10/20/2015
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School Health Research: 2015 Updates from CDC
Laura Kann, Ph.D.
Nancy Brener, Ph.D.
Lisa Barrios, Dr.PH
Holly Hunt, M.A.
School Health at CDC
• Split across 2 Centers • NCHHSTP (AIDS Center)
• Division of Adolescent and School Health
• Focuses on HIV and STD prevention
• Retains all 4 school-based surveillance systems
• NCCDPHP (Chronic Disease Center)
• School Health Branch in Division of Population Health
• Focuses on physical activity, nutrition, and obesity
CS231891
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Division of Adolescent and School Health
Division of Adolescent and School Health
Planning, Evaluation and Legislation Team
Gala Edwards, MPA Team Lead
Office of the Director
Director Stephanie Zaza, MD, MPH, FACPM
Deputy Director John R. Moore, PhD, RN
Associate Director for Science Stephen Banspach, PhD
Health Communications Team Tracy Ingraham, BS
Team Lead
Program Development and Services Branch
William Potts-Datema, MS Branch Chief
John Canfield, MEd Deputy Branch Chief
Elizabeth Haller, MEd State Implementation Team Lead
Large City Implementation Team Lead
Research Application and Evaluation Branch
Lisa Barrios, ScM, DrPH
Branch Chief
Leah Robin, PhD
Team Lead
Pete Hunt, MPH, MEd Team Lead
School-Based Surveillance Branch
Laura Kann, PhD
Branch Chief
Nancy Brener, PhD
Survey Operations & Dissemination Team
Lead
Tim McManus, MS
Data Management & Analysis Team Lead
09/22/2014
10/20/2015
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National Center for HIV/AIDS, Viral Hepatitis, STD & TB Prevention
Division of Adolescent and School Health
.
National Center for HIV/AIDS, Viral Hepatitis, STD & TB Prevention
Division of Adolescent and School Health
School-Based Surveillance Branch Division of Adolescent and School Health
Three Domestic Surveillance Systems
• Youth Risk Behavior Surveillance System (YRBSS)
• School Health Policies and Practices Study (SHPPS)
• School Health Profiles (Profiles)
Purposes of the YRBSS
• Focus the nation on behaviors among youth causing the most important health problems • Behaviors that contribute to unintentional injuries and violence
• Sexual behaviors
• Alcohol and other drug use
• Tobacco use
• Unhealthy dietary behaviors
• Inadequate physical activity
• Assess how risk behaviors change over time
• Provide comparable data
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YRBSS Components
• Ongoing
• National school-based YRBS
• State, territorial, and large urban school district YRBS
• Special population surveys
• Previously
• 2010 National Youth Physical Activity and Nutrition Study
• Psychometric and methods studies
• National alternative high school YRBS
• National college YRBS
• National household-based YRBS
YRBS Participation, 1991 – 2015
1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 2013 2015
# of states 26 40 39 38 41 37 43 44 44 47 47 47 47
# of cities 11 14 17 17 17 19 22 23 22 23 22 22 23
# of
territories
2 2 5 5 4 7 5 4 5 4 4 5 2
# of tribal
governments
-- -- -- -- -- -- -- -- -- 2 2 2 3
Total # of
sites
38 56 61 60 62 63 70 71 71 76 75 76 75
% of sites
with
weighted
data
45% 59% 61% 72% 61% 60% 80% 90% 93% 87% 93% 92% ?
YRBSS 2015 Release June, 2016
• Scientific products • MMWR Surveillance Summary
• National, state, and local datasets
• Youth Online
• Fact sheets
• Updated technical resources
• Social media
• Web site: www.cdc.gov/yrbs
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Number of Sites* Asking About Sexual Minority Status, by Year
0
5
10
15
20
25
30
35
40
45
50
Both
Sexual contactonly
Sexual identityonly
*With weighted data.
**Preliminary estimate only.
What is SHPPS?
SHPPS is a national survey periodically conducted to assess school health policies and practices at the state, district, school, and classroom levels
SHPPS was conducted in 1994, 2000, and 2006
SHPPS 2012 State and district data collection
Results released on August 26, 2013
SHPPS 2014 School and classroom data collection
Results released on October 13, 2015
SHPPS content follows Whole School, Whole Community, Whole Child model
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SHPPS 2014
• School- and classroom-level data collection
• National sample of schools and health education and physical education classrooms
• On-site data collection
– Computer-assisted personal interviews
– Vending machine photographs (data will be released in 2016)
SHPPS 2014 Release: www.cdc.gov/shpps
• Web posting of report, fact sheets, datasets, and
documentation • Social media promotion • Twitter Chat on LGBT youth (October 21) • Presentations at national conferences
SHPPS 2016
• District-level data collection
• National sample of public school districts
• Online data collection
• Current activities
– Programming and testing questionnaires
– Obtaining district agreements to participate
• Data collection will begin in early November
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What is Profiles?
• A system of surveys assessing school health policies and practices in states, territories, and school districts
• Conducted biennially by education and health agencies with support from CDC
• Questionnaires administered to middle and high school principals and lead health education teachers
• Mail or online administration
What is Measured by Profiles?
• School health education requirements and content
• Physical education and physical activity
• Practices related to bullying and sexual harassment
• Policies related to tobacco use and nutrition in schools
• School-based health services
• Family engagement and community involvement
• School health coordination
1998 2000 2002 2004 2006 2008 2010 2012 2014
# of states 38 38 43 41 44 50 50 49 50
# of large urban
school districts 10 13 14 13 16 21 20 19 21
# of territories -- -- -- -- -- 5 6 5 3
# of tribal
governments -- -- -- -- -- 2 2 2 --
Total # of sites 48 51 57 54 60 78 78 75 74
Total % of sites
with weighted
data
77% 75% 77% 70% 82% 94% 99% 92% 96%
Profiles Participation, 1998 – 2014
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State and District Participation, Profiles 2014
10/20/2015
Profiles 2014 Release: December, 2015
www.cdc.gov/schoolhealthprofiles
National Center for HIV/AIDS, Viral Hepatitis, STD & TB Prevention
Division of Adolescent and School Health
.
Research Application and Evaluation Branch Division of Adolescent and School Health
10/20/2015
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RAEB 2015 Priorities
Sexual health education Fort Worth Independent School District applied evaluation
Scope and sequence tool
HECAT Institutions of Higher Education Guide
Sexual health services Get Yourself Tested
Modeling HIV testing strategies
Safe and supportive environments Bullying and absenteeism
Parent engagement in schools
Sexual and gender minority youth School-centered HIV prevention for adolescent sexual minority males
Twitter Chat on protective factors for LGBT teens
RAEB 2015 Priorities
Sexual health education Fort Worth Independent School District applied evaluation
Scope and sequence tool
HECAT Institutions of Higher Education Guide
Sexual health services Get Yourself Tested
Modeling HIV testing strategies
Safe and supportive environments Bullying and absenteeism
Parent engagement in schools
Sexual and gender minority youth School-centered HIV prevention for adolescent sexual minority males
Twitter Chat on protective factors for LGBT teens
Fort Worth ISD Applied Evaluation
Introducing new, stronger health education curriculum
Used CDC’s Health Education Curriculum Analysis Tool (HECAT) Selected ETR’s HealthSmart
2014-15 roll out in high schools; this year in middle schools
Extensive professional development (PD) Health education
HealthSmart
Curriculum specialist conducts classroom observations and provides feedback
Does this combined set of efforts result in better outcomes for teachers and students?
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Guidance for Developing a Scope and Sequence for Sexual Health Education
Purpose and essential elements of a scope and sequence
How to design a scope and sequence for sexual health education using the sexual health expected outcomes in the HECAT General steps a school district can use
Example
Available December 2015 at
www.CDC.gov/healthyyouth
A written scope and sequence is an essential part of a curriculum framework and pre-requisite to selecting or identifying curriculum and instructional materials.
HECAT: A Guide for Health Education Teacher Preparation Programs in Institutions of Higher Education (IHE)
Lessons for use by IHE instructors for professional health education teacher preparation programs to improve health education curriculum selection and instruction
6 lessons on the HECAT and how to use it
Instructional materials include objectives, lesson plans, slide presentations with narrative, student activities, activity scoring rubrics, and end of lesson student assessments
Available December 2015 at
www.CDC.gov/healthyyouth
RAEB 2015 Priorities
Sexual health education Fort Worth Independent School District applied evaluation
Scope and sequence tool
HECAT Institutions of Higher Education Guide
Sexual health services Get Yourself Tested
Modeling HIV testing strategies
Safe and supportive environments Bullying and absenteeism
Parent engagement in schools
Sexual and gender minority youth School-centered HIV prevention for adolescent sexual minority males
Twitter Chat on protective factors for LGBT teens
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Get Yourself Tested
Project goal To adapt a multi-component health communication intervention
for use with high school students to
• Increase communication about HIV and STD risk
• Normalize HIV and STD testing
• Increase HIV and STD testing
Participating partners Collaboration with scientists in CDC’s Division of STD Prevention
Chicago Public School District
Parents, students and staff at 2 Chicago high schools
Get Yourself Tested
Project outcomes Preliminary evidence about the effects of GYT on high school
students’ knowledge, attitudes, and behaviors related to HIV and STD
Process to tailor GYT to high schools
Sample GYT materials and messages
Finalize evaluation and report
Peer-review publication(s)
Communicate findings
Minority AIDS Initiative funding for a third year To develop technical assistance resources to assist other schools
with their own GYT adaptation and implementation
Contract expected to run September 2015-March 2017
2 sets of tailored materials for
• education agencies (e.g., school districts, high schools)
• public health practice (e.g., local health departments or health systems, school-based health centers)
: Next Steps
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Modeling HIV Testing Strategies
Project goals Identify yield, cost, and cost-effectiveness of HIV testing among
school-age youth
Refine current population-based guidelines to consider
• At what age should HIV testing begin?
• How should race, region of the country, and sexual risk behavior factor into testing?
• Who should be retested and at what interval?
Data sources & model HIV case reports
• Will estimate undiagnosed HIV infections
Harvard’s “Cost-Effectiveness of Prevention AIDS Complications Model”
RAEB 2015 Priorities
Sexual health education Fort Worth Independent School District applied evaluation
Scope and sequence tool
HECAT Institutions of Higher Education Guide
Sexual health services Get Yourself Tested
Modeling HIV testing strategies
Safe and supportive environments Bullying and absenteeism
Parent engagement in schools
Sexual and gender minority youth School-centered HIV prevention for adolescent sexual minority males
Twitter Chat on protective factors for LGBT teens
Bullying and Absenteeism
More than 15% of bullied students have missed school because of safety concerns ~600,000 high school students
Education agencies can: Share this information
Address electronic bullying
Respond to co-occurring types of bullying
Partner with health professionals
Steiner RJ, Rasberry CN. Brief Report: Associations between in-person and electronic bullying
victimization and missing school because of safety concerns among U.S. high school students. J Adolesc. 2015;43:1-4.
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Promoting Parent Engagement in Schools to Prevent HIV and other STDs among Teens
Provides the rationale for promoting parent engagement in HIV/STD prevention
Released August 2015
Available at: http://www.cdc.gov/healthyyouth/protective/pdf/PE-HIV_prevention_rationale.pdf
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RAEB 2015 Priorities
Sexual health education Fort Worth Independent School District applied evaluation
Scope and sequence tool
HECAT Institutions of Higher Education Guide
Sexual health services Get Yourself Tested
Modeling HIV testing strategies
Safe and supportive environments Bullying and absenteeism
Parent engagement in schools
Sexual and gender minority youth School-centered HIV prevention for adolescent sexual minority males
Twitter Chat on protective factors for LGBT teens
School-Centered HIV/STD Prevention for Adolescent Sexual Minority Males
Project goal To reduce HIV infection and other STD among Black and Latino
sexual minority males aged 13-19 years through school and community-based partnerships by
• Increasing the number tested and treated for HIV and STD
• Reducing sexual risk behaviors
• Reducing absenteeism and school drop-out
Participating partners Broward County Public Schools (Fort Lauderdale, FL)
Los Angeles Unified School District (Los Angeles, CA)
San Francisco Unified School District (San Francisco, CA)
Advocates for Youth
ICF International (evaluation contractor)
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School-Centered HIV/STD Prevention for Adolescent Sexual Minority Males
Project strategies Testing and treatment in schools and school-based health centers
(SBHCs)
Strengthening organizational partnerships, particularly to support testing and treatment
Referring students for testing and treatment
Assessing and implementing policies related to testing, treatment, and prevention interventions
Enhancing healthy school and SBHC environments
Marketing testing, treatment, and referrals
Tailoring and implementing evidence-based sexual risk reduction interventions, as appropriate
Twitter Chat!
Wednesday October 21st from 2:00 to 3:00pm ET
Protective factors and the health of sexual and gender minority youth Findings from project synthesizing knowledge on protective
factors for sexual and gender minority youth
Use #LGBTyouthChat
How can parents and other trusted adults improve the health of LGB youth?
National Center for Chronic Disease Prevention and Health Promotion
Division of Population Health | School Health Branch
School Health Branch
Holly Hunt, MA Chief, School Health Branch
Division of Population Health
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Putting Local School Wellness Policies Into Action: Stories from Districts and Schools
Common themes: Importance of a wellness
champion
Establishing wellness councils
Partnerships
Including parents and students in the process
A need for more quantitative evaluation
http://www.cdc.gov/healthyyouth/npao/wellness.htm
School Health Policies and Practices Study (SHPPS) School-level data
2000, 2006, and 2014
Sample size 554-944 schools Response rates 66%-71%
Mostly school nutrition professionals
9 school nutrition practices Fruits & vegetables
Whole grains
Sodium
MMWR. 2015 Aug 28;64(33):905-8
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Water Access Toolkit Evaluation
Summer (June-Aug
2014)
• Toolkit Launch and Dissemination
• Follow up with key partners
Fall (Sept-
Nov 2014)
• Back to School Dissemination
• 1305 Partner Survey--Assess familiarity with
resource and plans for utilization
Spring (May-June
2015)
• 1305 Partner Survey--Assess experience with the
toolkit and feedback
W
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B
M
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T
R
I
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Chronic Conditions in Children
Prevalence and Cost of 5 Chronic Conditions Asthma Food Allergies Diabetes Epilepsy Hypertension
Offers recent, population-level estimates by demographic and socioeconomic status for each condition estimated from the same national database
Medical Expenditure Panel Survey (MEPS) (2005-2012) 83,552 observations aged 0 to 18 9,772 have at least one chronic condition listed
Under review
Chronic Conditions in Schools
Systematic Review
Relationship between School Health Services and Health and/or Academic Outcomes in Children with Chronic Conditions
Academic Achievement Research Brief
Evidence based research brief addressing the challenges associated with chronic health conditions and academic achievement
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Food Allergy Toolkit for Schools
• 6 audience-specific tip sheets
• 6 audience-specific customizable PowerPoint presentations
• 7 audience-specific podcasts
• Select Resources list for schools
http://www.cdc.gov/healthyschools/foodallergies/index.htm
Parents for Healthy Schools
A set of resources that school groups (e.g., PTA/PTO) can use to engage parents in helping schools create a healthy school environment for students.
Resources:
Parents for Healthy Schools: A Guide for Getting Parents Involved in K-12
Parents for Healthy Schools: Making a Difference in Your Child’s School PowerPoint Presentation
Ideas for Parents
Check-in questions
Release date: November 2015
Community Guide Review
Community Preventive Services Task Force
Obesity Prevention and Control REVIEW IN PROGRESS: School-Based Programs
NEW: Behavioral Interventions that Aim to Reduce Recreational Screen Time Among Children (2014)
www.thecommunityguide.org
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Translation Resources
Online presentation with notes on the WSCC and academic achievement, 2016
New CDC resources for recess, 2016
Update of School Health Index (SHI) to align with WSCC, 2016
Revise the Physical Education Curriculum Analysis Tool (PECAT), 2017
Research Projects
Health and Academics JOSH, October 2015
School Start Times for Adolescents 2011-2012, Aug 2015
Two manuscripts on Comprehensive School Physical Activity Programs National Data about Implementation of Comprehensive School
Physical Activity Programs, 2016
Association of Comprehensive School Physical Activity programs and increased physical activity, 2016
Association between school climate/connectedness and physical activity, 2016
Evaluation Projects
Evaluation of the common measures across 3 Let’s Move Active Schools grant programs, 2016
Evaluation of SHI and Health and Academic Resources, 2015
State Public Health Actions (1305) Evaluation, ongoing
President’s Youth Fitness Program, 2017
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