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Priority Health Topic: Violence Prevention


Background & History

Violence remains a significant preventable health issue for Alaskans today. In the State Health Assessment, survey respondents noted that violence in Alaska was a topic that was very or extremely concerning to them. Violence prevention was represented in the HA2020 plan with the LHI’s 11, 12, and 13, that addressed child maltreatment, adolescent dating violence, and rape. There was no significant progress with all Alaskans to meet the targets for the child maltreatment and rape indicators in the HA2020 plan, but the adolescent dating violence target was successfully met.

The HA2030 teams decided to keep a HA2020 objective on child maltreatment since there was no significant progress made by 2020. The measure for HA2030 was changed to “percent of repeated substantiated child maltreatment within the last 12 months” to better align with the measurement data being tracked for federal reporting. The repeated incidence also gives a better picture of the potential impact of interventions and prevention efforts on this objective. HA2030 also retained the HA2020 indicator focused on rape for the HA2030 plan. There is acknowledgment of several data limitations, including issues with underreporting, case backlogs, and no national Alaska Native/American Indian dataset, but the objective itself is considered important and efforts to make progress on it are priority.  This measure is based on the only known source for rape data that has a national comparison.

The HA2030 teams decided to keep the HA2020 indicator focused on adolescent dating violence for HA2030. This is supported with a reliable data source in the YRBS to measure it semi-annually. The progress on this objective helps to reflect the work that is being done across the state on adolescent dating violence and can be used to help the continued funding of this priority work.

Objective 28: Reduce the percentage of repeated substantiated child maltreatment within last 12 months

Target: 9.5%

Strategy 1: Promote early intervention in maltreatment and with families at risk for maltreatment

Addressing some of the support related issues that cause conditions that may result in contact with the Office of Children’s Services is one way to prevent further escalation of child neglect and maltreatment and perhaps additional contact with OCS. Preventive services as a cost savings action.

Sources:

  • Mathematica-Cody 2010– Cody S, Reed D, Basson D, et al. Simplification of health and social services enrollment and eligibility: Lessons for California from interviews in four states. Princeton: Mathematica Policy Research (MPR); 2010.
  • RAND-Europe 2012– RAND Europe, Ernst & Young LLP. National evaluation of the DH integrated care pilots. RAND Health Quarterly. 2012;2(1):8.
  • MDRC-Support center– Manpower Demonstration Research Corporation (MDRC). Work advancement and support center demonstration.
  • King 2006*– King G, Meyer K. Service integration and co-ordination: A framework of approaches for the delivery of co-ordinated care to children with disabilities and their families. Child: Care, Health, and Development. 2006;32(4):477-492.
  • Packard 2013– Packard T, Patti R, Daly D, Tucker-Tatlow J. Implementing services integration and interagency collaboration: Experiences in seven counties. 2013;37(4):356-371.
  • Fisher 2012*– Fisher MP, Elnitsky C. Health and social services integration: A review of concepts and models. Social Work in Public Health. 2012;27(5):441–68.
  • Guerrero 2014*– Guerrero EG, Henwood B, Wenzel SL. Service integration to reduce homelessness in Los Angeles County: Multiple stakeholder perspectives. Human Service Organizations: Management, Leadership & Governance. 2014;38(1):44-54.
  • Rosenheck 2001– Rosenheck R, Morrissey J, Lam J, et al. Service delivery and community: Social capital, service systems integration, and outcomes among homeless persons with severe mental illness. Health Services Research. 2001;36(4):691–710.
  • YG-Program search– Youth.gov (YG), Interagency Working Group on Youth Programs (IWGYP). Evidence-based program directories: Program directory search.
  • Smith 2013*– Smith TJ. One Stop Service Center Initiative: Strategies for serving persons with disabilities. Journal of Rehabilitation. 2013;79(1):30-36.
  • IHI-Craig 2011*– Craig C, Eby D, Whittington J. Care Coordination model: Better care at lower cost for people with multiple health and social needs. IHI Innovation Series white paper. Cambridge, MA: Institute for Healthcare Improvement; 2011.
  • CWF-McGinnis 2014– McGinnis T, Crawford M, Somers SA. A state policy framework for integrating health and social services. Commonwealth Fund (CWF). 2014.
  • CDC-Community center– Alcaraz R. New community center to prevent youth violence. Atlanta: Centers for Disease Control and Prevention (CDC), US Department of Health and Human Services (US DHHS).

Action Step 1

ActionDevelop information sharing agreement for OCS to share intake cases that are screened out or those who are repeatedly screened out with local agencies, Tribes or contractor who works for local agencies. Tribes to reach out to screened out families who have provided consent to assess and address conditions with the aim of preventing further contact with OCS and escalation of child neglect or abuse.
MeasureOCS has either developed a data sharing agreement and mechanism to share screened out information with a contractor or developed an internal process to supported screened out families in place
Timeframe2020-2025
Key Partners• State of Alaska, Office of Children’s Services
• Alaska Children’s Trust
• R.O.C.K Mat-Su
• Alaska Impact Alliance

Action Step 2

ActionExplore funding for contractors to provide outreach to families who have been screened out of the OCS case intake system to help support their needs.
MeasureFunding secured and contract in place
Timeframe2020-2025
Key Partners• State of Alaska, Office of Children’s Services
• Alaska Children’s Trust
• R.O.C.K Mat-Su

Strategy 2: Promote early childhood home visiting programs

Early childhood home visitation programs (such as Nurse Family Partnerships, Parents as Teachers, Early Head Start, Head Start, and Infant Learning Programs) are recommended to prevent child maltreatment on the basis of strong evidence that these programs are effective in reducing violence against visited children. Programs delivered by professional visitors (i.e., nurses or mental health workers) seem more effective than programs delivered by paraprofessionals, although programs delivered by paraprofessionals for ≥2 years also appear to be effective in reducing child maltreatment. Home visitation programs in this review were offered to teenage parents; single mothers; families of low socioeconomic status (SES); families with very low birth weight infants; parents previously investigated for child maltreatment; and parents with alcohol, drug, or mental health problems. (From The Community Guide)

Sources:

  • http://www.thecommunityguide.org/violence/home/RRchildmaltreatment.html
  • http://www.crimesolutions.gov/ProgramDetails.aspx?ID=187
  • http://policyforchildren.org/wp-content/uploads/2013/08/Effectiveness-of-Early-Head-Start.pdf
  • Sama-Miller 2017– Sama-Miller E, Akers L, Mraz-Esposito A, et al. Home visiting evidence of effectiveness review: Executive summary. Washington, DC: Office of Planning, Research and Evaluation, Administration for Children and Families, US Department of Health and Human Services; 2017.
  • Casillas 2016*– Casillas KL, Fauchier A, Derkash BT, Garrido EF. Implementation of evidence-based home visiting programs aimed at reducing child maltreatment: A meta-analytic review. Child Abuse and Neglect. 2016;53:64-80.
  • Selph 2013– Selph SS, Bougatsos C, Blazina I, Nelson HD. Behavioral interventions and counseling to prevent child abuse and neglect: A systematic review to update the U.S. Preventive Services Task Force recommendation. Annals of Internal Medicine. 2013;158(3):179–90.
  • Peacock 2013– Peacock S, Konrad S, Watson E, Nickel D, Muhajarine N. Effectiveness of home visiting programs on child outcomes: A systematic review. BMC Public Health. 2013;13:17.
  • Sweet 2004*– Sweet MA, Appelbaum MI. Is home visiting an effective strategy? A meta-analytic review of home visiting programs for families with young children. Child Development. 2004;75(5):1435-56.
  • MacLeod 2000*– MacLeod J, Nelson G. Programs for the promotion of family wellness and the prevention of child maltreatment: A meta-analytic review. Child Abuse & Neglect. 2000;24(9):1127-49.
  • CG-Violence– The Guide to Community Preventive Services (The Community Guide). Violence.
  • Cochrane-Kendrick 2013*– Kendrick D, Mulvaney CA, Ye L, et al. Parenting interventions for the prevention of unintentional injuries in childhood. Cochrane Database of Systematic Reviews. 2013;(3):CD006020.
  • Roberts 1996– Roberts I, Kramer MS, Suissa S. Does home visiting prevent childhood injury? A systematic review of randomised controlled trials. BMJ. 1996;312(7022):29-33.
  • MDRC-Michalopoulos 2017– Michalopoulos C, Faucetta K, Warren A, Mitchell R. Evidence on the long-term effects of home visiting programs: Laying the groundwork for long-term follow-up in the Mother and Infant Home Visiting Program Evaluation (MIHOPE). Washington, DC: Manpower Demonstration Research Corporation (MDRC). 2017.
  • Goyal 2013*– Goyal NK, Teeters A, Ammerman RT. Home visiting and outcomes of preterm infants: A systematic review. Pediatrics. 2013;132(3):502-516.
  • Issel 2011– Issel LM, Forrestal SG, Slaughter J, Wiencrot A, Arden H. A review of prenatal home-visiting effectiveness for improving birth outcomes. Journal of Obstetric, Gynecologic & Neonatal Nursing. 2011;40(2):157-65.
  • Kendrick 2000*– Kendrick D, Elkan R, Hewitt M, et al. Does home visiting improve parenting and the quality of the home environment? A systematic review and meta analysis. Archives of Disease in Childhood. 2000;82(6):443-51.
  • Cochrane-Dennis 2013*– Dennis CL, Dowswell T. Psychosocial and psychological interventions for preventing postpartum depression. Cochrane Database of Systematic Reviews. 2013;(2):CD001134.
  • El Fadl 2016– El Fadl RA, Blair M, Hassounah S. Integrating maternal and children’s oral health promotion into nursing and midwifery practice – A systematic review. PLOS ONE. 2016;11(11):e0166760.
  • RAND-Kilburn 2017*– Kilburn MR, Cannon JS. Home visiting and use of infant health care: A randomized clinical trial. Pediatrics. 2017;139(1):e20161274.
  • Cochrane-Yonemoto 2017*– Yonemoto N, Dowswell T, Nagai S, Mori R. Schedules for home visits in the early postpartum period. Cochrane Database of Systematic Reviews. 2017;(7):CD009326.
  • Cochrane-Lopez 2015*– Lopez LM, Grey TW, Hiller JE, Chen M. Education for contraceptive use by women after childbirth. Cochrane Database of Systematic Reviews. 2015;(7):CD001863.
  • Maravilla 2016*– Maravilla JC, Betts KS, Abajobir AA, Couto e Cruz C, Alati R. The role of community health workers in preventing adolescent repeat pregnancies and births. Journal of Adolescent Health. 2016;59(4):378-390.
  • Prosman 2015*– Prosman GJ, Lo Fo Wong SH, van der Wouden JC, Lagro-Janssen ALM. Effectiveness of home visiting in reducing partner violence for families experiencing abuse: A systematic review. Family Practice. 2015;32(3):247-256.
  • Sharps 2016*– Sharps PW, Bullock LF, Campbell JC, et al. Domestic violence enhanced perinatal home visits: The DOVE randomized clinical trial. Journal of Women’s Health. 2016;25(11):1129-1138.
  • Mraz Esposito 2017– Mraz Esposito A, Coughlin R, Malick S, et al. Assessing the research on home visiting program models implemented in tribal communities – Part 1: Evidence of effectiveness. Washington, DC: Office of Planning, Research and Evaluation, Administration for Children and Families, US Department of Health and Human Services; 2017.
  • Cochrane-Turnbull 2012*– Turnbull C, Osborn DA. Home visits during pregnancy and after birth for women with an alcohol or drug problem. Cochrane Database of Systematic Reviews. 2012;(1):CD004456

Action Step 1

ActionIdentify need for services, gaps in services, program expansion opportunities, and potential resources through the State of Alaska DHSS Division of Public Health Section of Women’s Children’s, Family Health Maternal Infant Early Childhood Home Visiting (MIECHV) Needs Assessment.

This assessment is a resource to assist in meeting the needs of families. It will 1. Identify communities with concentrations of risk, 2. Identify the quality and capacity of existing programs for early childhood home visiting 3. Discuss the State’s capacity for providing substance abuse treatment 4. Coordinate with other early childhood partner’s and program’s needs assessments.
MeasureMaternal Infant Early Childhood Home Visiting (MIECHV) Needs Assessment completed
Timeframe2020-2025
Key Partners• State of Alaska, Division of Public Health, Section of Women’s, Children’s, and Family Health
• AK Early childhood Coordinating Council
• State of Alaska, Department of Education and Early Development

Action Step 2

ActionProvide training, coaching, and ongoing support for home visit programs regarding the impacts of adverse childhood experiences and supportive interventions.
MeasureNumber and percent of home visiting staff participating in training and coaching.
Timeframe2020-2025
Key Partners• State of Alaska, Division of Public Health, Section of Women’s, Children’s, and Family Health
• State of Alaska, Office of Children’s Services
• AK Early Childhood Coordinating Council
• State of Alaska, Department of Education and Early Development
• Southcentral Foundation
• Providence Nurse Family Partnership
• Kid’s Corps
• Southeast Alaska Association for the Education of Young Children (AEYC)
• RurAL CAP
• Alaska Family Services

Action Step 3

ActionConduct comprehensive impact evaluation on current home visiting programs that the State of Alaska Division of Public health funds.
MeasureCompleted evaluation report with recommended actions.
Timeframe2020-2025
Key Partners• State of Alaska, Division of Public Health, Section of Women’s, Children’s, and Family Health
• State of Alaska, Department of Education and Early Development
• Alaska Early Childhood Coordinating Council
• Help Me Grow

Strategy 3: Adopt a universal Pre-K education system in Alaska for children ages 0-5

According to Robert Wood Johnson County Health Ranking and Roadmaps What works for health, publicly-funded pre-kindergarten (pre-K) programs are large-scale efforts to provide school-based early learning opportunities to preschool aged children. Programs are voluntary and can be for 3- and 4-year-olds, though programs often only or disproportionately serve 4-year-olds. Publicly-funded pre-K programs can be universally available regardless of family income or focus on specific populations, usually children from low income backgrounds. Programs also vary based on state early learning standards and guidelines for choosing curricula. Public pre-K programs are typically funded by the state but can be funded by municipalities and school districts (Brookings-Phillips 2017).  The expected beneficial outcomes of universal pre-K programs is increased academic achievement, increased school readiness, improved social emotional skills, reduced child care costs, and longer terms increased earnings.

Sources:

  • There is strong evidence that publicly-funded pre-kindergarten (pre-K) programs improve school readiness and increase academic achievement (Brookings-Phillips 2017, Gormley 2018, Haslip 2018, Lipsey 2018, Hustedt 2015*), especially among children from disadvantaged backgrounds (Brookings-Phillips 2017, Fitzpatrick 2008*, Gormley 2005*, Dorman 2017*, NIEER-Lamy 2005*) and English language learners (Lipsey 2018, Brookings-Phillips 2017, Peisner-Feinberg 2013). However, additional evidence is needed to confirm long term effects (Brookings-Whitehurst 2018, Brookings-Phillips 2017, Hill 2015b*).
  • In general, children who attend preschool demonstrate gains in cognitive and social skills (Camilli 2010*, Manning 2010*, Burger 2010*), as well as modest improvements in social-emotional and self-regulatory development (Brookings-Phillips 2017). State-sponsored pre-K programs, whether universal or not, improve children’s language, math, and reading skills (Wong 2008). Among children from lower income backgrounds, state pre-K enrollment is associated with increased time reading at home, likelihood that mothers work, and improved test performance, often lasting through eighth grade (Brookings-Cascio 2013). In an Oklahoma-based study of universal pre-K, positive effects on math achievement, enrollment in honors courses, and grade retention persist through middle school for pre-K participants, although effects on standardized test scores diminish over time (Gormley 2018). 
  • State universal pre-K programs are associated with increases in licensed child care availability and enrollment in formal care among 4-year-olds, and enrollment decreases among 3-year-olds (Bassok 2016*). Attending high-quality universal pre-K increases the likelihood a child will be diagnosed with asthma, hearing, or vision problems and receive treatment (NBER-Hong 2017).
  • Several universal pre-K programs demonstrate stronger effects for Hispanics, blacks, and children from very poor families than for whites and children from more advantaged families (NBER-Cascio 2017, Gormley 2005*). Georgia’s universal pre-K program benefits disadvantaged children in rural areas the most, possibly because they cannot access alternative pre-K programs (Fitzpatrick 2008*). Effects for low income children in such programs diminish with time but can last through fourth grade in reading and eighth grade in math (Brookings-Cascio 2013). Effects may be more likely to persist for students enrolled in more mature pre-K programs (Hill 2015b*) or for students who continue to receive interventions through grade school (Brookings-Phillips 2017). Economically integrated pre-K programs may improve academic achievement more for children from low income families than programs that only serve children from disadvantaged backgrounds (Miller 2017a*, NBER-Cascio 2017).
  • The quality of pre-K classroom experience varies significantly by community characteristics (Bassok 2016a*). In states with high levels of residential segregation, black and Hispanic children from low income backgrounds often experience worse publicly-funded pre-K environments than white children in more affluent areas (Valentino 2018).
  • Some researchers recommend states focus resources on minority and disadvantaged children, who will benefit the most from pre-K access (Fitzpatrick 2008*). Others contend that universal pre-K should be promoted as it garners more public support than programs for vulnerable populations (Gormley 2005*). Offering preschool universally can increase enrollment for children of all income levels. Among high income families, universal programs can reduce child care costs as families enroll their children in public preschool (Brookings-Cascio 2013). Universal pre-K can reach children from lower income backgrounds who do not meet eligibility requirements for targeted programs and otherwise may not enroll in preschool (NBER-Cascio 2017).
  • Preliminary evidence indicates that pre-K programs that focus on instruction and coaching learners as they think through tasks can yield more cognitive growth than those focused on child-directed play and exploration (Chien 2010*). Explicit academic instruction, low staff-to-student ratios (Camilli 2010*), good classroom management, and emotional support can improve children’s cognitive and social outcomes (Hamre 2013*). High quality, successful pre-K programs can support early learning through well implemented, evidence-based curricula, coaching for teachers, initiatives to promote orderly and active classrooms (Brookings-Phillips 2017), and strong instructional and emotional support systems (Anderson 2017a*). Challenges for such programs include staff turnover, student enrollment levels, staff time to complete accountability requirements for public funding, and government regulation changes (Dorman 2017*).
  • In 2017-18, state pre-K programs spent an average of $5,175 per student in addition to federal and local funding (NIEER-Friedman-Krauss 2019). One model suggests additional costs for taxpayers would be between $2 and 4 billion annually to increase access to state pre-k programs enough to cover all 4-year-olds currently without access to such programs (Brookings-Whitehurst 2015).

Action Step 1

ActionPassage of Senate Bill 6 (SB6) increasing access to early childhood education.
MeasurePassage of SB6 (BASIS)
Timeframe2020-2025
Key Partners• AK Children’s Trust
• Local government, service providers and coalitions
• RuralCAP: Parents as Teachers program
• Dept of Education

Action Step 2

ActionSupport communities (i.e. local governments, service providers and coalitions) to explore potential of generating local revenue dedicated to the investment in early childhood education.
MeasureNumber of communities who dedicate funds to support early childhood education.
Timeframe2020-2025
Key Partners• AK Children’s Trust
• Local government, service providers and coalitions

Strategy 4: Decrease the rate of children that are uninsured in Alaska

According to the Robert Wood Johnson Foundation County Health Rankings and Roadmaps What Works for Health, Health insurance enrollment outreach and support programs assist individuals whose employers do not offer affordable coverage, who are self-employed, or unemployed with health insurance needs. Such programs can be offered by a variety of organizations, including government agencies, schools, community-based or non-profit organizations, health care organizations, and religious congregations. Outreach activities vary greatly, and can include community health worker (CHW) efforts, other person-to-person outreach, mass media and social media campaigns, school-based efforts, case management, or efforts in health care settings. Outreach can occur at local events, via hotlines, or at fixed locations (e.g., community centers, non-profit offices, etc.) and are often supported through grants from federal agencies or private foundations. The expected outcomes of this strategy is increased health insurance coverage for children.

Sources:

  • There is some evidence enrollment outreach and support activities increase enrollment in health insurance programs (Mathematica-Hoag 2014), especially among children (Cochrane-Jia 2014*, Cousineau 2011). However, additional evidence is needed to confirm effects.
  • Health insurance application support and information by community-based case managers may increase enrollment of uninsured children and reduce the time it takes for them to be enrolled (Cochrane-Jia 2014*). Providing insurance applications to families seeking care in emergency departments may also increase child enrollment (Cochrane-Jia 2014*). Multi-component approaches may also increase new enrollments of children (Cousineau 2011).
  • Based on the experience of programs working to enroll children in public insurance programs, school-based programs and campaigns appear to be successful strategies to reach those who are uninsured (Urban-Courtot 2009, Mathematica-Irvin 2006). An evaluation of Covering Kids and Families, a broad effort to reach uninsured children and their families, indicates that the program increases awareness of the availability of public health insurance programs for low and moderate income families, and may increase enrollment (Urban-Courtot 2009).
  • Partnering with other organizations (Urban/SHADAC-Courtot 2012, Urban-Courtot 2009) and using a mix of targeted messages and approaches is often recommended for successful outreach and enrollment activities (Urban/SHADAC-Courtot 2012). Including technology-based systems (e.g., online benefit applications) in enrollment efforts may maximize enrollment overall, while more traditional methods (e.g., community health worker outreach) may increase enrollment among harder to reach populations (Cousineau 2011). Outreach efforts that consider cultural and linguistic norms appear to increase insurance enrollment among Hispanic populations (AHRQ HCIE-Capitman, AHRQ HCIE-Chaves-Gnecco).

Action Step 1

ActionDevelop a mobile texting system to provide information and support related to Medicaid/CHIP to potential eligible families. (Funded by AK Children’s Trust (Partnership between AK Children’s Trust and 2-1-1/United Way of Anchorage)
MeasureMobile texting system in place and in use
Timeframe2020-2021
Key Partners• AK Children’s Trust
• 2-1-1 United Way of Anchorage
• ASHNA
• ANTHC

Action Step 2

ActionLaunch an outreach program in the 4 primary communities (Anchorage, Mat-Su Valley, Fairbanks and Kenai) to notify families of the resource. (Funded by AK Children’s Trust (Partnership between AK Children’s Trust and 2-1-1/United Way of Anchorage)
MeasureOutreach program implemented in 4 primary communities
Timeframe2020-2022
Key Partners• AK Children’s Trust
• 2-1-1 United Way of Anchorage

Strategy 5: Promote parent education programs

There is some evidence that parent education and engagement classes such as Parents as Teachers (PAT) improves cognitive skills and school readiness among children from families with low incomes (YG-PAT, Welsh 2014, PPN). These coures can also have positive effects on child development (Avellar 2013). Additional evidence is needed to confirm effects.

Sources:

  • YG-PAT– Youth.gov (YG), Interagency Working Group on Youth Programs (IWGYP). Parents as Teachers (PAT).
  • Welsh 2014– Welsh JA, Bierman KL, Mathis ET. Parenting programs that promote school readiness. In Boivin M, Bierman KL, eds. Promoting School Readiness and Early Learning: The Implications of Developmental Research for Practice. New York: Guilford Press; 2014:253-278.
  • PPN– Promising Practices Network (PPN). On children, families and communities.
  • Avellar 2013– Avellar SA, Supplee LH. Effectiveness of home visiting in improving child health and reducing child maltreatment. Pediatrics. 2013;132(Suppl 2):S90–S99.
  • Zigler 2008*– Zigler E, Pfannenstiel JC, Seitz V. The Parents as Teachers program and school success: A replication and extension. Journal of Primary Prevention. 2008;29(2):103-20.
  • Carroll 2015*– Carroll LN, Smith SA, Thomson NR. Parents as Teachers Health Literacy Demonstration project: Integrating an empowerment model of health literacy promotion into home-based parent education. Health Promotion Practice. 2015;16(2):282–290.
  • PAT– Parents as Teachers (PAT).

Action Step 1

ActionDevelop and launch Request for Proposals (RFP) targeting 13 identified rural communities with greatest need for parenting classes.
MeasureNumber of adults and children trained in parenting classes
Timeframe2020-2022
Key Partners• AK Children’s Trust
• State of Alaska, Office of Children’s Services

Action Step 2

ActionAward parent training grants and provide on-going support to selected grantees.
MeasureNumber of grant awards issued
Timeframe2020-2022
Key Partners• AK Children’s Trust
• State of Alaska, Office of Children’s Services

Strategy 6: Implement child welfare compacting

The Alaska Tribal Child Welfare Compact is a one of a kind landmark government-to-government agreement between the State of Alaska and Alaska Tribes and Tribal organizations that recognizes the Tribes’ inherent authority to oversee placement of their children and provide child welfare services. This umbrella agreement broadly defines the services and support that are to be carried out by each Tribe (Co-Signer) within their service area and memorializes how information and resources are shared between the State and each Co-Signer. This unique Compact has been created in the hopes of reducing the disproportionate number of Alaska Native children in State custody and improving the lives of Alaska Native families state-wide.

Sources:

  • The Compact’s novelty (started in 2017) makes it difficult to gauge its effectiveness up to this point. However, a formal evaluation of the Compact is currently underway

Action Step 1

ActionRemove barriers to establishing child welfare compacting.
MeasureExistence of child welfare compacting.
Timeframe2020-2025
Key Partners• State of Alaska, Office of Children’s Services
• Tribal Health Orgs

Objective 29: Reduce the rate of reported or attempted rape per 100,000

Target: 146.5 per 100,000

Strategy 1: Strengthen the capacity of communities to prevent violence through coalition work, data driven practices and evaluation

The strategies presented in this Report Form are from the Center for Disease Prevention and Control (CDC) STOP SV: A Technical Package to Prevent Sexual Violence, which highlights strategies based on the best available evidence to help communities and states prevent and reduce sexual violence. Many of the strategies focus on reducing the likelihood that a person will engage in sexual violence. These strategies include the following: 1) Promote Social Norms that Protect Against Violence, 2) Teach Skills to Prevent Sexual Violence, 3) Provide Opportunities to Empower and Support Girls and Women, 4) Create Protective Environments, and 5) Support Victims/Survivors to Lessen Harm.

Community initiatives in Alaska, supported by state and federal funds, are encouraged to be comprehensive, coalition driven, and culturally relevant. Ensuring that Alaskan communities are engaged in supporting the social and structural environments that promote healthy relationships is a key strategy across many statewide plans.
Preventing sexual violence requires addressing factors at all levels of the social ecology—the individual, relational, community, and societal levels. The strategies presented below are focused on primary prevention efforts.

Sources:

  • https://www.cdc.gov/violenceprevention/sexualviolence/prevention.html
  • https://andvsa.org/pathways/
  • UCR Crime in Alaska 2018 Publication-https://dps.alaska.gov/getmedia/cedaeccd-674a-476a-a6fd-db16a609c15e/Crime-in-Alaska-2018

Action Step 1

ActionCommunities are building their capacity to reduce violence through the development and/or expansion of community coalitions. The goal of these coalitions is to engage community members, local organizations, agencies, as well as faith based and Tribal entities in building or enhancing culturally appropriate responses that prevent rape, teen dating violence and/or domestic violence.
Measure• Quarterly reports that address capacity and risk and protective factors of strategies being implemented.
• Annual Capacity Assessment from all Grantees
• Annual evaluation of CDVSA funded Primary Prevention Grantees.
• Biennial Evaluation of Statewide Primary Prevention Summit.
Timeframe2021-2024
Key Partners• State of A• laska, Department of Safety, Council on Domestic Violence and Sexual Assault
• State of Alaska, Division of Public Health, Section of Women’s, Children’s, and Family Health
• AK Network on Domestic Violence and Sexual Assault (ANDVSA)
• Missing and murdered indigenous persons coalition, DOJ
• ANTHC

Action Step 2

ActionCommunities are engaged in the identification and implementation of evidence based and/or promising practice strategies that address risk and protective factors related to the reduction of rape across the social ecological model.
Measure• Quarterly reports that address capacity and risk and protective factors of strategies being implemented.
• Annual Capacity Assessment from all Grantees
• Annual evaluation of CDVSA funded Primary Prevention Grantees.
• Biennial Evaluation of Statewide Primary Prevention Summit.
Timeframe2021-2024
Key Partners• State of Alaska, Department of Safety, Council on Domestic Violence and Sexual Assault
• State of Alaska, Division of Public Health, Section of Women’s, Children’s, and Family Health
• AK Network on Domestic Violence and Sexual Assault (ANDVSA)
• AK Native Women’s Resource Center

Strategy 2: State level prevention efforts are integrated and promote societal norms, values and beliefs that reinforce safe and healthy relationships

Current research through the CDC, identifies that sexual violence shares common risk and protective factors with other forms of violence including child maltreatment, bullying, teen dating violence and suicide attempts (CDC-connecting the dots and SV-Prevention-Technical Package). State level policy and implementation efforts that are integrated and align with shared factors have the potential for the broadest reach and positive impact.

Sources:

  • https://www.cdc.gov/violenceprevention/pub/connecting_dots.html
  • https://www.cdc.gov/violenceprevention/pdf/SV-Prevention-Technical-Package.pdf

Action Step 1

ActionImplement statewide AK Safe Children’s Act curriculum
• Erin’s Law- information to schools on child sexual assault prevention
• Bree’s Law- Grades 7-12, teen dating violence preventions
• These are both unfunded mandates but schools are required to implement these curricula. Elements of teacher and parent training within these laws.
• Online curriculum is currently being piloted.
AS 14.30.355 (Erin’s Law) AS 14.30.356 (Bree’s Law)
Measure• Annual survey of school districts implementing K-12 Erin’s Law Curriculum- DEED
• Annual survey of school districts implementing 7-12, Bree’s Law Curriculum-DEED
• Biennial review of YRBS sections on Violence and Bullying
• Annual review of CDVSA Dashboard sections on prevention
Timeframe2021-2024
Key Partners• Department of Education & Early Development (DEED)
• State of Alaska, Department of Safety, Council on Domestic Violence and Sexual Assault
• AK Network on Domestic Violence and Sexual Assault (ANDVSA)

Action Step 2

ActionExpand statewide current efforts to engage and reach men to promote equitable gender norms and to prevent sexual violence by increasing understanding of consent using sexual violence prevention messaging.
Measure• Statewide Coaching Boys into Men program implementation and evaluation through Alaska School Activities Association (Mollie Rosier with WCFH will have this information (CBIM)
• Statewide social media campaign (in development) process evaluation in development (funded by RPE and DELTA/ANDVSA)- Mollie and Rae Romberg with ANDVSA will have this information.
Timeframe2020-2024
Key Partners• State of Alaska, Division of Public Health, Section of Women’s, Children’s, and Family Health
• AK Network on Domestic Violence and Sexual Assault (ANDVSA)
• State of Alaska, Department of Safety, Council on Domestic Violence and Sexual Assault

Action Step 3

ActionImplement standardized curriculum for earlier adolescent (12-15) youth, as a means to prevent acts of sexual violence or acting out sexually in inappropriate ways.

The Division of Juvenile Justice provides educational information to all youth admitted to DJJ facilities in compliance with the federal Prison Rape Elimination Act (PREA). The PREA educational materials and follow up discussion with staff provides youth with information about what constitutes sexual abuse and sexual harassment, their right to be free of abuse, the division’s zero tolerance policy for abuse, how to report abuse or suspected abuse, and how reports are addressed. In FY2020, all 461 youth admitted to a DJJ facility received this information.
Measure# of youth admitted to a DJJ facility who complete the PREA curriculum on annual basis
Timeframe2020-2030
Key Partners• State of Alaska, Department of Health and Social Services (DHSS), Division of Juvenile Justice
• Alaska Children’s Alliance
• State of Alaska, Office of Children’s Services

Objective 30: Reduce the percentage of adolescents (high school students in grades 9-12) who were ever hit, slammed into something, injured with an object or weapon, or physically hurt on purpose by someone they were dating or going out with during the past 12 months.

Target: 6.6

Strategy 1: Strengthen the capacity of communities to prevent violence through coalition work, data driven practices and evaluation

The Centers for Disease Control and Prevention (CDC) has developed technical packages to help states and communities take advantage of the best available evidence to prevent violence.

Source:

  • https://www.cdc.gov/violenceprevention/communicationresources/pub/technical-packages.html

Action Step 1

ActionIncreased community capacity to reduce violence through the development and/or expansion of community coalitions. The goal of these coalitions is to engage community members, local organizations, agencies, as well as faith based and Tribal entities in building or enhancing culturally appropriate responses that prevent rape, teen dating violence and/or domestic violence.
Measure• Quarterly reports that address capacity and risk and protective factors of strategies being implemented.
• Annual capacity assessment from all Grantees (Prevention Grantees)
• Annual evaluation of CDVSA funded primary prevention grantees.
• Biennial Evaluation of Statewide Primary Prevention Summit.
Timeframe2021-2023
Key Partners• State of Alaska, Department of Safety, Council on Domestic Violence and Sexual Assault
• State of Alaska, Division of Public Health, Section of Women’s, Children Family Health
• AK Network on Domestic Violence and Sexual Assault (ANDVSA)

Strategy 2: Implement evidence‐based school violence prevention programs

Universal school-based violence prevention programming, that is evidence based, is recognized by the CDC as an effective approach to reducing violence and victimization among students. In recognition of the positive impact universal, grade specific, curriculum has in reducing violence, the Alaska Legislature passed legislation in 2015, titled the Alaska Safe Children’s Act that has (as part of the act) a requirement for school districts, across the state, to implement curriculum in grades 7-12 that specifically addresses teen dating violence and healthy relationships.

Source:

  • https://www.cdc.gov/policy/hst/hi5/violenceprevention/index.html

Action Step 1

ActionImplement statewide AK Safe Children’s Act curriculum
• Erin’s Law- information to schools on child sexual assault prevention
• Bree’s Law- Grades 7-12, teen dating violence preventions
• These are both unfunded mandates, but schools are required to implement these curricula. Elements of teacher and parent training within these laws.
• Online curriculum is currently being piloted.
Measure• Annual survey of school districts implementing K-12 Erin’s Law Curriculum- DEED
• Annual survey of school districts implementing 7-12, Bree’s Law Curriculum-DEED
• Biennial review of YRBS sections on Violence and Bullying
• Annual review of CDVSA Dashboard sections on prevention
Timeframe2020-2030
Key Partners• State of Alaska, Department of Education & Early Development (DEED)
• State of Alaska, Department of Public Safety, Council on Domestic Violence and Sexual Assault
• AK Network on Domestic Violence and Sexual Assault (ANDVSA)

Strategy 3: Implement social and emotional learning (SEL) curriculum in Alaska schools grades K-12

There is now significant research highlighting the relationships between the development of social-emotional competencies during early childhood and outcomes in learning and academic success, mental health, and general wellbeing (Rhoades, 2011; Shonkoff, 2000; Zins, 2004). In a meta-analytic review of SEL programs across diverse student outcomes, Durlak and colleagues (2011) found that students exposed to an SEL intervention demonstrated enhanced SEL skills/attitudes (e.g. motivation), positive social behaviors, and less emotional distress compared to a control group. Further, academic performance was significantly improved, with an 11% point difference between groups on standardized scores.

Sources:

  • https://www.cdc.gov/ncbddd/childdevelopment/facts.html\
  • https://ice.aasb.org/social-and-emotional-learning/

Action Step 1

ActionSupport children, youth and adults in developing skills for life and school related to the five SEL skill areas or competencies – self-awareness, self-management, social awareness, relationship skills, and responsible decision making. These skills help students manage life tasks such as learning, developing positive relationships, solving everyday problems, and operating in the workplace.
MeasureCDVSA dashboard:
• School Climate and Connectedness Survey through AASB related to SEL
• YRBS related to SEL and other protective factors
Timeframe2020-2030
Key Partners• State of Alaska, Department of Safety, Council on Domestic Violence and Sexual Assault
• Association of Alaska School Boards
• All School districts in Alaska
• Center for Safe Alaskans, Anchorage Youth Development Coalition
• DEED
Previous Priority Health Topic: Tobacco Use ……………………………………………

News Bulletins


PDFs now available for 2024 scorecards

May 6, 2025

Healthy Alaskans releases first set of 2030 health improvement scorecards, issues final report, scorecards from 2020 plan

January 31, 2023

Healthy Alaskans releases scorecards assessing Alaska’s health progress for 2020 and a health improvement plan for 2030 that sets goals for the next decade

February 4, 2021

State Health Improvement Plan, Healthy Alaskans 2030 (HA2030), Draft for Public Comment Released

August 5, 2020

Healthy Alaskans 2030 Sets Framework for Alaska’s Health Goals; Strengthening communities and empowering individuals

January 22, 2020

Healthy Alaskans Co-Chairs

Cheley Grigsby

Deputy Director
Division of Public Health
State of Alaska Department of Health
Cheley.Grigsby@Alaska.gov

Annette Marley, MPH

Public Health Program Specialist III
Wellness and Prevention
Division of Community Health Services
Alaska Native Tribal Health Consortium
aamarley1@anthc.org
wellnessprevention1@anthc.org

Contact HA2030

Email: healthyalaskans@alaska.gov

© 2024 Healthy Alaskans 2030