Every two weeks the Agency for Health Care Research and Quality (AHRQ) releases an Innovations Exchange newsletter in order to share innovative health practices from around the country that can be adapted by other communities. The Innovations Exchange supports the Agency's mission to improve the quality of health care and reduce disparities.

The current issue focuses on school-based programs for youth at risk. According to AHRQ, many adolescents—particularly those in minority and low-income communities—lack access to health information, preventive care, and clinical services, leaving them at risk for untreated physical and mental health issues. School-based health care delivery, according to AHRQ, can improve access to care and address the needs of this vulnerable population. 

The featured innovations for at risk youth include:

• A school-based program to reduce type 2 diabetes risk factors for children and young adults;
• An inner city school district's reproductive health services model;
• A school-based health center that improved access to mental health services, particularly for minorities.

The newsletter also features quality tools that schools can use to support HIV and STD prevention programs in schools and to facilitate school-based preventive, mental health, nutrition, and oral health services.

>>Read the latest issue of the AHRQ Innovations Exchange.

Shortly after the shooting of 20 children and six adults in Newtown, Ct., a large group of Hollywood stars released a video  asking viewers to “demand a plan” on action to be taken to prevent future mass shootings.  Since then several videos have popped up on YouTube that show almost all of the actors in the video wielding weapons in films and television shows.

Another video also demands a plan on gun violence, with a compelling set of spokespeople. This one stars and was developed with minority teens in California and produced by the California Endowment, a private health foundation. At last check, the teens’ video had gotten close to 750,000 hits on YouTube.

NewPublicHealth spoke with Barbara Raymond, director of youth opportunity at the California Endowment about how the video came to be and what the next steps are for taking action on gun violence.

NewPublicHealth: How did this video come to be?

Barbara Raymond: The Endowment looks at health very broadly, including things that happen in our schools and happen in our neighborhoods. We started work a couple of years ago in 14 communities across California, and through the process we’ve worked with  over 20,000 residents and they came back so strongly saying safety and my own health prevention are our number one issues. And they drilled down further to issues including school safety and school climate and the epidemic of suspensions and extreme school discipline policies.  

We have been able to engage a whole set of young people and they have really identified these issues as well. It’s especially the young people saying that working on these issues is urgent, including violence in the community and on the streets of our neighborhoods, fixing issues in our schools and what the kids call the school-to-prison pipeline. These issues have just come up so strongly so when the Newtown tragedy happened, young people wanted to say something and react to that.  

As staff, we talked about how the tragedy would open up a whole public conversation around mental health and school safety practices and staff members suggested we reach out to the kids with the video idea.  

NPH: How were the kids involved in the development of the video?

Yes, today is Wednesday. But as a new year dawns and New Year's resolutions kick in (learning Zumba and building yoga into our weekly schedule are high on the list for NewPublicHealth staffers) let's call today an honorary Monday—a day to embrace a new plan for health.  The Monday Campaigns are here to help.

With the slogan "The day all health breaks loose," Monday Campaigns are a public health initiative of the Columbia University Mailman School of Public Health, the Johns Hopkins Bloomberg School of Public Health and the Lerner Center for Public Health Promotion at Syracuse University. The goal is to help prevent chronic disease by offering a weekly prompt that can support people in starting and sustaining healthy behaviors.

Why Monday?

Research at Johns Hopkins found that a week is a critical unit of time in planning lives and Monday has special significance as the beginning of the week. People view Monday as a day for a fresh start and a chance to set healthy intentions for the next 6 days. They’re more likely to start diets, exercise regimes, quit smoking and schedule doctor’s appointments on Monday than any other day. And, according to the Hopkins researchers, they’re looking for help in setting and carrying out their healthy intentions for the week.

The campaigns have grown to include government and non-profit organizations, businesses, media outlets and communities. The three schools provide research, case studies, health-related content, marketing concepts and programs ready for individuals, communities and public health departments. Specific campaigns include:

• Meatless Monday 
• Quit & Stay Quit Monday 
• Kids Cook Monday 
• Move It Monday 
• Man Up Monday 
• Caregiver Monday
  

The 2013 campaigns began last Monday, with a weekly series that offers tips for 2013. First up: set some long and short term goals:

A long-term goal can be something to work towards, like getting 2 ½ hours of activity each week or eating 5 servings of produce each day. Short-term goals are the smaller actions you take to build up to your objective.  

>>Weigh in: Which Monday campaigns will your community try this year?

A study released this fall in the American Journal of Public Health looks at a critical evidence-based teen pregnancy prevention program led by the United Way of Greater Milwaukee. The United Way catalyzed critical partnerships between schools, community organizations and the Milwaukee Health Department to focus on the goal of reducing teen pregnancies.

In 2008, United Way of Greater Milwaukee, together with its partners, made a public commitment to reduce teen births among 15- to 17-year-olds by 46 percent by 2015. In October 2011, the City of Milwaukee and United Way announced the fourth consecutive yearly drop in the teen birth rate, by 13.5 percent, to its lowest level in decades. The current trend indicates that the partners are on track to reach their goal of 30 births per 1,000 (a 46 percent drop) by 2015.

Initiatives to support these goals include:

• Significant investments in programs through the Healthy Girls project that helps young people understand the consequences of teen pregnancy while also teaching them the skills needed to cope with social pressure to engage in sexual activity.
• A collaboration with the Medical College of Wisconsin and Children's Hospital of Wisconsin residents to develop content for a youth-focused, website, Baby Can Wait, with medically accurate and age-appropriate content on preventing pregnancy and promoting healthy relationships.
• United Way worked with Milwaukee Public Schools and other community leaders to revise human growth and development curriculum. Community members were given an opportunity to review the materials and make suggestions about content, and teachers received training in the new curriculum.

NewPublicHealth caught up with Nicole Angresano, Vice President at United Way of Greater Milwaukee, to get her take on the program’s successes and what other communities can learn from them.

NewPublicHealth: What is different about this effort to focus on teen pregnancy for your community?

Study: Doctors Say they Need Help Counseling Obese Patients
A survey by researchers at the Johns Hopkins School of Public Health found that only 44 percent of primary care physicians reported success in helping obese patients lose weight. The survey included 500 general practitioners, family practitioners and general internists and the responses show that primary care physicians overwhelmingly support additional training such as nutrition counseling and practiced-based changes such as having scales report body mass index to improve obesity care. Read more on obesity.

New Allocations for School-Based Health Centers Announced
The U.S. Department of Health and Human Services has announced awards of more than $80 million to 197 school-based health center programs around the country. School-based health centers generally provide primary care, mental health care, substance abuse counseling, case management, dental health, nutrition education, health education and health promotion activities. Read more on school health.

Department of Transportation Offers Research Grants for Universities
The U.S. Department of Transportation’s Research and Innovative Transportation Administration is providing $72.5 million in funding for eligible colleges and universities to establish and operate University Transportation Centers (UTCs). Past projects have included a study that identified economic benefits using public-private partnerships for construction of the I-73/74 National Highway System Corridor in West Virginia, and a study from the University of South Florida that helped developed an app for GPS-enabled cell phones to assist riders with disabilities navigate public transportation systems. Read more on transportation.

The use of school-based health services has gained momentum and recognition across the United States as a unique tool in the fight to prevent poor outcomes in both health and education, especially among vulnerable populations. When last surveyed in 2008, the number of school-based or school-linked health clinics in the U.S. had surpassed 1,900. Recently, the federal government has acknowledged their potential, too, creating a distinct grant program for school-based health centers as part of ACA and recognizing them as providers in the Children’s Health Insurance Program Reauthorization Act. [Read more on school-based health center policy developments.]

The typical school-based health center (SBHC) provides free or low-cost basic physical and mental health services, and sometimes oral and vision care. They’ve been shown to reduce asthma-related ER visits and hospitalization costs; reach greater numbers of racial minorities, especially young men; and increase the likelihood by 10 to 20 times that a student uses mental health services. But, the conversation at the American Public Health Association annual meetings was focused on the unique effects these centers are having on students and communities beyond the clinic walls.

Youth Successfully Influencing Their Peers

One session on youth as public health champions covered how receiving services directly on campus involves youth in their own health and the health of their peers in a powerful way. Kathleen Gutierrez from the California School Health Centers Association highlighted innovative ways in which California’s SBHCs are utilizing youth as messengers. 

A new report released today examines state standards for the types of snacks that can be sold in secondary schools. The report was developed by the Kids’ Safe & Healthful Foods Project, a joint initiative of RWJF and The Pew Charitable Trusts that is focused on ensuring all foods and beverages in school are healthy and safe. 

Some of the findings were discussed earlier this week at a session at the American Public Health Association annual meeting, and the full report is now available online. NewPublicHealth caught up with Jessica Donze Black, the project’s director, to learn more about the report.

NewPublicHealth: You’ve just released a new report about school snacks – what did you find?

Jessica Donze Black: We found that the majority of our nation’s students live in states where less healthy snacks like full-fat chips and candy are readily available in snack bars, school stores and vending machines – but there is limited access to healthy snacks. What students are able to buy varies widely from state to state, with some offering healthy snacks and others primarily providing less-healthy snack options.

The report recommends that the U.S. Department of Agriculture issue consistent, science-based standards to ensure all students have access to healthy snacks at school, regardless of where they live. The standards will establish a baseline that will help local communities make healthy choices when choosing what snacks to offer.

NPH: Have any states had success with offering healthy snack foods in schools? 

The Kids Safe & Healthful Foods Project, a collaboration between the Robert Wood Johnson Foundation and The Pew Charitable Trusts, recently posted a Q&A with their director, Jessica Donze Black. The Q&A about new healthy school lunch nutrition guidelines is reposted below.

Q: As the new nutrition guidelines for school meals go into effect, lunches now feature healthier foods and portion sizes. What are the new calorie limits for meals being served in schools?

Jessica Donze Black: The new nutrition guidelines make sure that meals and portions are healthy and “right sized” for kids based on their age. School lunches have always been intended to provide about a third of the recommended daily calories for the average student. Under the new standards, lunches in elementary schools range between 550 and 650 calories, middle school lunches between 600 and 700, and those in high schools have roughly 750 to 850.  These numbers allow schools to serve a large variety of filling foods.

Q: Are these enough calories for highly-active students such as athletes?

The Centers for Disease Control and Prevention is reminding schools and parents that while many interacting with a “class pet” at school can present important opportunities to help children learn responsibility and nurturing, having animals in the classroom can pose a risk of illness and injury if not handled properly. The CDC has a list of over thirty diseases animals can spread, and a fact sheet onanimals in school and daycare settings. Little kids are at increased risk because their immune systems are still developing, also because they are more likely than older kids and grownups to put their fingers in their mouths after touching an animal.

In the United States, human illness from animals include salmonella, E. coli and rabies, and germs that spread the infection can be found in droppings, cages or wherever animals walk around.

The CDC advises that everyone wash their hands right after handling animals, their food and their habitats such as cages, water bowls and toys. Soap and water are best, and if hand sanitizer alone is used, wash hands with soap and water as soon as it is available.

The National Prevention and Health Promotion Strategy offers a comprehensive plan to increase the number of Americans who are healthy at every stage of life. A cornerstone of the Strategy is that it recognizes that good health comes not just from quality medical care, but also from the conditions we face where we live, learn, work and play—such as healthy homes, clean water and air and safe worksites. The strategy was developed by the National Prevention Council, which is composed of 17 federal agencies including the Department of Education, the Department of Housing and Urban Development and others.

As the Strategy is rolled out, NewPublicHealth will be speaking with Cabinet Secretaries, Agency directors and their designees to the Prevention Council about their prevention initiatives. Follow the series here.

We spoke with Arne Duncan, Secretary of the U.S. Department of Education, about the connection between health and education. Listen to the short podcast, and read the full interview below.

NewPublicHealth.org: The Department of Education is a member of the National Prevention Council. Why is health a priority for the Department?

Secretary Duncan: Very simply, if children aren’t healthy they can’t fulfill their academic and social potential. I always talk about the foundation of building blocks for great education, which includes good physical and emotional health. If children can’t see the blackboard they can’t do well. If children are hungry they can’t do well. If children are obese they are not going to do as well as they should. So we have to collectively make sure that children are physically and emotionally healthy so they can think about AP Chemistry and Biology and Physics and the rest of their learning.

NPH: What are the Department of Education’s key target areas and specific initiatives in implementing the National Prevention Strategy?