health risk is in addition to the associated increased lifetime risks of childhood obesity for adverse health outcomes including diabetes, heart disease, asthma, high blood pressure, depression, sleeping difficulties, and higher risk of being obese as an adult.

 

There are eight counties in Texas where 30% or more children experience food insecurity. Moreover, the 2019 Youth Risk Behavior Surveillance System (YRBSS) showed that less than 15% of students in grades 9-12 consume fruits and vegetables five or more times a day. Racial and ethnic differences in healthy eating habits among adolescents were highlighted in the 2016 Texas School Physical Activity and Nutrition survey; Black students were more likely to report eating foods with low nutrient value three or more times the previous day compared to White/Other and Hispanic students in similar grade levels.

 

The obesity epidemic is a multi-faceted problem that will require changes in social, economic, and built environments that take time. In FY22, MCH’s efforts will focus on leading, funding, and supporting activities that support healthy eating and active living in a variety of settings. SPM 2 is a new performance measure for adolescent health during the 2021-2025 cycle, and activities continue to be reflected on for relevance, success, and feasibility. The effects of the pandemic on overweight and obesity in youth and young adults has yet to be fully examined, but with more families in economic duress, highlighting healthy eating and physical activity and how to adopt these behaviors regardless of socio-economic status is a priority.

 

To address the prevalence of overweight and obese youth and young adults in Texas, MCH leads multiple obesity prevention promotion activities. In FY22, MCH will continue to lead the Nutrition Toolkit Initiative, Adolescent Health quarterly meetings, Adolescent Health webpages, and Adolescent Health Granicus messaging.

 

The Nutrition Toolkit Initiative is an innovative nutrition education initiative that continues the work from the Children’s Healthy Weight Collaborative and the MCH Workforce Development Center’s 2020 Cohort program. The aim of the initiative is to supply MCH staff in the PHRs with a go-to presentation resource on healthy eating – an evidence-based strategy for SPM 2. FY21 involved the creation and piloting of an overview toolkit focused on child, adolescent, and children with special health care needs (CSHCN) health. COVID-19 prolonged the initiative as most PHR staff were focused on direct services for COVID-19 and their bandwidth was limited. However, MCH was able to conduct a needs assessment survey in FY21 on PHR staff that illuminated the need for a specific resource on adolescent nutrition directed at adolescents as the target audience. Thus, FY22 will see the expansion of the initiative by adding another nutrition toolkit specifically focused on adolescent nutrition directed at adolescents. By partnering with obesity prevention, healthy eating, and health promotion subject matter experts, MCH will target youth and young adults in their eating habits to promote evidence-based nutrition recommendations and resources.

 

In FY22, MCH will promote obesity prevention and reduction strategies through intentional and targeted messaging through adolescent health promotional activities. Throughout the planned Adolescent Health quarterly meetings for FY22, MCH will focus on obesity prevention during at least one quarterly meeting with a potential presentation from subject matter experts of MCH-funded activities on obesity prevention and reduction. By engaging youth-serving professionals on SPM 2, MCH hopes to identify and act on opportunities for collaboration and coordination. For more information on the Adolescent Health quarterly meetings, see NPM 7.

 

To address SPM 2 in FY22, MCH plans to collaborate with the Obesity Prevention Program at DSHS to link information specific to adolescents and obesity prevention on the adolescent health webpage. Using the MCH web platform to promote SPM 2 will add an evidence-informed strategy for education and promotion of obesity prevention and reduction strategies. This activity will also highlight the new-to-adolescent health performance measure to youth-centered organizations and stakeholders. See NPM 7 for specifics on the Adolescent Health webpages.

 

As part of MCH’s health promotion strategies in FY22, there are plans to distribute messaging on obesity prevention through the Adolescent Health Granicus, a listserv for youth-center organizations and public health professionals, at least three times throughout the year on different factors associated with overweight and obesity status in youth and young adults. This activity complements MCH health promotion strategies for a more evidence-informed approach to educating Texans on SPM 2. COVID-19 lowered the priority for Granicus messaging, but MCH plans to shift this activity to a higher priority in FY22. For more information on the Adolescent Health Granicus listserv, see NPM 7.

 

MCH funds the University of Texas Health Science Center School of Public Health in Austin (UTHealth) to implement the Texas School Physical Activity and Nutrition (TXSPAN) project. TXSPAN is a statewide surveillance system that monitors trends in body mass index, and health behaviors of children and youth in 2nd, 4th, 8th, and 11th grades. COVID-19 stalled data collection in FY20 and FY21 causing TXSPAN to postpone data collection in schools to FY22. A contingency plan is in place if schools do not allow research on their campuses in FY22 due to the pandemic. Activities that may overlap FY21 and FY22 related to data surveillance include ensuring Institutional Review Board approval, finalizing analyses from data collected during the 2019–2020 school year, and disseminating TXSPAN findings. TXSPAN will also review and update the survey and observation tools and adapt them for virtual and hybrid data collection approaches. Moreover, TXSPAN and MCH will work closely to include pandemic-related questions to allow for at-large comparison of health eating and physical activity behaviors between pre-pandemic and amidst-pandemic data.

 

In FY22, pending ability to go into schools due to COVID-19, TXSPAN will recruit districts and schools as well as prepare for data collection, including training contracted groups, research staff, field staff, school personnel, and UTHealth student volunteers. TXSPAN plans to conduct SPAN measurements at the individual level through parent surveys of 2nd graders, student surveys of 4th, 8th, and 11th graders; and anthropometric measures of 2nd, 4th, 8th, and 11th graders. Data collection at the school level include administering the School Health Policy Survey, conducting the Healthy Signage Observation and Vending Machine Observation, and collection of Campus Improvement Plans. FY22 will also involve TXSPAN performing survey cleaning, dataset cleaning, data entry, and sending survey hard copies to Scantron to scan and create unique datasets by survey type.

 

In addition to data surveillance, TXSPAN also has several dissemination activities planned for FY22. Activities include but are not limited to updating infographics displaying TXSPAN data, updating the TXSPAN Data Explorer that allows health professionals to look through up-to-date health behavior data, and developing publications and presentations using TXSPAN data to disseminate in-person and virtually to a variety of audiences (e.g., public health professionals, parents, and other community stakeholders). Infographic and one-pager topics cover child and youth obesity, nutrition, physical activity, screen time, sleep quality, and sugar-sweetened beverage consumption data. Throughout FY22, TXSPAN will work to ensure these one-pagers are up to date. MCH will use these one-pagers as tools for data dissemination to and education of youth-centered organizations and public health professionals.

 

Partnering with the CSHCN domain to address SPM 2 is a priority for Adolescent Health in FY22. Children and adolescents with mental health conditions and physical disabilities are an important subpopulation of children who require focused attention in relation to obesity prevention. Participation of youth with disabilities in school and other social activities is lower than in the general population of youth. Thus, youth with special health care needs are less likely to be exposed to population-based obesity prevention strategies in schools or community organizations. Activities planned for FY22 to address this priority need are conducting a gap analysis of SPM 2 regarding children and youth with special health care needs and undergo a strategic planning session to ensure alignment and coordination of SPM 2 activities with the CSHCN domain.

 

To educate Texans on obesity prevention and reduction, MCH supports the Texas PHRs, THS-OPE, and Friday Beat.

 

In FY22, PHR staff will address overweight and obesity in youth within their communities. PHR staff will facilitate numerous awareness and education activities. Staff will participate in obesity prevention coalitions and provide subject matter expertise. Staff will also partner with local School Health Advisory Committees (SHACs) to provide technical assistance on implementation of evidence-based school health programs such as Coordinated Approaches to Child Health (CATCH), 5-2-1-0 Healthy Children, and Learn, Grow, Eat, Go!. To further support school health, staff will support the implementation of TXSPAN by facilitating recruitment of schools to participate in data collection. Finally, regional staff will promote obesity prevention resources, such as THS-OPE modules and WIC services, to clients.

 

Education will continue to be provided through THS-OPE Modules related to obesity prevention, nutrition, and physical activity to healthcare providers, teachers, regional staff, and other relevant professionals. MCH will provide subject matter expertise for module reviews in FY22. Modules related to SPM 2 include Management of Overweight and Obesity in Children and Adolescents and Diabetes Screening, Diagnosis and Management, Additionally, the THS-OPE modules will be promoted and disseminated through Adolescent Health webpage, listserv, and Granicus messaging.

 

In FY22, MCH will recommend the importance of topics related to SPM 2 to the school health staff. Activities include dissemination of, and support for, School Health staff’s Friday Beat e-newsletter and quarterly meetings between MCH and School Health staff. For more information on Friday Beat, refer to NPM 7 above.