MCH Block Grant FY21 Application & FY19 Report

Adolescent Health Domain

NPM-09: Bullying: Percent of adolescents, ages 12 through 17, who are bullied or who bully others

FY21 Annual Plan

Annual Plan:

Our objective to decrease the percentage of Utah students in grades 8, 10, and 12 who report that they were bullied in the previous 12 months. This objective will be achieved through the utilization of several different approaches:

1. TEEN Speak is a communications program (total eight hours: including self-study and in-person presentation) that provides parents a menu of strategies they can use to improve communication with their youth;
2. The Upstanding Program, a bystander intervention program with the potential to make a positive difference in a bullying situation, particularly for the youth who is being bullied. The Upstanding Program teaches children simple strategies for standing up to bullying that effectively removes, rather than provides, more peer attention;
3. Physical activity options to increase the number of students who are active through a variety of options throughout the day;
4. The Wyman Teen Outreach Program (TOP) increases teens' ability to build positive connections with others through weekly peer group meetings and community service learning.

Proposed Activities:

• Provide a communications program to the parents of Utah adolescents
• Provide bystander training to school-aged children
• Provide physical activity opportunities to adolescents
• Provide the Wyman Teen Outreach Program to Utah adolescents

New ESMs related to NPM-09*

*The following seven ESMs (9.1 – 9.7) are new for FY21. These ESMs were developed following the 2020 MCH Needs Assessment.

ESM 9.1 – Number of parents with youth between 10-18 years of age that complete the communications course (Teen Speak).

Goal/Objective:

Implement the Teen Speak training with 500 Utah parents in 5 years.

Significance of ESM 9.1:

Teen Speak is a communications program that provides parents a menu of strategies they can use to improve communication with their youth. The program is 8 hours and includes self-study and an in-person presentation.

ESM 9.2 – The number of adolescents who receive bystander training (Upstanding).

Goal/Objective:

Increase the number of adolescents who have received the Upstanding curriculum.

Significance of ESM 9.2:

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.

ESM 9.3 – Percent of adolescents who are physically active at least 60 minutes per day.

Goal/Objective:

Increase the number of students who are active for at least 60 minutes a day, through a variety options, throughout the school day.

Significance of ESM 9.3:

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.

ESM 9.4 – The number of youth participating in the Wyman Teen Outreach Program (TOP).

Goal/Objective:

Increase the opportunities for 400 youth to build positive connections with others through the Wyman Teen Outreach Program.

Significance of ESM 9.4:

The Wyman Teen Outreach Program (TOP) increases teens' ability to build positive connections with others through weekly peer group meetings and community service learning.

ESM 9.5 – The proportion of Utah students participating in an evidence-based school based prevention program (PAX Good Behavior Game).

Goal/Objective:

Increase the proportion of Utah students participating in an evidence-based school based prevention program to reduce referrals for fighting, bullying, and other forms of aggression.

Significance of ESM 9.5:

Multiple systematic reviews of various universal school-based programs demonstrate beneficial impacts on youths’ skills and behaviors, including delinquency, aggression, bullying perpetration, victimization, and bystander skills that lower the likelihood of violence and support victims. For example, among students in pre-kindergarten through high school, the Task Force for Community Preventive Services found a 15% relative reduction in violent behavior. Using different outcome measures, the median relative reduction in aggression and violent behavior associated with universal school-based programs, varied by grade level, with a 32% reduction for pre-kindergarten and kindergarten students, 18% reduction for elementary students, 7% reduction for middle school students, and 29% reduction for high school students.

Researchers suggest the benefits of these school-based approaches could be strengthened if programs implemented at early grade levels are continued into the critical high school years. These programs were effective in reducing youth violence in different types of school environments, including ones with varying socioeconomic status, crime rates, or predominant race/ethnicity of students. Examples of effective classroom-based programs are Good Behavior Game (GBG), Promoting Alternative Thinking Strategies® (PATHS), Life Skills®, Training (LST), and Steps to Respect (STR). The GBG has demonstrated that participants had significantly lower levels of classroom aggression in elementary school, and some studies of the long-term effects of GBG showed significantly lower levels of aggression in middle school and lower prevalence of antisocial personality disorder and violent crime by age 19 to 21.These effects were for male youth with relatively higher levels of early aggression when compared to youth in alternative intervention conditions. These participants also had lower prevalence of alcohol abuse, smoking, and suicidal ideation by the time they reached young adulthood.

PAX improves classroom performance. Compared to their peers, students in PAX classrooms demonstrated higher test scores on Statewide Standardized Math and Reading, higher reading levels, reduced need for Special Education Services, and higher graduation and college entrance rates.

PAX has also been show to Improve mental health outcomes. Students in PAX classrooms demonstrated remarkably fewer problematic behaviors, reduced risk for mental, emotional, and behavioral disorders, fewer symptoms of depression, fewer school-related injuries and symptoms of aggression, reduced rates of bullying, and decreased suicide ideation and fewer attempts.

PAX is also associated with substance use prevention. Students in PAX classrooms demonstrated decreased tobacco use, reduced alcohol use, decreased illicit drug including opioid abuse, and less overall service use for drug abuse or psychiatric disorder.

The PAX Good Behavior Game adheres to SAMHSA’s six key principles of a trauma-informed approach and model for a trauma-informed classroom. PAX creates a nurturing environment in every school and classroom, allowing young people to develop pro-social behaviors in a safe setting far from the predatory environments that encourage anti-social behavior. PAX provides teachers with proven and tested strategies shown to support development, preventing the re-traumatization of children who have been exposed to adversity and violence. PAX strategies allow students to co-create consistent expectations, and summon peer support in creating a nurturing classroom/school environment. The GBG has shown a $64.18 benefit for every $1 investment.

ESM 9.6 – Strengthen Household Economic Security through an uptick in Utah filings for the Earned Income Tax Credit.

Goal/Objective:

Increase the percent of Utahns who qualify and file for the Earned Income Tax Credit from 75% to 83%.

Significance of ESM 9.6:

Bullying is associated with a number of community-level risks, such as concentrated poverty, residential instability, and density of alcohol outlets. Reducing exposure to these community-level risks can potentially yield population-level impacts on youth violence outcomes. Prevention approaches to reduce these risks include changing, enacting, or enforcing laws, city ordinances, and local regulations, and creating policies to improve household financial security, safe and affordable housing, and the social and economic sustainability of neighborhoods. Public-private partnerships and community-driven needs and services are important elements of these approaches. Strengthening household financial security through tax credits, such as the Earned Income Tax Credit (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. Simulations show that a Child Tax Credit of a $1000 allowance per child, paid to each household regardless of income or tax status, would reduce child poverty in the United States from 26.3% to 23.2%; a $2000 allowance per child would reduce child poverty to 20.4%; a $3000 allowance per child would reduce child poverty to 17.6%; and a $4000 allowance per child would reduce child poverty to 14.8%.

ESM 9.7 – Number of Utahns who have been trained in Question, Persuade, Refer (QPR).

Goal/Objective:

Increase the number of Utahns who have been trained in Question, Persuade, Refer (QPR).

Significance of ESM 9.7:

While the 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. When QPR is applied to distressed youth with informed compassion and understanding, the intervention becomes useful for the detection of a wide range of "troubled" behavior, e.g., non-suicidal self-injury (NSSI), perfectionism, eating disturbances, sleep problems, bullying, and other behavioral indices of youth who may be at risk, identified, and treated "upstream" of the onset of suicidal ideation.

MCH Block Grant FY21 Application & FY19 Report

Adolescent Health Domain

SPM-03: Economic Stability: Number of students enrolled in the free or reduced price lunch program

FY21 Annual Plan

Annual Plan:

We will work with the State Board of Education Child Nutrition Program to help increase participation to ensure that the children in Utah have adequate access to safe and nutritious foods. Meeting this basic need is essential to establishing healthy eating patterns and development of a strong foundation for academic achievement. Child Nutrition Programs administer ten federal food programs and sub programs for school nutrition. These programs are appropriated under United States Department of Agriculture (USDA) and administered by Food and Nutrition Service (FNS). The federal food programs are primarily designed to ensure that Local Education Agencies (LEAs) to have the necessary knowledge and resources to enable them to provide children access to safe and healthy foods. The EPICC Program will work with the State Board of Education Child Nutrition Program to continue to support LEAs to strengthen the Local Wellness Policies by using the WellSAT 2.0 assessment tool.

Proposed Activities:

• Support and assistant Local Education Agencies to strengthen Local Wellness Policies by using the WellSAT 2.0. This will be aligned with the Child Nutrition Program Administration Review that is conducted on a five year cycle.
• Work with the Utah State Board of Education to provide professional development opportunities to LEAs, schools, food service, and teachers.
• Work with the State Board of Education, Local Health Departments, and community partners to promote and increase the number of school sites that participate in food programs and sub programs for school nutrition.