The Total Child

Blog Tour: Impact School Safety by Learning to Love

(National Awareness, Student Support Services) Permanent link

Guest post by Dr. Bernadine Futrell, Director, Leadership Services at AASA, The School Superintendents Association. This blog was written as part of National Healthy Schools Day.

When considering the question, How can school system leaders help children in their district feel safe, as well as have their physical and social – emotional needs met in a healthy school environment?, I look to love.

Centuries of research continue to point to a loving and caring adult as a principle factor in a child’s life¹ . Coupled with high rigor and expectations, love can be a significant tool in the search for solutions for school safety.  

In my experience as a district administrator, educational researcher and now through my work in professional learning at AASA, love – self-love and the love of others has always been a goal in public education. Because it has consistently nourished healthy environments.

Schools who focus on the social emotional needs of students have shown the most advances in other areas of student outcomes including student achievement. Simply put, when students feel like they belong (are loved) the academic outcomes are also positive.  

Students learn love from a variety of ways, including exposure to positive examples of people from all backgrounds and experiences. Creating opportunities for students to develop mental models of success that reflect themselves as well as others helps students develop love and compassion. School across the country are making intentional efforts to introduce diversity in their district leadership, classroom and curriculum.

This mental modeling, helps children see a future that is attainable and positive for them. It also helps all students see value in all humans.

Simple, yet powerful, when kids learn to love, communities learn to love, and when love is spread – environments are safer for all – including in and out of school.

¹Center on the Developing Child, Harvard University.

2018 National Healthy Schools Day AASA Blog Tour: School Safety and Positive Social Emotional Learning (SEL) Overview

(Coordinated School Health, National Awareness, Student Support Services) Permanent link

 National Healthy Schools Daynewsletter

 As part of National Healthy Schools Day today, AASA Children’s Programs Department hosted a blog tour on school safety to help stimulate conversation on healthy schools and positive SEL, in response to the debate surrounding our schools in light of recent violence in Florida and elsewhere. Participants were asked to one or both of the following questions:

  1. Considering the continued threat of gun violence in our schools, what does a healthy school look like to you today? Have school shootings altered your view of what it means to be a healthy school?
  2.  How can school system leaders help children in their district feel safe, as well as have their physical and social-emotional needs met in a healthy school environment?

CoCAT school safety pop up

Below is a list of the posts that were published as part of the Blog Tour:

Superintendent Voice

Public Health Organizations

Higher Education Researchers

LGBTQ & Student Voice 

  • Time Out Youth, a youth center for lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth and their allies, ages 11-20, in Charlotte, NC and the surrounding areas.  


Blog Tour: Healthy and Safe at School: If not now, when?

(National Awareness, Student Support Services) Permanent link

The following is cross-post by Donna Mazyck, MS, RN, NCSN, CAE , Executive Director of the National Association of School Nurses. The original post can be found here. 

What do you say when a third grade student asks a trusted teacher if she is safe from violent intruders in the school? Who champions implementation of a dormant school wellness policy in order to support students with the best nutrition and physical activity choices? How do you press past frustration with social factors that impact the health of children and youth? On this National Healthy Schools day we ask: How can school system leaders help children in their district feel safe, as well as have their physical and social-emotional needs met in a healthy school environment?

The National Association of School Nurses (NASN) envisions school communities where students are healthy, safe, and ready to learn. Violent acts, such as school shootings, threaten the safety and well-being of students and school staff; action must be focused on common sense solutions. As with any complex and multifaceted situations, a multi-disciplinary approach enables interventions.

What we do know is that a healthy school environment begins with a student-centered collaborative approach by leaders within schools and communities. The Whole School, Whole Community, Whole Child (WSCC) model centers on the whole child and incorporates 10 components vital for a healthy and safe school environment. The WSCC model components include.

  •  Counseling, Psychological & Social Services
  • Social & Emotional Climate
  • Physical Environment
  • Employee Wellness
  • Family Engagement
  • Community Involvement
  • Health Education
  • Physical Education & Physical Activity
  • Nutrition Environment & Services
  • Health Services

 That third grade student who wonders if she is safe from violent intruders in her school relies on the trusted teacher who depends on the school administrator who convenes an emergency preparedness of staff and community partners to plan, mitigate, train, and practice response to the plan. The specialized instructional support team, i.e., school counselor, school nurse, school psychologist, and school social worker, focus on counseling, psychological, social and emotional climate.

NASN Blog Tour April 2018

A new school nurse who found an untapped wellness policy in her school district organized a wellness committee that would oversee implementation of wellness policy activities. Parents, school superintendent, principals, school nurses, and community members became the wellness committee. After completing the CDC’s School Health Index – a self assessment and planning tool – the wellness committee had the information needed to learn the school strengths and growth opportunities. The next step involved identifying recommendations to foster a healthy and safe school environment.

Another aspect of attending to student well-being is to acknowledge the factors that are barriers to health. School nurses assess social determinants and connect students and families with community resources that may address those factors.
NASN’s vision is for all students to be healthy and safe in schools. Now is the time for making schools healthy and safe environments.

Blog Tour: Telemedicine Offsets Loss of Learning Time

(Children’s Health Insurance , Coordinated School Health, National Awareness, Student Support Services) Permanent link

The following is a cross-post which was originally published by the Center for Health and Health Care in Schools at the Milken Institute School for Public Health at George Washington University on March 30, 2018. 

This post is by Dr. Dan Leikvold, Superintendent, Lead-Deadwood-School District (South Dakota)

The Lead-Deadwood School District is a rural district located in the Northern Black Hills of western South Dakota. It has a K-12 population of around 710. The tourism, gaming, and mining industries are the primary economic drivers in the Lead-Deadwood Community.

Although there are many outstanding opportunities for workers in the area, as with many school districts, we too have our share of challenges that are directly associated with the effects of poverty. This includes behavioral issues, transiency, limited access to transportation, and a lack of affordable housing. The free and reduced lunch rate in our district is around 50%. 

Over the course of the last ten years, the school district has identified and worked with multiple local and regional agencies to address the needs of our children and families affected by poverty. We realize we cannot be all things to all people, but we recognize the crucial connection between our children being happy, healthy, safe and supported and their ability to learn at school.

As part of this comprehensive approach, the school district entered into a partnership with Behavior Management Systems (BMS) in 2013 to bring a Family Pathways therapist from BMS to our schools/community full-time. All of the children and adolescents with whom the therapists work must meet the severely and emotionally disturbed criteria as outlined by the Individuals with Disabilities Education Act (IDEA), and the program is open to anyone with this diagnosis whether or not they have an Individualized Education Program (IEP). This partnership has been a win-win opportunity for both parties and has benefited our children and families immensely. Family Pathways is a fee-for-service program, so the direct costs to the school are minimal and include providing the therapist with an office and internet access, use of a copier, and parking.

After five years of a successful partnership in which we have been able to serve approximately 100 children and families onsite, we have identified another very important issue to address in order to have an even better program. In conjunction with BMS, we will now be providing mental health services to the students in the Lead-Deadwood School District via telemedicine free of charge to students and families, as well as the school district, during the school day.

Telemedicine is the remote delivery of healthcare services, such as health assessments or consultations, over the telecommunications infrastructure. It allows healthcare providers to evaluate, diagnose and treat patients without the need for an in-person visit with the medical provider. TeleMed is the service provider BMS and the district use for the service.

 The TeleMed program will alleviate barriers for families, so that medication and other therapies are consistent and maintained. Many times, appointments are missed due to challenges with transportation facing students and families. As a result, obtaining and maintaining adequate medication therapy is interrupted. This new approach will alleviate that problem.

This is how it works. A parent/guardian must be present at each appointment with BMS. BMS will handle all release requirements prior to our students receiving services in our schools. Before each BMS appointment, the School Nurse takes weight and blood pressure data for each student so the BMS provider has this information, but the District is not responsible for or charged for any portion of the services provided in the Lead-Deadwood School District. We are responsible for providing a computer and technical support during the time of the TeleMed appointment with BMS. Our students meet virtually with the BMS provider once per month or more if needed.

Students that receive free lunch will qualify for BMS services at no cost and there is a sliding scale rate for students that do not qualify. We will make referrals to BMS based on school and parent communication, similar to what we currently do with BMS on-site counseling services. BMS has contacted the Lead and Deadwood pharmacies and both are capable of receiving escripts.

Instead of taking a student out of school from three to four hours to an entire day, these virtual, in-building appointments will take a maximum of 20 minutes to half an hour. This will allow parents to come to the elementary school, eliminating the barriers of time, transportation hassles for parents and students, and loss of attendance. We appreciate this partnership and are excited to be able to offer this new service to our children and families.

 Dr. Leikvold is also an Education Advisor to the Center for Health and Health Care in Schools at the Milken Institute School for Public Health at George Washington University for a RWJF-funded project to provide state and local stakeholders in the education and health sectors with tools they can use to develop a sustainable, cross-sector infrastructure to provide integrated supports for the healthy development and academic success of students. For more information visit the Center’s website or Partner Build Grow: An Action Guide for Sustaining Child Development and Prevention Approaches.

Blog Tour: Three Supportive Ways School Districts Can Create Healthy Schools and Reduce Threats of Weapon Violence

(National Awareness, Student Support Services) Permanent link

Guest post by Ron Avi Astor and Rami Benbenishty  


 RonAviAstor  RamiHeadshot
Ron Avi Astor Rami Benbenishty

Ron Avi Astor, is the Stein-Wood Professor of School Behavioral Health at the University of Southern California in the Suzanne Dworak-Peck School of Social Work and the Rossier School of Education. Rami Benbenishty is a professor in the School of Social Work, Bar Ilan University. They work together on international efforts designed to support school climate improvement and prevent bullying and school violence. They are co-authors of "Welcoming practices: Creating schools that support students and families in transition" and "Mapping and monitoring bullying and violence: Building a safe school climate." The opinions expressed in this commentary are their own.

We are in the midst of a national battle over what our schools should be. How do we create citizens who are A+ human beings in addition to being A+ students? How do we create thriving, optimal academic school environments where the interactions between students, teachers, parents, and the community create a better union both within our schools and for the future of our fractured society? Indeed, we are debating not only what we want our schools to be but also what we want our society to be.

One vision for our nation’s schools upholds the belief that the path toward lasting safety comes from welcoming, caring, and supportive environments. This path focuses on improving school climate, engaging in social emotional learning (SEL), and fostering a compassionate community — in addition to offering a high-quality academic program. This vision advocates for humane social supports, institutional linkages, and community resources for those students struggling with mental health, societal obstacles, and family or community strife.

Another vision is a response to mass shootings. This strategy uses tools and ideas that originate in law enforcement, prison architecture, and military and anti-terror strategies. This approach tries to “harden” schools and aims to protect students from murder by creating prison-like, high-security environments patrolled by armed staff members. 

This is not only a philosophical and ideological debate, it also raises a set of empirical and scientific questions. We believe the answers are quite clear. Decades of well-conducted, large-scale studies from across the world strongly support one vision and not the other. Schools with a positive climate, where SEL is integrated into their DNA, have significantly less bullying and victimization, and have lower weapon use, threats by a weapon, and students reporting they have seen or know of a weapon on school grounds. There is no evidence for the success of “hardening” schools with armed staff members, zero-tolerance measures, and harsher law enforcement measures. In fact, the lion’s share of findings and studies point to negative outcomes of these approaches, including higher drop-out rates, a school-to-prison pipeline, higher expulsion and suspension rates, and climates of fear or restricted freedom.

Our research and experience in numerous schools around the world suggest three main principles that could guide district superintendents to create better climate, more welcoming schools, and lower violence on school grounds.

  1. District- Level Vision: Go for central air vs. window air-conditioning.

Be clear with all district administrators and school site principals how climate, SEL, academics and school safety are integrated into the mission of the district and of each school. There is a need for an overall and comprehensive approach that encompasses every aspect of the lives of schools — a “central air conditioning,” rather than an endless and short-lived series of disjointed programs (“window air-conditioning”). Research shows that when this comprehensive and integrated approach is adopted, climate, safety and welcoming environments are more sustainable, and can more easily spread to multiple schools within a district. When programs addressing SEL, climate, safety and the school’s academic mission separately, these missions compete against each other and are not easily sustained over time.

 From this perspective, the best investment districts can make is to build a core team of pupil personnel, social workers, psychologists, and counselors who work with every school and build sustainable capacity at the district and school level. The long-term yield and the flexibility of this group of professionals would be greater than an evidence-based-program that is not directly linked to the specific social or mental health needs of the schools in that community. Well-trained pupil personnel can sustain and extend evidence-based and youth empowerment interventions district-wide. They can reach beyond program limitations and adapt interventions specifically to the school and community’s cultural needs.

A stable group of district- and school-level pupil personnel staff members is an important defense against the inevitable turnover among school and district personnel. They can help train new educators and other staff members, and maintain the organizational memory.

 2.    Good school safety is an extension of the principal’s vision and organization of the school.

 Research from around the world has shown that the principal's vision and organization of each school is the strongest safety tool a district can employ. In schools where strong leaders have an integrated vision of climate, SEL, academics, and safety, many types of interventions can be effective. In schools with weak organizations and leadership, most safety approaches fail. Superintendents need to find ways to support principals and provide them with resources that can help them carry out the district’s safety mission. These include in-service training for all district and school employees, technological support, and flexibility in using safety resources.  

Strong and knowledgeable school leaders are aware of the unique safety concerns and characteristics of their schools. They resist a “one-size-fits-all” approach in order to create a unique blend of school safety policies and practices that reflect both the shared district vision and the uniqueness of their site. 

3.      Listen to the voices of teachers, students and parents, and empower all stakeholders to take responsibility in creating welcoming schools.

 In Israel and California schools, we’ve employed mapping and monitoring processes that gather the experiences and ideas of principals, teachers, students, and parents. This data helps district and school leaders identify which schools and student groups are experiencing bullying, discrimination, and victimization. Furthermore, it helps identify schools in which students see weapons, are threatened by a weapon, or bring a weapon to school. This mapping process takes a public health approach that focuses on primary prevention across all schools, with a special emphasis on providing resources and support to schools with more challenges. It’s done in a kind and supportive educational way rather than through law enforcement. Evidence-based programs such as threat assessment can be used in schools where threats are high.

We have implemented these principles in several places around the world. In California, monitoring the multiple views of students, staff members, and parents (using the California Healthy Kids Survey) helped leaders understand their schools' challenges and needs, and work toward responses that were relevant for their own particular sites. These schools used students’ voices and self-reports to improve their school’s climate, reduce violence, and create welcoming schools. By building pupil personnel teams that work with administrators, parents, students, and teachers and by allocating resources based on the unique needs of each school and district, there were significant positive changes.

In a recent seven-year study on the use of these methods in 145 schools in California (serving over 100,000 students), we found (for secondary schools):

  • A 55% reduction in gun carrying on school grounds
  •  A 37.5% reduction in knives, guns, clubs or other weapons being used to injure someone or to threaten injury.
  •  A 40% reduction in seeing a weapon on school grounds
  •  A 44% reduction in gang affiliation and participation

Every district is different; every superintendent is unique, but we do think that the principles we outline are flexible enough to allow every superintendent and every district to find their own unique path. Programs without trained staff members do not work. Creating a welcoming and caring setting with a strong knowledgeable staff is the best way to both prevent violence and create thriving school settings that do not feel like prison.


Blog Tour: The Role of Education Leaders To Ensure Safe Schools

(National Awareness) Permanent link

Guest post by Dr. MaryAnn P. Jobe, Director, Leadership Development, AASA

Thanks to the AASA Children’s Program staff for having a blog tour on Healthy Schools today, April 3, 2018.

Schools today and especially the leaders of the school systems have a tremendous job to do to ensure the safety of students, staff and community in today’s world. Sometimes I am sure that it seems like an unsurmountable job. 

As a former administrator for a large urban/suburban school system, we dealt with many instances of school violence and community violence. How do work through this? Well, it is not easy. One of the most helpful ideas that emerged was to hold bi-yearly summits with school principals, school system security and the police. During these day long meetings, the school system employees learned about the newest and best tactics to use during violent situations that may occur on school campuses. And, the principals were also charged with being the community point person.

What does a healthy school environment look like today? Research suggests that educators should focus on the basic needs of childhood: food, clothing, shelter, etc. What is now emerging more than ever before is the need for advanced mental health support. Many school systems have 1 psychologist for the entire school system and there needs to be a contingent of professionals who can work with students. Over the next few months I hope that schools revisit their identification process for troubled teens and look at ways to support them and their families. And, we need families in the community to speak up. If your child is exhibiting dangerous behaviors, call the school and have a meeting about it.

Today, as gun violence in schools is a major focus especially after the shootings at MSDHS in Florida, school system employees need to be better prepared. How, do we do this? Well, there needs to be a rigorous shelter in place protocol, students and staff need to know what to do. School security guards need to be professionally trained by police or training updated if they are already receiving support and communities need to be proactive in working with the children to alleviate fears of going to school. Community forums can help get the word out. We have a lot of work to do.

Schools are still one of the safest places for children to be.

Blog Tour: School Safety and Positive Social Emotional Learning (SEL): 2018 National Healthy Schools Day

(Coordinated School Health, National Awareness, Student Support Services) Permanent link

 National Healthy Schools Daynewsletter

As part of National Healthy Schools Day today, AASA Children’s Programs Department is hosting a blog tour on school safety to help stimulate conversation on healthy schools and positive SEL, in response to the debate surrounding our schools in light of recent violence in Florida and elsewhere.

Join the Conversation

Join the conversation today on social media by using the hashtag #HealthySchoolsDay. Post blogs, videos and photos on what a safe learning environment looks like to you. Be sure to tag @AASATotalChild so we can share your posts.

 If you would like to post a blog, we encourage you to answer one or both of the following questions:

  1.  Considering the continued threat of gun violence in our schools, what does a healthy school look like to you today? Have school shootings altered your view of what it means to be a healthy school?
  2.  How can school system leaders help children in their district feel safe, as well as have their physical and social-emotional needs met in a healthy school environment?

Resources and Events 

In response to the horrific school shooting in Parkland, Florida, AASA has assembled a set of resources to support school system leaders.

These resources include an excellent guide on "Talking To Children About Terrorist Attacks and School and Community Shootings In the News" from our partner, the National Center for School Crisis and Bereavement. Access the resource library.

In late March, the National Prevention Science Coalition (NPSC) organized a Congressional Briefing on School Violence, Safety and Well-Being: A Comprehensive Approach.” You can view the briefing here.

Dr. David Schonfeld, who was one of the expert panelists, is the director of AASA’s partner, the National Center for School Crisis and Bereavement. He discussed how people process grief in a variety of ways from denial to anger. 

Lauren Hogg, a 14-year-old student who survived the Parkland shooting, gave an emotional account of her experience of what happened to her and her classmates before, during and after the shooting. Dr. Julie Phillips Pollack, the stepmother of Meadow Pollack, who was one of the 17 killed during the shooting, talked about what this tragedy and loss meant to her as both a parent and how it impacted her in her job as an emergency physician.

Celebrating 2018 National School Breakfast Week

(Alternative School Breakfast , Healthy Eating and Active Living , National Awareness, Student Support Services) Permanent link

Since 2011, AASA has engaged 30 school districts in the Alternative School Breakfast Initiative, supported by the Walmart Foundation. This program increases the number of children who eat school breakfast, by taking breakfast out of the cafeteria and into the classroom and hallways through Breakfast in the Classroom, Grab ‘n’ Go, and Second Chance options.

The eight districts in our most recent cohort held activities during National School Breakfast Week to raise awareness of their school breakfast programs. Here are some shining examples.

National Recognition 

Alhambra Unified School District receives USDA’s 2018 Champions of Breakfast Award

USDA awarded Alhambra Unified School District (CA), the Western Region's 2018 Champions of Breakfast Award for the category, Implementation of an Innovative School Breakfast Model. This award recognizes schools and districts that operate exemplary school breakfast programs. Alhambra USD implemented a Grab N' Go Breakfast Model.

National School Breakfast Week Activities: Breakfast Samples, Active Living Prizes and More 

First Lady of Virginia Samples Grab N’Go Breakfast in Chesterfield County Public Schools

 Chesterfield first lady visit
 The First Lady of Virginia, Pamela Northam, preparing to sample breakfast on a Grab N' Go Kiosk at an elementary school in Chesterfield County Public Schools (Va.). Photo Credit: The Office of Governor Ralph Northam.

As part of National School Breakfast Week, Pamela Northam, The First Lady of Virginia, visited one of the elementary schools participating in AASA's alternative school breakfast initiative program in Chesterfield County Public Schools (VA). The elementary school offers Grab N' Go Breakfast with a kiosk in the hallway. Read more about this event.

An Array of Activities Celebrating Breakfast at Community Consolidated School District 21 (Ill.)

Community Consolidated School District 21 had a variety of activities to celebrate NSBW including Dress Up Days like crazy hat day and school spirit day. Students and staff wrote thank you notes to cafeteria staff, and principals at breakfast with their students. A principal was selected as a breakfast champion. Students who participated in breakfast that week won prices included scooters and swim passes.

Chef Tables Offer Opportunity to Sample School Breakfast at Stamford Public Schools (Conn.)  

Stamford Smoothies NSBW 2018

 Students sampled breakfast smoothies and oatmeal (flavors included apple pie and peaches and cream) at a chef table at an elementary and middle school in Stamford Public Schools (Conn.) during lunchtime. A dairy farmer from the New England Dairy Council visited the middle school to illustrate the importance of ensuring optimal nutrition for cows.  

AASA Also Got Out to Support Districts

New York State Press Event

On March 15th, Kayla Jackson presented at an event in Albany, NY which was held by The American Dairy Association North East. With the goal of highlighting Governor Cuomo's "No Student Goes Hungry" campaign, the event presented a "state of the state" on New York School Breakfast. Crystal FitzSimons from FRAC highlighted the great work that several NY districts had done on school breakfast, specifically calling out the success of school breakfast in Newburgh Enlarged City School District and Schenectady City School District. Jessica Pino-Goodspeed, a mentor from Hunger Solutions New York, shared findings from "Bridging The Gap: Ending Student Hunger with Breakfast After the Bell 2018 New York State School Breakfast Report."

Kelly Masline, Senior Associate Director of the New York State Council of School Superintendents was also in attendance.

AASA was invited to share the importance of superintendent support for breakfast as a crucial component for success and sustainability and to introduce two of our currently funded districts, Rochester City School District and Enlarged City School District of Middletown, both of whom shared the success of their school breakfast work.

 Yogurt Parfaits at Enlarged City School District of Middletown (NY) 

MiddletownSmoothies MiddletownKiosk
 During National School Breakfast Week, students in the Enlarged City School District of Middletown tried new Fruit -N- Yogurt Parfaits.


Join the Celebration: National School Breakfast Week!

(Alternative School Breakfast , National Awareness) Permanent link

Guest Post by: Alison Maurice , Child Nutrition Policy Analyst, Food Research and Action Center

 Why celebrate the 2018 National School Breakfast Week during March 5-9, 2018?


School breakfast not only fights hunger and improves children’s nutrition, but is a vital tool for improving the academic achievement of your students

Tight family budgets and hectic morning schedules make eating breakfast before the school day difficult for too many families. The School Breakfast Program plays a critical role in ensuring your students receive the basic nutrition they need to start the school day ready to learn.

Studies show that students who eat breakfast at school, closer to class and test-taking time, perform better on standardized tests when compared to students that skip breakfast or eat breakfast at home. Additionally, children and adolescents who are experiencing hunger have poorer grades and slower memory recall . Participating in school breakfast allows students to focus on the tasks ahead of them, rather than their empty stomachs.

Hunger also can contribute to student behavioral problems . Research suggests that students who eat school breakfast are less likely to exhibit behavioral and psychological distress. They also have lower rates of absence and tardiness. Furthermore, schools that are providing school breakfast through after the bell programs, such as breakfast in the classroom , “grab and go,” and second chance breakfast , have observed fewer behavioral problems requiring disciplinary office referrals, allowing educators to spend more class time on curriculums.

The School Breakfast Program is an essential tool for ensuring that students have the nutrition needed to thrive academically, but school breakfast helps support health, too! Studies have found that children and adolescents who participate in school breakfast are less likely to be overweight and have more favorable weight outcomes such as a lower body max index (BMI, an indicator of excess body fat), while skipping breakfast has been associated with a higher risk of obesity in the short and long terms. School breakfast also reduces visits to the school nurse, especially in the morning.

The Food Research & Action Center (FRAC) recently released its annual School Breakfast Scorecard: School Year 2016–2017 , which further details the benefits of school breakfast, strategies for successfully increasing participation, and state and national participation rates in the program.

 Here are a few highlights from the report:

  • 12.2 million low-income children participated in the School Breakfast Program on a typical day in the 2016–2017 school year.
  •  56.7 low-income children participated in school breakfast for every 100 that participated in school lunch.
  •  Breakfast after the bell programs and those that offer free breakfast to all students increase low-income students’ participation in school breakfast.
  •  Community eligibility, the most recent federal option for high poverty schools to offer breakfast (and lunch) to all students for free with less administrative work, helped drive school breakfast participation.

While school breakfast participation continues to grow and reach more students than ever before, there are still millions of low-income children missing out on school breakfast. The 2018 National School Breakfast Week offers an important opportunity to celebrate the amazing benefits of school breakfast and to spread the word about successful strategies to increase participation.

Visit FRAC’s school breakfast page for more information and countless resources on the National School Breakfast Program.

On Their Terms: Expanding PrEP Access for Young People

(National Awareness) Permanent link

 By Kristina Santana, Senior Associate, Prevention & Health Care Access, NASTAD

Every December 1, we commemorate World AIDS Day, a day to honor those living with HIV, those who have died from an HIV-related illness, and the history of the fight. Rooted in activism, people living with HIV and grassroot organizations demanded to not only be a part of the conversation, but lead the conversations around HIV prevention, HIV care, and sexual health. As support strengthens and we continue to bring awareness to all communities, it is important to acknowledge the work still needed and who is still missing from the conversation. With a renewed spirit in HIV activism, we are seeing a wave of young people demanding to be included. 

Data from the U.S. Centers for Disease Control and Prevention (CDC) indicate that of all age groups, young people are the least likely to get linked to care. This impacts their ability to receive treatment and ultimately reach a suppressed viral load. In 2012, only 44% of young people living with HIV had a reported suppressed viral load, which was the lowest of any age group. As a secondary method of prevention, viral load suppression is crucial to decreasing the number of new infections. When the viral load of a person with HIV can’t be detected, then there is no risk of sexually transmitting the virus to an HIV-negative person. As research confirms, undetectable = untransmittable (U=U). In 2015, 22% of all new HIV infections were among young people (ages 13-24).1 When the data is further examined, we see that the majority of new infection cases are among gay and bisexual men. Representative of all age groups, this trend is indicative of larger lapses in prevention and care efforts for certain populations. Despite having a significant decrease in new infections since 2008, this disparity is unacceptable, as we know we have the tools and innovations to eliminate new cases.

Pre-exposure Prophylaxis (PrEP) could be one answer for many young gay and bisexual men. PrEP is a medication that works to prevent HIV by disrupting its ability to replicate. Without replication, acquisition is impossible. Research shows PrEP is up to 99% effective in preventing new infections when taken daily. Yet, to be a successful strategy, young people must 1) know about it and 2) be able to access it.

One of the biggest barriers to access to PrEP for young people is consent. As it relates to sexual health services, in all 50 states and Washington D.C. minors may consent to Sexually Transmitted Infection (STI) services.2 Typically HIV prevention and treatment is included in such services, however, depending on the jurisdiction’s laws, PrEP may not be considered an STI service or as HIV treatment and prevention. Most states have a statute that indicates in the case of an actual or suspected HIV exposure, minors can consent when it comes to diagnosis and treatment. What is unclear is if PrEP is considered a form of treatment for those who were exposed, but did not seroconvert. Legislators and courts need to clarify if treatment will include a prophylaxis, which would include PrEP. If these ambiguous areas are not addressed or clarified, the lives of so many young people could be at risk of seroconverting to HIV.

In addition to consent, confidentiality issues play a central role in impacting young people’s decision to seek care and treatment. In some jurisdictions, when minors are seeking services, providers may be required to inform a caregiver. For example, in Iowa a minor can consent to HIV testing, but if the test is positive then by law a caregiver must be informed of the results.3 Depending on the home life or community of that person, this could potentially be frightening, stigmatizing, or even life-threatening. The ambiguity of consent laws, specifically regarding PrEP coverage, create confusion and additional barriers for all clients and providers. If we are going to continue to reduce new infections among young people, integrating PrEP services with existing prevention efforts (e.g., testing, condom distribution, treatment as prevention) is crucial. That is why it is important to examine how we are promoting access for all young people.

The voice of young people must be heard in the prevention strategies we implement, in the patient-centered care that is delivered, and in the policies that guide decisions. In order to have that voice, we must start holding conversations with young people about PrEP, educating them about its potential benefits, and listening to their experiences. Once we do, then can we truly start moving toward ending the HIV epidemic.