10/20/2015 - ASHA | American School Health Association · Selected ETR’s HealthSmart 2014-15 roll out in high schools; this year in middle schools Extensive professional development

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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


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

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National Center for HIV/AIDS, Viral Hepatitis, STD & TB Prevention


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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

http://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

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Profiles 2014 Release: December, 2015

www.cdc.gov/schoolhealthprofiles



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Research Application and Evaluation Branch Division of Adolescent and School Health

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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











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











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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”











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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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)

http://www.cdc.gov/healthyyouth/protective/pdf/PE-HIV_prevention_rationale.pdf





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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

E

B

M

E

T

R

I

C

S

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

http://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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Documents

10/20/2015 - ASHA | American School Health Association · Selected ETR’s HealthSmart 2014-15 roll out in high schools; this year in middle schools Extensive professional development