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News
THE ASSOCIATION OF STATE AND TERRITORIAL STATE OFFICIALS
Adolescent and High School Health Update
Volume 4; Number 4 - April 1, 2001
NATIONAL
NEWS
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CDC NEWS
CALENDAR ENDING NOTES |
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| U.S. SURGEON GENERAL RELEASES
REPORT ON SMOKING Surgeon General David Satcher released Women and Smoking: A Report of the Surgeon General on March 27. The report, prepared by the CDC Office of Smoking and Health, summarizes patterns of tobacco use among women and girls, factors associated with starting and continuing to smoke, the health consequences of smoking, tobacco marketing targeted at women, and cessation and prevention interventions. The report includes some of the following findings relevant to adolescent health:
The full report may be accessed online at www.cdc.gov/tobacco/.
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AAP RELEASES GUIDELINES FOR EMERGENCY MEDICAL CARE
IN SCHOOL Children and youth can be injured or become ill during the school day. Such events may require nonurgent, urgent, or emergency health care at school. School administrators, in consultation with the school health nurse and school physician (a pediatrician or other physician knowledgeable about child and adolescent health and school health issues employed or designated by the school) should develop policies and guidelines for all these situations, including emergency health care. Some of the recommendations given by the AAP are listed below:
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| PROGRAM REDUCES RISKY
BEHAVIOR IN YOUTHS WITH HIV Researchers in California report in the American Journal of Public Health that a new program called "Act Safe" has been proven to reduce risky sexual behavior among HIV-positive teenagers. Dr. Mary Jane Rotheram-Borus and colleagues from the University of California at Los Angeles studied the behaviors of 310 HIV-infected teenagers during the two-part intervention project, tracking risky behaviors associated with HIV transmission and then following-up with the students after six months. The "Act Safe" portion of the project focused on educating teens about changing risky behaviors and resulted in significant decreases in sexual encounters with HIV-negative partners, unprotected sexual encounters, and drug use. The "Stay Healthy" portion of the program--which counseled the teens about coping with HIV--demonstrated a better response from the girls than the boys as far as healthier lifestyle changes, although both sexes benefited from the social support issues. Rotheram-Borus, M.J., et al. (2001). Efficacy of a Preventive Intervention for Youths Living with HIV. American Journal of Public Health 91(3), 400-405. PARENTAL INVOLVEMENT AND ACCESSIBILITY OF DRUGS AFFECT ADOLESCENT RISK FOR SUBSTANCE ABUSE Adolescents with parents who supervise them and impose standards of behavior are less likely to abuse substances than those with "hands-off" parents, according to a report published recently by The National Center on Addiction and Substance Abuse (CASA) at Columbia University. The report also indicates that the availability of drugs at schools is related to the risk of adolescent substance abuse. The report findings are based on a survey conducted by QEV Analytics of 1,000 adolescents (ages 12 to 17) as part of the 2000 CASA National Survey of American Attitudes on Substance Abuse. For more information regarding the study and survey, go to: www.casacolumbia.org/publications 1456/publications_show.htm?doc_id=52809. SCHOOL-BASED CURRICULUM FOR ADOLESCENT SMOKING CESSATION PROVES EFFECTIVE A study in this April’s issue of Pediatrics demonstrates the effectiveness of a school-based curriculum in changing smoking behavior for students interested in quitting smoking. The randomized clinical trial was conducted with 74 students from a large public high school over a period of one school year. The students were randomized into two groups to receive either: 1) a 6-week, 8-session, classroom-based, smoking cessation curriculum designed for adolescents (n=35) or 2) an informational pamphlet on how to quit smoking with promise of the classroom curriculum in 3 months (n=39). Change in smoking behavior was measured by 1) self-reported smoking cessation and exhaled carbon monoxide <6 PPM (smoke-free); 2) self-reported quit attempts; and 3) change in cigarettes per day (cpd) at the end of the 6-week curriculum and then 4, 10 and 20 weeks later. Saliva continine was also measured at these points to validate these outcome measures. The results are stated below: |
Results: Participants in the classroom group attended an average of 4.4 sessions. At the end of the curriculum, the classroom group was significantly more likely to be smoke-free (59% vs. 17%), to have tried to quit smoking (82% vs. 54%), and to reduce mean cpd (7.0 vs. 1.0). Four weeks later, these differences persisted: smoke-free (52% vs. 20%), quit attempt (85% vs. 60%), and reduction in mean cpd (6.6 vs. 1.6). At 10 and 20 weeks after the curriculum, 41% and 31%, respectively, of the classroom group remained smoke-free. Once participants in the pamphlet group underwent the classroom intervention (average attendance of 2.2 sessions) their cessation rates were similar to the initial group: 31% at the end of the curriculum and 27% 10 weeks later. Although more research is needed to test the reproducibility, sustainability, and generalizability of this curriculum, it provides encouraging evidence that school-based smoking cessation curricula can be effective in decreasing the rate of smoking among adolescents. Adelman, W.P., Duggan, A.K., Hauptman, P., Joffe, A. (2001). Effectiveness of a High School Smoking Cessation Program. Pediatrics, 107(4) Part 1 of 2: e50. TEENS ON DEPO-PROVERA LESS LIKELY TO USE CONDOMS A recent study by Dr. Pamela J. Murray, head of adolescent medicine at the Children's Hospital of Pittsburgh, found that teenage girls using Depo-Provera, an injected hormonal birth control method, are less likely to use a condom when having sex than girls taking birth-control pills. The survey of 300 sexually active teenage girls revealed that in their most recent sexual encounter, 63 percent of girls on birth control pills used condoms, compared to only 52 percent of girls on the injected hormone. In addition, 97 percent of the girls taking birth control pills reported using condoms in the past, compared to 89 percent of the girls on Depo-Provera--indicating to the researchers that there may be a misconception on the part of the Depo-Provera users that makes them less likely to believe that a condom will prevent sexually transmitted diseases. The researchers also noted that the teens on Depo-Provera were not as likely as those taking birth control pills to believe that their sexual partners would use a condom. MALE INVOLVEMENT IN TEEN PREGNANCY LINKED TO ABUSE, BATTERED MOTHERS A retrospective cohort study in the February issue of Pediatrics demonstrates the relationship between boyhood exposure to physical abuse, sexual abuse, or to a battered mother and the subsequent risk of impregnating a teenage girl. The study used questionnaire responses from 4127 adult men in a primary care clinic, all of whom were members of a large health maintenance organization. Respondents provided the age of the youngest female whom they had impregnated, their own ages at the time, and information regarding childhood exposure to physical or sexual abuse and battered mothers. . |
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| ROBERT WOOD JOHNSON FOUNDATION
(RWJF) LAUNCHES NEW FUNDING PROGRAM The Local Initiative Funding Partners (LIFP) program is a matching grants program designed to establish partnerships between RWJF and local grantmakers in support of innovative, community-based projects that improve health and healthcare for underserved and at-risk populations. LIFP provides 36-to-48 month grants of $100,000 to $500,000. Grants must be matched dollar for dollar by local sources. In 2002, up to $8 million will be awarded under the program. Under LIFP, local grantmakers (such as community foundations, family foundations, corporate grantmakers, and others) propose a partnership with RWJF to fund a new initiative. Grants may be made to community non-profit organizations or institutions with the capacity to implement the new initiative. The grant cycle takes a full year from submission of an initial concept paper to the awarding of matching grants. The deadline for this year is August 1, 2001. For additional information, visit the website at www.lifp.org. FUNDING FOR SCHOOL-BASED NUTRITION PROGRAMS Recent federal legislation allows afterschool programs in Delaware, Michigan, Missouri, Oregon, New York and Pennsylvania to serve suppers as well as snacks to children age 18 and under with less paperwork and red tape. To qualify, an afterschool program must be located in a low-income area where 50 percent or more of the children in one of the schools serving the area are qualified to receive free or reduced-price school meals. The program then receives the highest rate of reimbursement for all the suppers and snacks that are served. This could add up to over $16,500 per year for a program serving 35 children suppers and snacks. If afterschool programs are required by state or local law to be licensed, they must be licensed to participate. Otherwise, they only need to meet local health and safety standards. To apply for the supper program, contact the state agency that administers the Child and Adult Care Food Program (CACFP). For a complete list of state contacts or additional information on CACFP, visit the Food Research and Action Center’s (FRAC) website at http://www.frac.org or contact Crystal Weedal at 202-986-2200, Ext. 3006, or cweedall@frac.org. SAMHSA OFFERS FUNDING TO "BUILD MENTALLY HEALTHY COMMUNITIES" GFA No. SM 01-007 is intended to increase the capacity of cities, counties, and tribal governments to provide prevention and treatment services to meet emerging and urgent mental health needs of communities. It is a services grant that gives funds to local governments like cities, counties (no states are eligible at this time as dictated by the legislation) to build local capacity for services. The grant is for three years and the grantee receives $400,000 per year to implement evidence-based services. Specifically the first part of the GFA addresses MH preventive services and early intervention services for infants, toddlers, pre-school, school-age and adolescents (birth to 18 year olds) and their families. |
One of the grant’s main goals is: "To develop mental health prevention and early intervention services targeted to infants, toddlers, pre-school and school-aged children and adolescents in both mental health and non-mental health settings (Group I)." Other sections of the new GFA address treatment services for adults and adolescents. The deadline for application is May 21, 2001. For additional information regarding this grant, access the website at www.samhsa.gov/grants /content/ 2001/sm01-007.html or call SAMHSA’s Knowledge Exchange Network (KEN) at 1-800-789-2647. FUNDING LIST FOR SCHOOL-BASED HEALTH CARE/MENTAL HEALTH IN SCHOOLS The Center for Mental Health in Schools at UCLA has put together a useful resource for those looking for funding in the area of coordinated school health. Although the list focuses primarily on finding funding for mental health programs, it is useful to anyone looking to finance various aspects of coordinated school health programs. The list may be found at http://smhp.psych.ucla.edu. Click "What’s New" on the left margin and then "Surfing for Funds" on the second page, right hand corner. BILINGUAL/BICULTURAL SERVICE DEMONSTRATION GRANT The Office of Minority Health of the Department of Health and Human Services (HHS) is now offering grants through the Bilingual/Bicultural Service Demonstration Grant Program. The purpose of this grant program for Fiscal Year 2001 is to:
GRANTS FOR COLLABORATIVE COMMUNITY ACTIONS TO PREVENT YOUTH VIOLENCE AND PROMOTE YOUTH DEVELOPMENT SAMHSA has announced the availability of $5 million in grants for collaborative community actions to prevent youth violence and promote youth development. Two types of awards will be made: Level 1 awards, for projects developing youth violence prevention community collaboration and services; and Level 2 awards, for well-established collaborations to enhance collaboration activities and to expand youth violence prevention services. Examples of organizations eligible to apply are community-based advocacy, mental health, and social service groups; public or private education systems; or public or private mental health systems or institutions. Additional information regarding GFA No. SM 01-009 can be accessed at www.samhsa.gov/grants/grants.html. The deadline for application is May 16, 2001. |
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| CDC UPDATES TWO DOCUMENTS
RELATED TO ADOLESCENT AND SCHOOL HEALTH The CDC has recently updated two documents relating to adolescent and school health on their website. The first document, School Health Programs: An Investment in Our Nation’s Future At-A-Glance 2001, highlights the health challenges currently facing young people, why school health education is an effective way to meet those needs, and success stories from some of the 20 states funded by CDC for coordinated school health programs. The publication is available at www.cdc.gov/nccdphp/dash/ataglanc.htm and is also available for download as a pdf document. The second document, Assessing Health Risk Behaviors Among Young People: YRBSS At-A-Glance, highlights the methodology used in the collection of the most recent YRBSS (Youth Risk Behavior Surveillance System) data, addresses how health and education officials use the data, and focuses attention on some of the most important results emerging from the 1999 survey. |
The document is available at www.cdc.gov/nccdphp/dash/yrbs/yrbsaag.htm and is also available for download as a pdf document.ASTHO WELCOMES NEW POLICY ANALYST ASTHO is pleased to welcome Ms. Bendu Cooper as our new Policy Analyst for Primary Care. Bendu is currently enrolled in the Master of Public Health program at The George Washington University School of Public Health and Health Services and is specializing in Epidemiology and Biostatistics. She received her Bachelors degree in Business Administration from the Howard University School of Business where she also participated in a Post Baccalaureate Program in Pre-Medicine. Most recently Bendu worked as Senior Medical Assistant in Hematology/Oncology at GWU Medical Faculty Associates. Prior to enrolling in graduate school, she worked with J.P. Morgan as a financial analyst and with the First National Bank of Maryland as an intern/credit analyst. Bendu has also been active volunteer in a number of service organizations. |
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| STATES OBSERVE NATIONAL
TEEN PREGNANCY PREVENTION MONTH During the month of May, many states will join together to observe National Teen Pregnancy Prevention Month. This year’s theme is "Building on Success," reflecting the important challenge now faced by those working to decrease teen pregnancy amongst the nation’s youth. In the face much "good news" about declining teen pregnancy and birth rates, in addition to decreased sexual activity and better contraceptive use, it is easy to become complacent. To guard against such complacency, various national, state and local groups are launching teen prevention activities to coincide with the May celebrations. The Maryland Governor’s Council on Adolescent Pregnancy will use a "For Teens, By Teens" approach to celebrate Teen Pregnancy Prevention Month. Following last year’s success, the council is holding a billboard design contest for teens ages 12-18. The theme for the contest is "Taking a Stand (Against Teen Pregnancy)." Five winning entries will be chosen and these teens will be given the opportunity to work with a professional advertising team to translate the grand prize-winning concept into a final design. The winning design will also be translated into a postcard to be unveiled at a press conference kicking off Teen Pregnancy prevention Month in early May. In addition to the billboard contest, Maryland is also developing and distributing a Community Action Kit, working with the media on a radio tour, and providing a media exclusive featuring model teen pregnancy prevention and parenting programs across the state. Many other states plan to observe the month in various creative ways. Some of the unique activities that came out of last year’s programs are listed to the right. |
For more information on the many activities planned
around teen pregnancy prevention for the month of May, access the
National Campaign’s website at www.teenpregnancy.org.
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| WEB-BASED TOOL FOR COORDINATED
SCHOOL HEALTH POLICY The California Center for Health Improvement has launched a new on-line resource for people seeking to improve community health through prevention-focused policy change. The site, http://www.healthpolicycoach.org, provides peer-reviewed, searchable health policies arranged under the five broad determinants of health: Healthcare, Education, Safety, Work and Environment. In addition, the site offers "how-to" information and coaching resources for individuals and groups interested in effecting policy change in their communities. Those working to advance coordinated school health will be pleased to find a wealth of policy resources, information and documents dedicated solely to this topic. To access the policy information relating to coordinated school health programs, go to www.healthpolicycoach.org/doc.asp ?id=5188. HIV/AIDS CD-ROM AVAILABLE FOR TEACHER EDUCATION The American Association of Colleges for Teacher Education (AACTE) is pleased to announce the availability of a free curriculum tool for teaching HIV/AIDS prevention to pre-service teachers. "Everything You Wanted to Know about HIV/AIDS in the Classroom, but Were Afraid to Ask: A Teacher's Interactive Journey" is a video-imbedded CD-ROM designed to prepare teacher education students to skillfully engage issues of HIV/AIDS before entering the classroom. This interactive CD-ROM was produced by AACTE and funded by the Centers for Disease Control and Prevention (CDC). It may be borrowed for a period of 2 months. For more information about the CD-ROM and to obtain a copy please contact Leslie A. Bozeman at 202-293-2450 or lbozeman@aacte.org. NEA ANNOUNCES SPANISH LANGUAGE VERSION OF "CAN WE TALK" The National Education Association’s Health Information Network (NEAHIN) has released ¿Conversamos?, a Spanish-language parent-child communication program. The program is a 4-part interactive workshop series for parents designed to help them enhance their role in educating their children about difficult topics such as puberty/sexuality, peer-pressure, self-esteem and mixed media messages. The ¿Conversamos? Training Kit can be purchased for $75 by calling the NEA Professional Library at 1-800-229-4200. To learn more about the ¿Conversamos? Program or how to set up a training in your community, contact Robert Kaiser at 202-882-7723 or visit the Can We Talk website at www.canwetalk.org ADOLESCENT PREGNANCY FACTS RELEASED BY ACOG The American College of Obstetricians and Gynecologists (ACOG) Adolescent Health Program recently released its updated Adolescent Pregnancy FACTS. This bulletin provides national trend data on health risk behaviors of adolescents, sexually transmitted diseases, adolescent pregnancy and pregnancy outcomes. For more information, or to obtain a free single copy, contact adolhlth@acog.org. SCHOOL-BASED HEALTH CENTER BIBLIOGRAPHY AVAILABLE ONLINE The Center for Health and Health Care in Schools has made available an extensive web-based bibliography on school-based health centers. The bibliography covers areas such as access, financing, policy and politics, school/health relationship, staffing and training and utilization. It may be accessed at www.healthinschools.org/sbhcs/biblio.asp |
NEW REPORT ON MENTAL HEALTH IN SCHOOLS The Center for Mental Health in Schools (UCLA) has just released a new publication entitled "Integrating Mental Health in Schools: Schools, School-Based Centers, and Community Programs Working Together." The brief background paper explores why integrated efforts are important within school-based centers, with school programs and personnel, and with community resources. The publication can be accessed at http://smhp.psych.ucla.edu. Once at the home page, click "Center Materials" in the left margin, then "VII. Special Reports & Center Briefs." The document can be found at the end of the page under "Center Briefs." ADOLESCENT RESEARCH PUBLICATION FROM UNIVERSITY OF MINNESOTA School performance and substantial amounts of unsupervised time with friends are particularly significant in predicting teen alcohol and tobacco use, violence, suicide, and sexual activity, according to recent research based on the National Longitudinal Study of Adolescent Health (Add Health). The new publication, Protecting Teens: Beyond Race, Income and Family Structure, points out that for teens, being involved in an ongoing relationship seems to be a primary risk factor in determining whether teens have sex. According to researcher Robert Blum, M.D., "It's really important to know who your kids hang out with, who they are dating, where they are going, who their boyfriends or girlfriends parents are. It's also important to be talking about relationships before they occur." The researchers also found that an adolescent's race and family income level alone "do not with any degree of accuracy, predict his or her health-risk behavior. Other important factors related to sexual behavior among teens included: perceived benefits and costs of having sex (except for Black females); perceived personal and social costs of pregnancy (except for Hispanic males); and perceived knowledge about contraception (except for Hispanic males). In conclusion, the study's authors suggest that the one most consistently protective factor found was the "presence of a positive parent-family relationship." To obtain a copy of the complete monograph, contact: aph@umn.edu or contact the Center for Adolescent Health, University of Minnesota, 200 Oak Street, SE, Suite 260, Minneapolis, MN 55455-2002. The publication may also be accessed online at www.peds.umn.edu/peds- adol/PDFs/10764%20Ethnicity.pdf. NEW PUBLICATION ON TEEN PREGNANCY The National Campaign to Prevent Teen Pregnancy recently released their newest publication, What’s Behind the Good News: The Decline in Teen Pregnancy Rates During the 1990s. This publication addressed three important questions: Why have the rates of teen pregnancies and births declined so dramatically since the early 1990s?; How much of this progress is due to fewer teens having sex and how much to lower rates of pregnancy among sexually active teens?; And, importantly, why are teens being more careful? Researcher Christine Flanigan shows readers that the answers to those questions are not as clear-cut as might be expected. The paper notes that two dynamics are driving the rates down: a smaller proportion of teens having sex at all, and a declining pregnancy rate among sexually active teens. This second factor reflects better contraceptive use and also, perhaps, less sexual activity among those with some sexual experience. Through detailed analysis of the National Survey of Family Growth, the paper offers explanations on the possible contribution of each of these factors to the good news of declining teen pregnancy. Copies of the publication can be purchased from the Campaign’s publication page at www.teenpregnancy.org |
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| July 23-27, 2001 The First National School Health Institute Program The theme of this program is "If Children Have a Safe Harbor, None Will be At Risk". It is sponsored by the Center for School Mental Health Assistance, The Center for Maternal and Child Health (Maryland Department of Health and Mental Hygiene) and the Maryland State Department of Education. Location: Timonium, MD Contact: Sylvia Huntley, (888) 706-0980, or via email at shuntley@psych.umaryland.edu July 30-Aug 1, 2001 Fundamentals of Program Planning and Evaluation: A Skills-Based Course for HIV/AIDS Prevention Providers Sponsored by California STD/HIV Prevention Training Center. This is a three-day course for prevention and education staff who have direct responsibility for planning and evaluating HIV or STD prevention programs in community settings. Location: Berkeley, CA Contact: Andrea Parriott, (510) 883-6600 August 12-15, 2001 2001 National HIV Prevention Conference Location: Atlanta, Georgia Contact: 404) 233-6446 or www.2001HIVPrevConf.org |
Oct 22-23, 2001 2001 Teen Pregnancy Prevention Conference Location: State College, PA Sponsored by Penn State’s College of Health and Human Development and the Pennsylvania Coalition to Prevent Teen Pregnancy will focus on the following four areas: Building Community Support for Pregnancy Prevention, Working with Diverse Communities, Improving Program Development and Impacting Public Policy. Contact: Stephanie Tyworth, Program Planner, (814) 865-0287 or sst3@outreach.psu.edu or see the website at www.cde.psu.edu/C&I /Teen Pregnancy/default.html. June 20-22 National School-Based Health Care Conference The theme of this conference is "School Based Health Centers and their Communities: A Catalyst for Children’s Health. The conference is sponsored by the National Assembly on School-Based Health Care along with numerous other sponsors, including W.K. Kellogg Foundation, University of Miami School of Nursing and the Health Foundation of Central Florida. Location: Denver, CO Contact: visit www.nasbhc.org/AMINFO.htm |
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| TO CONTACT US Help keep our calendar up to date! Let us know if your state is releasing a report, hosting a meeting, or any other information or event that may be of interest to your colleagues. Send information to Rachelle Johnsson-Chiang at rjohnsson-chiang@astho.org by the 10th of every month. |
ACKNOWLEDGMENT The Adolescent and School Health Update is produced monthly by ASTHO under Cooperative Agreement U87/CCU310224-06 with the CDC Division of Adolescent and School Health. Amy Greene, Project Director Adolescent and School Health agreene@astho.org Rachelle Johnsson-Chiang, Policy Analyst Adolescent and School Health rjohnsson-chiang@astho.org |
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