Other Youth Topics

TAG In Action: Successful Strategies

As part of its national call to action, Adolescent Health: Think, Act, Grow® (TAG), the Office of Adolescent Health in the U.S. Department of Health and Human Services has identified a number of successful strategies for improving adolescent health throughout the country.

TAG in Action: A Place 4 Me
GOAL: The A Place 4 Me initiative is working to prevent and end homelessness among youth and young adults (ages 15 to 24), with special emphasis on youth leaving foster care without the material and emotional support of a family.

The Game Plan
A Place 4 Me — named and inspired by youth — is a public-private collaboration devoted to supporting youth experiencing homelessness and housing instability throughout Cuyahoga County, Ohio. A steering committee guides A Place 4 Me, with the YWCA of Greater Cleveland as the lead organization and more than 30 partners including the Sisters of Charity Foundation of Cleveland, the Cuyahoga County Office of Homeless Services, the Cuyahoga County Division of Children and Family Services (DCFS), and the national Jim Casey Youth Opportunities Initiative.

To begin the effort, the Sisters of Charity Foundation brought together diverse partners — especially young adults who had experienced homelessness — to envision an ideal system of supports for homeless and unstably housed youth. Working from their vision, partners spent ten months developing a comprehensive plan to address youth homelessness. The approach includes a focus on youth leaving the foster care system, a subpopulation that is particularly vulnerable for housing instability. A Place 4 Me utilizes two national models: the Jim Casey Youth Opportunities Initiative’s that focuses on child welfare reform; and the U.S. Interagency Council on Homelessness’, which works to improve homeless services. Both frameworks seek the same outcomes for youth: stable housing; permanent connections; education and employment; and social, emotional and physical well-being.

The Winning Plays
In 2016, A Place 4 Me was selected to participate in A Way Home America’s 100-Day Challenge and set an ambitious goal to house 100 homeless youth in 100 days. In the end, A Place 4 Me housed 105 youth in 100 days. The effort did not stop and, to date, has housed 170 young people. Kate Lodge, Project Director, shares her thoughts on why they have been successful: “We met the challenge because, with the Sisters of Charity Foundation’s support, we had already sat side-by-side with young people, dreamed big and then created a realistic plan. We had also brought the right partners to the table. As a result, DCFS was able to create a firewall, ensuring that every youth that left foster care had a rock-solid housing plan. But most importantly, we’ve always understood the importance of relationships. Rather than just focusing on housing, we work very hard to reconnect youth with their family and friends. In the end, that’s how they find a stable place to live and also a place to dream.”

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TAG in Action: Anu Family Services
GOAL: Anu Family Services helps children and youth address their grief, loss and trauma so that they may develop permanent connections with loving and stable families.

The Game Plan
Anu Family Services, Inc. was established in 1992 as PATH Wisconsin, Inc. PATH was an early founder of the treatment foster care model and was cited nationally as a prime example. In 2008, PATH Wisconsin became Anu Family Services. Anu uses a unique combination of trauma-informed approaches to address relational trauma through a lens of grief and loss, which helps youth restore their capacity to connect and engage in healthy relationships. Anu now operates in Wisconsin and Minnesota and provides a full continuum of client-driven, family-centered services including treatment foster care, parent coaching, intensive permanence services, and intensive trauma services.

The majority of Anu’s clients are adolescents and their families. The youth have often experienced trauma from neglect; emotional, physical or sexual abuse; illness; parental illness; parental incarceration; or removal from their original parent’s home. It is not uncommon for youth to exhibit a wide variety of symptoms or pain-based behaviors such as opposition, lying, stealing or aggression. Anu staff learned that once youth understand that their pain-based behaviors are normal responses to grief and trauma, they could develop healthy, trusting relationships.

Anu builds networks of support for youth by engaging in exhaustive searches to find all the people that a young person had loved and lost: family, schoolmates, teachers, coaches, or even a lunch lady. Anu’s staff has expertise in trauma-informed parenting and provides one-on-one parent coaches to foster, adoptive and kinship parents. Parents are trained on utilizing “Present Moment Parenting” and are given skills to parent youth who, due to trauma, often don’t respond to typical parenting methods.

The Winning Plays
Mechele Pitt, Anu’s Executive Director, explained that Anu staff empower youth by putting them in control of their future. This is critical because youth in the “system” have been given little, if any, control in their lives. “Our specialty is understanding what you actually need to do differently to help youth heal. When we saw youth continue to push away adults who loved them, we better prepared the adults to understand the youths’ pain-based behaviors and respond accordingly. When we saw how little control these youth had, we let them set the pace of their casework and even fire their caseworkers. When we saw that it took a unique approach for each youth to heal, we took time finding what interests each of them and began connecting youth with all kinds of healthy activities from mindfulness to art or equine therapy. We are relentless. We do whatever works to help youth heal, build healthy relationships and re-connect.”

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TAG in Action: Aqui Para Ti / Here for You
GOAL: Aqui Para Ti/Here for You is a clinic-based health youth development program in Minneapolis, Minnesota that provides medical care, coaching, health education, and referrals for Latino youth and their families.

The Game Plan
Aqui Para Ti (APT) Here for You was founded in 2002 to address major inequities faced by Latino youth, including mental and sexual health outcomes and academic achievement. APT uses a parallel family care approach that simultaneously engages young people and their families. The APT model is built on the Latino community’s values of personalism, which celebrates personal connections, and familism, which stresses strong family connections and cohesion. Youth and their parents are supported by an APT multi-disciplinary team that includes a physician, community health workers, school/college connector and parent educator. The team uses trauma-informed practices to address chronic social and medical conditions facing the youth and family, while also providing holistic care in a one-stop clinic. APT has documented positive impacts on youth’s mental health and sexual health, and, in 2014, the Society of Adolescent Health and Medicine designated APT as an innovative approach to adolescent health.

APT has found that a parallel family approach can still support confidentiality and reproductive health care delivery for teens. At the initial visit, the young person and their parent meet with a team member to go over the "Confidentiality Mantra.” The Mantra discusses confidentiality in the usual way, but reinforces that the provider is a significant, caring adult for the adolescent and also a partner for the parent. When surveyed about their experience, the vast majority of youth report that they trust program staff and that the staff is responsive to their needs.

The Winning Plays
Dr. Maria Veronica Svetaz, Director of Aqui Para Ti, shared, “We have proven that using a family-centered approach to serve Latino youth actually accelerates their positive outcomes without harming their confidential care needs. By building a relationship with the young person, we bring yet another positive connection into their life. But, importantly, we also work to preserve and enhance the existing relationship with their parent/significant adult. Culture must also be a priority. Our team represents, celebrates and appreciates the community they serve. We are always ‘reflecting back’ to our youth their strengths. Young people who come from a minority culture that isn’t always valued need to hear those messages of strength over and over.”

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TAG in Action: Big Brothers Big Sisters of South Central W.V.
GOAL: Big Brothers Big Sisters of South Central West Virginia (BBBS SCWV) matches youth facing adversity with professionally-supported adult mentors that can help change their lives for the better.

The Game Plan
Through both school- and community-based programs, Big Brothers Big Sisters of South Central West Virginia works closely with teachers, parents, guardians, social workers and juvenile justice officials to provide mentors to children and youth who need a positive role model. Adult mentors receive training and ongoing support from professional case managers to help build lasting relationships between the mentors and mentees. Mentors also attend group discussions where they talk through how to address specific challenges their mentees may face, such as dealing with illness or food insecurity.

BBBS SCWV incorporates the Focus5Initiative throughout its mentoring programs. Focus5 promotes key skills sets for personal and professional success: problem solving, team building, financial literacy, health and wellness, and entrepreneurship. As part Focus5, mentors (BIGS) and mentees (LITTLES) can use the local YMCA facilities at no cost to play sports and be active. The BIGS and LITTLES take a selfie, submit how many active hours they logged, and receive rewards for reaching milestones.

In 2014, BBBS SCWV received a three-year grant from the Department of Labor through Big Brothers Big Sisters of America. The funding helped start a local Youth Workforce Opportunity Initiative, a mentoring program for adjudicated youth age 14-20. The mentors work with youth to improve academic success, avoid truancy, and gain employment or access to higher education.

The Winning Plays
Sara McDowell, Executive Director of BBBS SCWV, shared that, “[t]he mentors and our professional case managers are the key to our success. Case managers help mentors problem-solve and develop strategies for empowering youth. West Virginia has the highest rates of juvenile detention and truancy in the country, so mentoring is a successful strategy to help kids stay out of placement and in school. Mentors are there to encourage and support their LITTLES to believe they can achieve and succeed – that their current circumstances do not have to define their future. It’s hard to be what you can’t see, so our goal is to show them opportunities do exist and then help them develop strategies to overcome obstacles and barriers to achieve success.”

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TAG in Action: Boys & Girls Clubs of America Health and Wellness
GOAL: The Boys & Girls Clubs of America brought together more than 155 experts for a Health & Wellness Great Think to renew their purpose and dialogue around supporting youth health and wellness.

The Game Plan
In recent years, the Boys & Girls Clubs of America has held a series of meetings called “Great Thinks” to spark national thought leadership and grow the capacity of their clubs to better serve children and youth. Health and wellness emerged as a critical issue as Boys & Girls Club staff and volunteers regularly saw the children and youth they serve facing serious health crises including food insecurity, poor nutrition, lack of physical activity, obesity and mental health issues.

At the Health & Wellness Great Think, the Boys & Girls Clubs of America shared its vision for working with clubs to become centers of health and wellness in their communities. Introduced as a framework for creating a “Culture of Wellness,” the Boys & Girls Clubs of America identified four target initiatives: Food Security, Preventative Care, Physical Literacy and Social Emotional Resilience. Participants shared best practices related to each initiative and made recommendations for how community groups can create a safe, healthy, and fun environment where youth thrive.

Following the Great Think, the Boys & Girls Clubs of America developed an action plan to advance health and wellness for youth. Follow-up has included partnering with the Centers for Disease Control and Prevention to train and implement Healthy Eating Physical Activity (HEPA) standards in clubs and working with the U.S. Department of Health and Human Services to promote enrollment in insurance.

The Winning Plays
Boys & Girls Clubs serve nearly 4 million youth and their families each year, through more than 4,200 club facilities, including 1,520 school-based clubs, 480 youth centers on U.S. military installations worldwide, 960 clubs in rural areas, 290 clubs in public housing, and 170 clubs on Native lands. The out-of-school time programs at Boys & Girls Clubs provide opportunities to teach youth how to lead healthy lifestyles, improve academic success, and build leadership skills. Sage Learn, BGCA Director of Policy and Advocacy, noted that “when you can bring together diverse partners to share best practices - in this case to promote a culture of wellness in our clubs and for our youth - it is really powerful. The Great Think sparked our creativity and spurred us to take new actions, and these new and innovative collaborations have just begun.”

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TAG in Action: CANFIT
GOAL: CANFIT works with communities and youth to develop culturally resonant policies and practices that improve food and fitness environments for adolescents in low-income communities and communities of color.

The Game Plan
CANFIT focuses on meeting the health needs of low-income, African-American, American Indian, Latino/Hispanic, Asian American and Pacific Islander adolescents. Many of these historically underserved populations have limited access to affordable, healthy foods and safe places for physical activity. CANFIT provides training, consultation, and technical assistance to strengthen the capacity of youth-serving organizations and the youth themselves so they may address these challenges. The technical assistance helps identify strategies to address current conditions, such as expanding community fitness opportunities or improving the quality of snacks/meals provided in out of school settings.

CANFIT engages youth in every stage — from community-based planning to implementation and evaluation. The organization serves as the Youth Engagement Lead for nine communities as part of the W.K. Kellogg Foundation’s National Food and Community Program, an effort to address the root causes of health inequities for children. In their work with youth, CANFIT strives to:

  • Provide a space where youth feel welcome, honored and can support each other;
  • Present a realistic approach and lens, especially if cultural boundaries are present;
  • Apply an interactive and shared learning approach; and
  • Support the development of leadership skills.

CANFIT's capacity-building model has been recognized by the Centers for Disease Control and Prevention, the Robert Wood Johnson Foundation Community Health Leaders Program, the Center for American Indian Research and Education, and the U.S. Department of Agriculture.

The Winning Plays
Arnell Hinkle, Executive Director of CANFIT, shared that “We put culture first, and that includes youth culture and ethnic culture. We take time to get to know a community before we start any work. We acknowledge where they are and work with youth and community leaders to figure out how to get them to a better place. Because of that approach, we develop interventions that resonate and make a difference.”

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TAG in Action: Chicago's Citywide Adolescent Health Efforts
GOAL: In an effort to reach more teens across the city, the Chicago Public School (CPS) and the Chicago Department of Public Health’s (CDPH) Office of Adolescents and School Health partnered to develop public awareness campaigns and programs that would complement their existing, evidence-based Teen Outreach Program® (TOP) model.

The Game Plan
Building upon the classroom and community service learning components of TOP, CDPH created a cross-functional collaboration with experts in other disciplines to develop:

  • The city-wide Action Plan for Healthy Adolescents which identifies 40 measurable health targets as well as 65 strategies that will be implemented by CDPH and its partners;
  • The Condom Availability Program, which makes free condoms available at participating public high schools and school-based health centers and includes complimentary mobile health apps to connect students to health resources;
  • An innovative public awareness campaigns; and
  • A teen health hotline.

Youth were involved throughout the process. For example, a teenage boy inspired the Condom Availability Program. He had taken hundreds of condoms from the school health office and sold them to his friends. He was so much more effective than other approaches that his idea was developed and branded as a strategy called “Teen Health Agents.” Youth also helped develop the “Unexpected?” public awareness campaign which challenged gender stereotypes by depicting pregnant boys. Not surprisingly, the campaign tested poorly with adults, but it got the attention of its target audience and the media. The campaign went viral worldwide, earning more than 1 billion media impressions.

The Winning Plays
Chicago knew that youth are essential partners in improving health outcomes for teens, and learned a few lessons, including:

  • Know your audience. (P.S. It’s not you).
  • Ideas are not enough; you have to execute or build the team that can.
  • Solutions already exist, just not where you think.
  • Tokenize youth at your peril. They are not the objects of your work, they are your partners!

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TAG In Action: Colorado 9to25
GOAL: Colorado 9to25 is a collective, action-oriented group of Colorado youth and adults working in partnership to align efforts and achieve positive outcomes for all youth, ages 9-25, so they can reach their full potential.

The Game Plan
Since 2010, the Colorado Department of Public Health and Environment has used federal Maternal and Child Health (MCH) block grant funding to build a youth system now known as Colorado 9to25 (CO9to25). In 2013, state legislation in Colorado directed the Colorado Department of Human Services to create a statewide youth development plan. Having partnered on CO9to25 since its inception, staff identified alignment between the legislative requirements and CO9to25’s existing work.

With CO9to25 serving as the foundation of the legislated plan, community and state youth initiatives were reviewed across the state. CO9to25 then identified gaps and barriers to services, including: missing connections to adults, behavioral health needs, homelessness, disparities and stigma experienced by various populations, and a need for cross-systems coordination and collaboration. A nonprofit organization, The Civic Canopy, worked to maintain and enhance the CO9to25 infrastructure to align youth-serving programs, practices and policies across Colorado to address these gaps and promote positive youth development.

The Winning Plays
CO9to25 representatives modeled a positive youth development approach as they designed a plan for the entire state. Two key practices for engaging young people stood out: building upon the inherent interests and strengths of youth participants through preparation and debriefing to enhance their capacity to sit at the table, and facilitating meaningful engagement of youth in decision-making roles including changing meeting norms to make them more inclusive of young people’s needs. As one young woman said about the process, “It’s when there is give and take, and respect for diverse opinions that we change the world. The Colorado Statewide Youth Development Plan gives us, the youth, a chance to be heard.”

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TAG in Action: Engaging Youth at FosterClub
GOAL: FosterClub was founded to help young people navigate foster care when they are removed from their homes because of suspected abuse or neglect. Led by former foster youth, the FosterClub All-Star internship program aims to help young people process their experience in foster care and develop skills for lifelong success.

The Game Plan
FosterClub helps young people currently and formerly in foster care connect to a peer support network and gain awareness of their rights. Based in Seaside, Oregon, and Washington, D.C., the organization seeks to inspire and empower youth involved in foster care by sharing stories of people who have succeeded before them. FosterClub also elevates the voice of young people in policy conversations so they can be represented in the decisions which have such a profound impact on their lives. The FosterClub All-Star program is an intensive one-year internship that engages youth in learning about foster care, leading training sessions for peers and other stakeholders, and sharing their story strategically to advocate for improvements in the child welfare system.

The Winning Plays
FosterClub developed a method for how a youth can share his or her own personal story to help others. Youth are trained in hosting peer-led events, such as at foster care conferences, which includes a routine, in-depth debrief procedure to help youth process the experience and promote positive youth development. Following a peer-led model, new interns learn from fellow alumni who have previously served as FosterClub interns in the past. The young people identify what works and what needs to be improved. Impact Justice evaluated FosterClub’s successful youth engagement framework and identified five integral elements for building resilience: 1) System knowledge: young people understand the system they are navigating and are aware of the resources available to them; 2) Personal narrative: young people are able to reflect on their own story and recognize the value and impact of their lived experience; 3) Self-regulation: young people have an understanding about how past trauma impacts current thinking and behavior, and possess skills to make healthy decisions; 4) Connectedness: young people value permanence and connections to people they trust, and are connected to individuals and networks that can support them; and 5) Meaningful contribution: young people recognize how they can impact the people, systems, and world around them. “We’re placing our bet on young people. We believe they are the catalysts for transforming their own lives – and for reforming the child welfare system…” — Celeste Bodner, CEO

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TAG in Action: Georgia Power
GOAL: The Georgia Campaign for Power & Potential (GCAPP) empowers young people to make healthy choices, which in turn ensures their ability to achieve their full potential, unencumbered by teenage pregnancy, bolstered by strong physical health, and supported by healthy relationships.

The Game Plan
When adolescents need information, most turn first to their smart phones. Following this trend, Georgia Campaign for Power & Potential (GCAPP) developed a free mobile phone app, gPOWER, giving teens a convenient source of information on sexual health. GCAPP worked with young people to develop the app to locate free or low-cost clinical services for sexual health in Georgia. The app makes it easy for youth to learn about their rights to receive sexual health services. They can explore options for birth control and STD prevention, find out what to expect at clinical appointments and equip themselves with questions to ask at these visits.

The gPOWER app also leverages the value of social media to share the views of teens who have used sexual health services with other teens. Just as adults use Yelp or Trip Advisor, adolescents in Georgia can use gPOWER to write anonymous reviews of the clinics for their peers. Their feedback helps other teens find out what the clinic experience was like. Comments may cover the availability of same-day or next-day appointments, the atmosphere of the clinic and whether staff made youth feel comfortable and respected.

The Winning Plays
gPower reflects GCAPP’s broadened adolescent health mission. After 17 years of focusing primarily on reducing teen pregnancy, the organization and its coalition partners expanded their work in 2013 to include healthy relationships and strong physical health, an approach urged by the U.S. Office of Adolescent Health. “We know the adolescent years represent a critical stage of development. It’s well documented that these are years that harbor many risks, but as the gateway to adulthood, they also present an opportunity for sustained health and wellbeing through education and prevention efforts.”

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TAG in Action: Gilda's Club Seattle
GOAL: Gilda’s Club Seattle works with high schools to provide support and information to teens about cancer, and to ensure that no young person has to face cancer alone.

The Game Plan
Cancer affects the lives of many adolescents, whether they are diagnosed with cancer themselves or one of their friends or family members has cancer. Gilda's Club Seattle identified a gap in outreach to teens about cancer — including cancer prevention and support when friends or family members have been diagnosed with cancer — and has provided targeted outreach and educational information to teens in Washington State since 2005.

The organization notes that "More than 73 percent of teens have been touched by cancer yet teens are often an overlooked audience, especially regarding cancer risk factors, prevention and dealing with the social and emotional needs brought about by a cancer diagnosis."

Gilda's Club Seattle is reaching teens where they are already learning — in their high schools. The organization's Cancer Education for Teens (CET) program has been delivered in-person to more than 36,000 teens in 66 Seattle and Puget Sound area high schools. Gilda's Club Seattle also empowers teens to share their thoughts and perspectives through its annual "It's Always Something" Teen Writing Contest. This special project provides a venue for teens in 9th through 12th grades in Washington State and Alaska to give voice to their own experiences with cancer, either their own diagnosis or that of a loved one.

The Winning Plays
Beginning in 2015, Gilda's Club Seattle began offering an online version of CET that provides an e-learning approach to help teens learn about cancer prevention, risk factors, and how to support people with cancer. With this online version of the training, which includes videos and interactive components, Gilda's Club Seattle empowers high schools to provide this important educational opportunity to teens wherever they are.

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TAG In Action: Girls on the Run
GOAL: Girls on the Run is a positive youth development program designed to enhance girls’ social, psychological, and physical skills and behaviors.

The Game Plan
Girls on the Run uses running and other physical activities as a platform for teaching life skills and promoting holistic health outcomes. Girls on the Run began in 1996 in Charlotte, North Carolina with thirteen girls. Today, approximately 53,000 volunteer coaches help to serve more than 200,000 girls each year across the Unites States and internationally.

Girls on the Run offers two 10-week programs, one for girls in 3rd to 5th grade (Girls on the Run) and another specifically designed for middle schoolers (Heart & Sole). Each 10-week curriculum addresses themes girls can relate to and includes lessons that target competence, confidence, caring, character, connection and contribution. The volunteer coaches participate in a National Coach Training Program which prepares them to build relationships with and between the girls, create a positive, inclusive environment, support individual improvement and deliver the intentional curriculum. During the program, girls learn specific skills and strategies on topics such as managing emotions and resolving conflict, and discuss how the skills can be applied at home, school, and with friends. Girls also have the opportunity to give back to their communities in meaningful ways. The programs conclude with a celebratory 5k event that gives the girls a tangible sense of achievement as well as a framework for setting and achieving goals.

In 2016, Dr. Weiss from the University of Minnesota conducted a rigorous, independent study on the Girls on the Run program. The study compared Girls on the Run participants with girls involved in physical education or organized sports programs. The study concluded that Girls on the Run has a stronger impact in the areas that the curriculum intentionally addresses including managing emotions, resolving conflict, helping others and making intentional decisions.

The Winning Ways
Allie Riley, the Senior Vice President of Programming and Evaluation, shared that “We know that adolescents bring a lot to the table. We help the girls to recognize their inner strength and celebrate what makes them unique. The program accomplishes this by combining physical activity with a very intentional approach to teaching social and emotional skills. We provide girls with a relevant and safe environment where they can learn and practice team work, conflict resolution, emotion management, healthy relationship skills and more. They explore how they can positively shape the world around them. And when they cross the finish line of the 5k, they see that anything is possible!”

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TAG in Action: Health Centers in Schools
GOAL: Health Centers in Schools is demonstrating the power of an innovative, integrated program to improve the health and well-being of students and support educational progress.

The Game Plan
In Baton Rouge, Louisiana, Health Centers in Schools is providing no-cost medical and mental health services on site at 11 public school campuses. With additional rotating school nurses and support staff, Health Centers in Schools serves 72 school buildings in East Baton Rouge Parish and provides health and mental health services to approximately 45,000 students. In 2009, more than 6,000 students in East Baton Rouge public schools had chronic health conditions or required special health services. These students can now receive health services within their school, which minimizes their time away from class and supports better educational outcomes.

In addition to providing school-based health and mental health services, Health Centers in Schools offers an online searchable guide to community organizations in the greater Baton Rouge area. The guide links youth and families to a variety of services and programs including groups that address family relationships, substance abuse, and parenting skills.

The Winning Plays
A large, multi-disciplinary collaboration among community partners contributes to the success of Health Centers in Schools. It is run by Our Lady of the Lake Children’s Hospital in partnership with the East Baton Rouge school system and the Louisiana Office of Public Health. Other partners include the Nurse-Family Partnership, Vaccines for Children, the Louisiana Department of Agriculture & Forestry, Area Health Education Center, Pennington Biomedical Research Center, Greater Baton Rouge Food Bank, Children’s Coalition of Greater Baton Rouge, and multiple pediatric dentists, optometrists, and a child/adolescent psychiatrist.

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TAG in Action: Houston Teen Community Health Workers
GOAL: The Houston Health Department Office of Adolescent Health Services’ Teen Community Health Worker program teaches youth about adolescent health resources and risks and how to share health information with their families, communities, and schools.

The Game Plan
Created in Houston, the Teen Community Health Worker program model is derived from the Texas state-certified adult Community Health Worker (CHW) training program. Teens age 13-17 complete a modified version of the CHW curriculum and focus on health concerns that are prevalent among adolescents and common in their communities. The teenagers who complete the program accumulate 40 hours of CHW training, which they can apply to the adult CHW certification program if they are interested in becoming state-certified community health workers at age 18.

Throughout the program, youth learn about traditional health topics such as sexual health and physical activity/nutrition, and less traditional topics including juvenile delinquency, motor vehicle safety, and the social determinants of health. The program also equips the Teen Community Health Workers with skills such as navigating the healthcare system, cultural competency, and locating community resources. Teens involved in the program are expected to relay the information they learn within their homes, schools, and communities. For example, teens set up informational tables in school cafeterias and participate in health fairs and adolescent conferences.

The Winning Plays
The majority of topics covered during the program are topics that teens care about but are not taught during traditional health classes in schools. The program answers questions that teen participants are often afraid to ask parents and teachers, dispels many common misbeliefs, and minimizes the stigma around certain health topics. Kim Williams, Division Manager, noted “this program promotes a strengths-based view of adolescents. We help young people take responsibility for their own health and for promoting healthy communities. Youth are uniquely positioned to be influencers. There is just so much capacity among youth to communicate with their peers. It’s amazing to think about unleashing their power.”

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TAG in Action: Identity Wellness Centers
GOAL: Identity Wellness Centers offer a range of programs and services that improve student’s cognitive, physical, social and emotional development.

The Game Plan
Identity was founded in 1998 as a community-based organization to meet the needs of Latino youth and families. Based in Montgomery County, Maryland, Identity now assists more than 3,000 in-school and out-of-school Latino and other vulnerable youth and their families who live in high-poverty areas and who are most at-risk for poor academic and economic outcomes.

Identity is the lead agency at three Montgomery County area high school Wellness Centers. The Wellness Centers provide a broad array of evidence-informed programs and services focused on improving the physical, social, emotional, and mental well-being of the students. The wide variety of programs and support services offered include on-site health screenings and mental health counseling, curriculum-based after-school programs, mentoring and case management services, and restorative practices. In the 2015-16 school year, Identity worked in collaboration with health and youth development partners to serve over 1,300 diverse youth.

In addition to providing school-based health center services, the Wellness Centers offer opportunities for physical activity and recreation, family gatherings, student service learning and youth leadership training. Although the Wellness Centers serve all students enrolled in the school, they specifically target those who have few protective factors or demonstrate risky behaviors. Identity’s annual evaluation of their Wellness Centers’ outcomes demonstrate improvements in students’ emotional well-being, increases in connection to school, and decreases in risky behaviors.

The Winning Plays
Identity meets the needs of the youth they serve by developing comprehensive and integrated programs that respond to specific and evolving community needs. Identity’s Wellness Center model is based on Positive Youth Development concepts and regards youth as assets to be nourished rather than problems to be fixed. Youth are provided with opportunities to forge positive and trusting relationships with caring adults on staff. Staff also work with parents or other key adults in the youth’s life to repair and reconnect the parent-child bond. Carolyn Camacho, Identity Youth Centers Director, shared that “relationships with reliable and caring adults and their peers can be healing for youth facing challenges such as poverty, family separation, discrimination, immigration status, cultural isolation and other traumatic experiences.”

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TAG in Action: Let Me Run
GOAL: Let Me Run combines exercise with fun activities and lessons to help boys learn teamwork, build relationship skills, create friendships, grow emotionally, amplify their self-esteem, empower themselves and others, and live an active lifestyle.

The Game Plan
Let Me Run is a holistic health program for 4th through 8th grade boys. Using running as the vehicle to inspire, teach, and reach boys, the Let Me Run curriculum breaks down destructive male stereotypes that often stand in the way of positive futures for boys. Twice a week for seven weeks, trained coaches guide teams of six to fourteen boys through lessons about wellness and well-being such as respect, positive competition, and nutrition. The lesson plans, including “Real Men Show their Feelings,” “Everyday Heroes,” and “Getting to Know You,” encourage boys to fully express their individual feelings. Boys are also instructed on proper running form and correct stretching techniques, and each season culminates in a 5-kilometer race that celebrates the boys’ emotional, social, and physical growth.

A 2016 study by the Institute to Promote Athlete Health & Wellness at the University of North Carolina at Greensboro examined the impact of Let Me Run on participants. The study found that, among other things, participation in the program improved attitudes and behaviors associated with healthy masculinity to a significant degree, improved social competence, increased vigorous physical activity, and reduced sedentary behaviors on school days.

The Winning Plays
Ashley Armistead, Let Me Run’s founder and director of programming, shared why their program is successful. “It’s the training of the coaches. We educate the coaches on healthy masculinity and how to challenge the boy code. Coaches learn how to create a safe space where boys can be themselves. Too often, boys feel like they have to act a certain way. This program may be the first time some of these boys can share feelings other than anger. There is a 5k race at the end and we promote competition, but we have whole lessons devoted to healthy competition and we stress improving over winning. We often have kids who finish the race and go back to find their teammates and cheer them on. They are excited for the boys who have improved the most. In the end, we’re just giving boys permission to be who they are. Those positive, caring traits are there. We don’t have to create or teach them, we just have to uncover them.”

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TAG in Action: Lifeskills Training Program
GOAL: Botvin LifeSkills Training program is an evidence-based curriculum designed to teach youth healthy alternatives and skills that reduce risky behaviors, such as smoking, substance use, and violence.

The Game Plan
Botvin LifeSkills Training (LST) is an interactive and flexible curriculum that helps youth to develop skills to resist negative peer pressure, build confidence and self-mastery, and cope with social anxiety. LST also increases youth’s knowledge of the immediate and long-term consequences of substance abuse. LST is designed for upper elementary, middle, and high school students, and can be taught either on an intensive schedule (two to three times a week), or on a more extended schedule (once a week) until the program is complete.

More than 35 rigorous studies, conducted over a 30-year period, have demonstrated that the LST program reduces tobacco, alcohol, and illicit drug use by as much as 80%. In additional to other outcomes, a recent evaluation by the National Institute on Drug Abuse reported that LST specifically helps youth avoid misusing prescription opioids throughout their teen years. Multiple studies have also found that LST effects on drug use can last for up to 12 years — through high school and college and even into young adulthood. As a result, communities more than recoup the program’s costs in reduced health, social, and other expenditures related to teen risky behavior.

In 2017, in response to the opioid crisis, LST released a Prescription Drug Abuse Prevention Module to further help youth avoid the misuse/abuse of opioids and prescription drugs. The new module is designed for school districts, community-based organizations, and agencies serving students ages 11 – 14, and can be delivered either online or in a classroom. The module can be used in conjunction with the existing LST program or can be integrated into other prevention programming.

The Winning Ways
Paulina Kalaj, Director of Communications for LST, shared, “LST works because rather than merely teaching about drugs, violence, and other risky behaviors, we help youth develop the skills they need to navigate adolescence. We build their confidence and self-mastery to reject negative social pressures. LST has been shown to work with a broad range of youth, including various multi-ethnic and socioeconomic groups. This is particularly important within the current context of the opioid crisis, which is hitting every demographic. We developed the new module on prescription drug use in order to reinforce prevention of opioids in our already-effective LST program, and to reach an even broader audience of youth.”

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TAG in Action: Michigan Adolescent Health Initiative
GOAL: The University of Michigan Health System Adolescent Health Initiative (AHI) advances innovative approaches to adolescent-centered healthcare through practice improvement, education, research, and youth and community engagement.

The Game Plan
AHI’s Adolescent Champion Model gives health care providers a framework to make youth-friendly enhancements to their clinic’s physical space, policies, and practices. The model improves the care of adolescent and young adult patients through:

  • Comprehensive Adolescent-Centered Environment (ACE) assessments, customized implementation plans and robust resources
  • Targeted quality improvement initiatives
  • Innovative training and professional development opportunities for all staff
  • Opportunities for Continuing Medical Education (CME) and Maintenance of Certification Part IV credits
  • Ongoing, personalized technical and capacity-building assistance

The Adolescent Champion Model was developed after interviews with health care providers and staff from across the country revealed that most did not feel equipped or prepared to meet the needs of their teen and young adult patients. Many reported that they had not been trained on important issues like confidentiality and minor consent or providing culturally competent care for transgender and gender nonconforming patients. AHI began its effort with funding from the Michigan Department of Health and Human Services, and was met by an overwhelming demand. The success of the ACE assessment process and Adolescent Champion model quickly spread across Michigan and has recently expanded to other states including Iowa, Mississippi, and Wisconsin, with plans for further rollout.

The Winning Plays
The Adolescent Health Initiative involved their teen advisory council in development of the Adolescent Champion model, which lent credibility and youth perspective. For example, young people made clear that anyone can make or break their experience in a healthcare setting so the model’s training and capacity building framework involves everyone– physicians, call center staff, front desk staff, nurses, administrators, etc. Lauren Ranalli, AHI Director, shared that “Teens are often a forgotten population, and health centers aren’t necessarily set up to meet their specific needs. We are looking at transforming primary care and school-based health centers into adolescent-centered medical homes, and this involves everyone from the person who answers the phone to the provider who treats them.”

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TAG in Action: Minnesota Partnership for Adolescent Health
GOAL: The Minnesota Partnership for Adolescent Health engaged stakeholders from across the state in the development of a new State Adolescent Health Strategic Plan.

The Game Plan
The Minnesota Partnership for Adolescent Health (MPAH) was formed in 2014 with support of the Maternal and Child Health Advisory Taskforce and the Minnesota Department of Health (MDH), Community and Family Health Division. MPAH’s mission is to support the health and development of all Minnesota youth and young adults’ ages 10-24 years old. The MPAH leadership team includes state advocacy organizations, health practitioners, local public health, community youth serving organizations, and the University of Minnesota Prevention Resource Center.

MPAH began its strategic planning process by hosting regional discussions on adolescent health. MDH used the World Café method for the listening sessions and called them Adolescent Health Café discussions. The sessions were designed to learn about needs in rural and urban communities, identify gaps, and bring stakeholders together to discuss adolescent health. More than 400 individuals participated across the state including young people, school administrators, doctors, nurses, clergy, county staff, community advocates, and local business leaders. In addition to the in-person listening sessions, MDH encouraged people to submit their thoughts via email, an online submission tool, fax, or phone calls.

Throughout the process, stakeholders identified ten adolescent health priorities. As input was compiled into the state strategic plan, staff consulted the TAG Playbook and realized that the Minnesota priorities aligned with TAG’s Five Essentials for Healthy Adolescents. This reassured the MPAH leadership that they were on the right path. In the final plan, MDH used TAG’s Five Essentials to organize the priorities and share related resources and examples. MDH plans to support each priority by distributing information on its listserv, developing webinars, and providing technical assistance.

The Winning Plays
Stakeholder engagement was critical to the development of the State Adolescent Health Strategic Plan. The flexible methods of information gathering and the use of stipends to cover young people’s time helped ensure broad representation. Julie Neitzel Carr, the State Adolescent Health Coordinator, shared that, “It is important that our communities have buy-in to what we are doing, and have a voice in how MDH supports adolescent health in Minnesota. The stipends were particularly critical because they ensured that youth voice was central in the planning, and that their input was valued. The 139 young people that participated helped make sure our strategic plan aligned with their needs. The listening sessions also helped to identify who was most interested in working on adolescent health, and facilitated conversations among community leaders who work with and on behalf of young people, but don’t usually have the opportunity to interact. The process built and strengthened partnerships that can now help us carry out our plan and ensure that all young people in Minnesota thrive.”

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TAG in Action: Mobile Teen Van
GOAL: The Mobile Adolescent Health Services program, known as the Teen Health Van, provides comprehensive, coordinated and adolescent-friendly medical, mental health, and nutrition/fitness care to vulnerable youth ages 10-25.

The Game Plan
The Teen Van is a mobile health unit that travels the San Francisco Bay Area, regularly visiting schools and community agencies in order to reach young people who are homeless, uninsured or underinsured, and who don’t have access to health services. The staff includes a physician specializing in adolescent medicine, a nurse practitioner, a social worker, a dietitian, a medical assistant, and a registrar/driver.

Serving as a one-stop shop, the Teen Van focuses on eliminating barriers so that vulnerable youth can get the comprehensive health services they need. Staff is able to draw blood, run tests and dispense medicine, all from the van. If a young person needs specialized follow-up tests or care, the staff help arrange the appointments, and transportation to and from those appointments, if needed. The full-time social worker is able to counsel youth and can also connect them with additional community resources. The dietician, who is also a fitness expert, promotes overall healthy adolescent eating and fitness, and also works one-on-one with youth on issues from obesity to malnourishment.

Every six months the staff compiles data to review both individual and collective progress. They look at everything from whether youth are up-to-date with immunizations to overall health and nutrition to their engagement in risky behaviors. They are also able to review outcomes by subgroups, such as gender, race/ethnicity, and homelessness and have published several peer-reviewed articles on their findings.

The Winning Plays
Dr. Seth Ammerman, the Teen Van’s founder and physician, explained, “We take a strengths-based approach very literally. Youth are asked to name their strengths at their first appointment and staff continues to build on that conversation at every appointment thereafter. Our focus on strengths creates a positive atmosphere while also providing us a way to bond with the youth. And because our approach is adolescent-focused, adolescent-friendly, and adolescent-respectful, we are actually meeting the young people where they are both physically and developmentally.”

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TAG in Action: Mount Sinai Adolescent Health Center
GOAL: Mount Sinai Adolescent Health Center (MSAHC) provides high quality, comprehensive, and inter-disciplinary health and wellness services focused solely on the unique needs of adolescents and young adults.

The Game Plan
Established in 1968, the Mount Sinai Adolescent Health Center is one of the largest standalone centers of its kind in the United States. MSAHC supports underserved and at-risk young people between 10 and 24 years old. Ninety-eight percent of clients are from low-income families and 70 percent have no insurance. Regardless of their ability to pay, however, MSAHC provides young people access to a wide range of targeted services, including medical, sexual and reproductive health care, dental, optical, behavioral and mental health service as well as nutrition, fitness, and wellness programs. Services are free and confidential. MSAHC also serves as a leading center of specialized training and innovative research in adolescent and young adult health.

At an average annual cost of only $1,000 per client, MSAHC supports approximately 10,000 patients a year. MSAHC keeps costs down by keeping administrative costs low, which allows them to put the majority of their funding into direct services. MSAHC increases retention by recruiting staff who love working with youth and who are deeply committed to providing teen-friendly and developmentally appropriate services. To meet the continued demand for services, MSAHC plans to expand its capacity over the next 5 years to serve 15,000 adolescents and young adults.

MSAHC’s model has been considered a leader in the field of adolescent health for many years. Recently, the New York State Health Foundation created a blueprint exit disclaimer icon that encourages health care providers and policy makers to adapt or replicate MSAHC’s method of providing services to adolescents and young adults. The blueprint includes guidelines to help providers implement key parts of the model or phase it in over time, tailoring it to their needs and capabilities.

The Winning Plays
Dr. Angela Diaz, the Center’s director for more than 25 years, shared that MSAHC focuses on being a safe and welcoming place for every young person. Diaz explained, “We see every young person as full of promise rather than full of risk. There are no judgments, no stigmas at our Center. Each young person is treated with compassion and respect. And then, within that context, we provide them with everything they need to be healthy. We remove all the barriers and we let them take the lead. And, even with our long history, we continue to learn from the young people each and every day.”

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TAG in Action: MY TURN
GOAL: MY TURN provides youth with comprehensive workforce recruitment, education, exploration, preparation, placement, and follow-up to ensure they are successful in achieving their career and education goals.

The Game Plan
MY TURN operates academic and employment training programs for young people aged 14 to 24 in high schools and communities across New Hampshire and North Central Massachusetts. Although each program is unique and designed to meet the needs of the community it serves, every MY TURN program is built upon a comprehensive and effective workforce development model, takes a holistic approach to providing services, and ensures that a focus on outcomes drives all activities from recruitment to follow-up.

MY TURN utilizes three unique models to deliver services: Diploma Plus Programs work with students actively enrolled in high school to prepare them for success in career or college; Employment Plus Programs work with students who have graduated from or dropped out of high school to prepare them for careers utilizing a combination of post-secondary training and internships; and Manufacturing Training Programs that prepare highly motivated young people for exciting careers in manufacturing through collaboration with local industry partners.

MY TURN staff are chosen and rewarded for their exhibition of MY TURN's five core values of empowerment, enthusiasm, integrity, relentlessness, and excellence. Staff must be deeply committed to working with young people; however, they must also be able to collect and utilize data regularly. For example, staff may look at trends in retention rates with different employers or sectors, or they may review students’ school attendance and training participation rates to identify any young people that may need additional support.

The Winning Plays
Allison Joseph, Executive Director of MY TURN, shared that, “It is really our staff and their dedication that makes a difference. We have a hierarchy of how we approach things: our students come first, then our staff, our employers, and our funders - in that order. We use a very student-centered approach, but we have to keep track of it all. We also work off a hierarchy of needs with the students. Youth need to be housed, clothed, fed, and safe before we can address academics or employment. Everybody’s needs are addressed on a case by case basis. We work to remove every barrier humanly possible. We are relentless.”

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TAG in Action: National 4-H and Molina Healthcare
GOAL: The National 4-H Council and Molina Healthcare collaborated to have teen viewpoints inform their health-related programs for adolescents.

The Game Plan
The private, non-profit National 4-H Council works in close partnership with 4-H National Headquarters at USDA and the Cooperative Extension System at the land-grant universities to fund, lead, and implement the 4-H program. Molina Healthcare provides health services in 11 states for 2.1 million members. Molina serves people enrolled in government-funded health insurance programs such as Medicaid and the State Children’s Health Insurance Plans, including many adolescents. Together 4-H and Molina partnered to create Teens Take on Health, a form of opinion research to help their organizations understand and respond to the needs of teens. 4-H’s goal was to shape its Healthy Living programs as part of its broader positive youth development work and Molina wanted to learn how to expand and enhance programs that reach low-income families. 4-H adolescent members were invited to articulate the definition of health for themselves, their families, their schools and their communities. The partners sought insights in three ways with strong appeal to teens — a survey on Facebook, a national video contest, and a series of town hall-style conversations. Four top health concerns for teens emerged from the research: 1) obesity; 2) sleep, stress, and mental health; 3) health care access and cost; and 4) personal, family, community, and public policy action.

The Winning Plays
More than 600 teens participated in the meetings, which used methods designed to engage teens such as rapidly prioritizing ideas as a group and using storyboards to plot plans of action. These approaches deepened engagement and helped the youth think in fresh, unconventional ways. Based on the feedback, 4-H is developing and enhancing programs to address mental and emotional health; providing more leadership opportunities; and modeling and reinforcing healthy behaviors at all 4-H events. Molina Healthcare will keep working with teens to develop health education and social media materials that inspire teens toward healthier behaviors; increase focus on adolescent socio-emotional issues, especially stress and sleep; and develop train-the-trainer materials on positive youth development for Molina’s community engagement work.

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TAG in Action: Next Generation Zone
GOAL: Next Generation Zone is a program of the Spokane Workforce Council and serves as a one-stop career center that brings together education, career skills training, and community and employment resources to provide wrap-around support for young people ages 16-24.

The Game Plan
Located in eastern Washington state, Next Generation Zone brings a trauma-informed approach to helping youth and young adults prepare for and connect to career opportunities. Three key concepts serve as the cornerstone of the center’s trauma-informed practice — safety, predictability, and consistency — and help to create a sense of belonging for the more than 750 young people served each year.

Next Generation Zone understands that meeting essential needs is fundamental to helping youth and young adults achieve overall success in their education and career pursuits. Food and nutrition programs, health and vision screenings, flu shots, parenting education and other support services are made possible through partnerships with agencies such as Second Harvest, Spokane County United Way, and the Providence Foundation. A mental health specialist is available to help with crisis intervention and to offer referrals to community providers. “Whenever there’s a transition, you can lose a young person. By having things in one location, it helps with success,” explained Jessica Clayton, Program and Development Director at the Spokane Workforce Council. One measure of success for Next Generation Zone is being able to re-engage out-of-school youth. During the 2017-2018 school year, 151 young adults received their GED through its on-site classroom.

Next Generation Zone partners with a wide range of employers to create many options for youth to build skills and connect to career pathways. The goal is to prepare youth to succeed in the workplace and to connect them to in-demand industries, such as information technology and healthcare. The average wage for young adults who obtained employment through Next Generation Zone last year was $12.45 per hour.

The Winning Plays
Ms. Clayton shares, “Success for us is creating career pathways through apprenticeships and employment. A job for a young person means they can have the freedom and independence to live how they want and to meet their personal goals. Often, the young people we serve are the first in their family to hold a job or gain an education. They are often motivated to create a stable family for their children. They want to be able to buy a home and live independently. It’s a hope for something better. That’s why we offer health services and health education. Health contributes so much to steady employment. Economic stability is more than an income, it’s about opportunity.”

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TAG in Action: Our Whole Lives Sexuality Education
GOAL: The Our Whole Lives sexuality education program, together with the Sexuality and Our Faith resource, helps teens make informed and responsible decisions about their relationships, health and behavior within the context of their faith. The United Church of Christ and the Unitarian Universalist Association developed both curricula.

The Game Plan
Our Whole Lives is designed to provide accurate health and sexuality information in affirming and supportive settings with trained adult leaders. The accompanying resource, Sexuality and Our Faith, specifically puts the exploration of identity, relationships, and sexuality in the context of faith, worship, scripture, and sacred principles. This program is part of the United Church of Christ’s broad faith-based efforts to support justice, peace, and community building.

The Our Whole Lives program covers the entire life span with age-appropriate curricula. The curricula for teens include commonly addressed topics such as anatomy and physiology, puberty, and reproductive health care. The curricula also address topics such as gender identity, intimacy, and healthy relationships. The interactive program goes beyond sharing information and provides youth with opportunities to practice scenarios where they must use critical thinking skills and apply the information that they are learning.

Overall, the program strives to make the faith community a safe and supportive place where teens can learn about sexuality and ask questions. Our Whole Lives involves parents and guardians throughout the program, reinforcing their role as the primary sexuality educator of their children. Our Whole Lives also addresses issues of sexual orientation and gender identity and strives to be sensitive and inclusive as well as medically accurate.

The Winning Plays
Amy Johnson, Our Whole Lives Coordinator for the United Church of Christ, shared that “Our Whole Lives is living out our vision of justice by empowering people. It’s about promoting healthy sexuality, and young people knowing what their values are, knowing how to make decisions, and how intimacy, identity and feelings come into play. We discuss everything from using social media to how to break up from unhealthy relationships and prevent bullying. We want them to take care of this part of their life, their sexuality, just like they take care of the rest.”

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TAG in Action: Palm Beach County Birth to 22 Initiative
GOAL: Birth to 22: United for Brighter Futures (Birth to 22) supports the healthy growth, development, and education of children and youth prenatal through young adulthood, so that they can graduate from high school and succeed in life.

The Game Plan
Birth to 22 is a coalition of more than 60 community partners in Palm Beach County, Florida committed to supporting children and youth to help them become successful adults. Birth to 22 was established following a 2013 Youth Symposium that brought together elected and community leaders. During the event, youth-serving organizations realized that they needed a common agenda with actionable goals to support children and youth. As a result, the participants created the Birth to 22 initiative.

Birth to 22 leadership knew that they needed to leverage the existing coalitions and authentically engage the county’s diverse communities. Leadership decided to utilize the Forum for Youth Investment’s collective impact approach and began their planning by holding several community conversations. A unique feature of this process is that youth were trained and co-facilitated the conversations. More than 700 community members and youth participated in the conversations and six common themes emerged: economics and access; parenting and home environment; social/emotional challenges; educational supports; health and wellness; and community stressors. The work culminated in the Birth to 22 Youth Master Plan entitled “Strengthening the Steps to Success,” which identifies common outcomes, data collection, and action steps for the community.

The Winning Plays
Birth to 22 engaged youth throughout the planning process and continues to do so. Tammy Fields, the Palm Beach County Youth Services Department Director, shared that, “It was very effective to have youth facilitate the community conversations. We didn’t want to lose that momentum. We started a Youth Advisory Council but the youth didn’t like that name. They suggested Future Leaders United for Change, which is much better! The group is comprised of youth that receive our services. They are helping guide our work. For example, the youth explained that they felt guilty getting food for themselves at school when their whole family needed to be fed, so they often refused. As a result, our hunger initiative is providing youth with extra food, such as rice or pasta, which can be stretched to feed the whole family. Over and over, they are showing us how relatively small oversights on our part can dramatically impact youth’s ability or willingness to benefit from our services.”

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TAG in Action: PATCH
GOAL: The Wisconsin-based Providers and Teens Communicating for Health Program (PATCH), is an innovative, teen-delivered educational program that strives to improve the ability of health care providers and teens to communicate effectively about sensitive health topics—such as sexual health, mental health, alcohol and drug abuse, or safety—thereby improving the quality of care that the teens receive.

The Game Plan
PATCH offers two workshops taught by Teen Educators, one for providers, and another for teens. PATCH for Providers is an interactive and practical training in which healthcare providers are taught a model for asking teens questions about sensitive subjects such as alcohol use, self-esteem and sexuality. Providers are also given guidance on how to effectively handle patient confidentiality with teens, for example by developing an office policy on confidentiality and clearly stating exceptions to confidentiality.

The PATCH for Teens workshop focuses on the importance of open communication between teens and healthcare providers and provides tips and tools to facilitate communication. Teen Educators equip their peers with skills to navigate the healthcare system and advocate for health care visits that prioritize judgment-free care. They also teach teens skills to help them engage in meaningful and effective communication with healthcare providers.

The Wisconsin Medical Journal recently published research that demonstrated that participating providers and teens experienced significant improvements in knowledge, self-efficacy, and behavioral intentions to seek and provide quality sexual health care. The PATCH program is planning to expand throughout Wisconsin and is working toward replication nationwide.

The Winning Plays
Amy Olejniczak, PATCH Program Director and Founder, explained the impact that PATCH has on those involved. “The power of PATCH comes from the Teen Educators. They become empowered to be advocates on health care issues. They learn to train adults, and not just any adults, but doctors and nurses. We see these skills [not only] getting the results we want in the workshops, but also affecting the rest of their lives. The Teen Educators become natural advocates for their peers and in our community. They have spoken out on other issues such as bullying. PATCH isn’t just improving health outcomes for the next generation, we’re also creating advocates for the next generation.”

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TAG in Action: Peer Health Exchange
GOAL: Peer Health Exchange empowers young people in under-resourced high schools with the knowledge, skills and resources they need to make healthy decisions.

The Game Plan
Peer Health Exchange (PHE) trains college volunteers to deliver health education in under-resourced high schools across the country. PHE volunteers utilize a thirteen-week curriculum that aligns with national health and education standards, and is designed to help adolescents learn essential health information and develop critical decision-making skills. PHE’s goal is to improve sexual and mental health outcomes and decrease substance abuse while working alongside partners to advance health equity for young people.

Since its inception in 2003, PHE has trained more than 8,500 college student volunteers and provided health education to more than 100,000 public high school students in New York City, Boston, Chicago, Los Angeles, the San Francisco Bay Area, and Washington, DC. A recent external, quasi-experimental evaluation found that the PHE program has a statistically significant effect on students’ sexual and mental health knowledge and skills. After participating in the program, students were also more likely to engage in help-seeking behaviors such as talking to an adult, having conversations about their health, and using a health center.

As part of the evaluation, PHE tested the impact of augmenting their program with a tour of a school-based health center. The study found that youth who received the tour were nearly twice as likely to later use a health center. PHE is now planning to partner with more school- and community-based health centers so that young people can learn first hand where and how to get health services.

The Winning Plays
Louisa Brown, PHE’s Director of Communications, shared that “[o]ur near-peer model, coupled with our skills-based curriculum, is what makes PHE’s approach work. Our college-age health educators are close enough in age to relate to what young people are going through and become a trusted source of information. They also work with young people on developing specific skills around decision-making, communication, self-advocacy and accessing resources. Our health educators focus on empowering young people rather than just sharing information.”

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TAG in Action: Sources of Strength
GOAL: Sources of Strength is a universal, peer-leadership approach to preventing youth suicide, bullying, violence and substance abuse. The program trains peer leaders to use positive social norming methods to create healthy climate and cultural change.

The Game Plan
Sources of Strength empowers both peer leaders and caring adults to impact their world through the power of connection, hope, help and strength. The program begins with an extensive training for adult advisors who will help coordinate the program and support the peer leader team. The adult advisors are trained on starting-up and implementing the program, and most importantly, on how to truly partner with youth throughout implementation. The peer leaders are then trained along side their adult advisors. Using games and fun activities, the youth learn to tell their own story of strength and overcoming adversity and to identify adults whom they trust. They talk about how seeking help from adults is a sign of bravery and courage, not weakness.

As part of the training and ongoing support, the peer leaders and their adult advisors are given tools to create similar opportunities for all youth in their school or community to develop their own positive narrative and build stronger connections with adults. Sources of Strength provides suggestions, materials and templates, such as sample campaigns. However they encourage peer leaders and adult advisors to adapt the program to fit their school or community culture and to create strategies that are contextual and localized. The program is currently in over 300 locations, including middle schools, high schools, universities, tribal communities and juvenile justice centers.

The Winning Plays
Sources of Strength national trainer, Daniel Adams, attributes the program’s success to “our radically positive, strengths-based approach.” The five-hour peer leader training focuses less on the negative outcomes and warnings signs of suicide and more on resiliency, recovery, and strengths that help youth and young adults overcome difficulties. Peer leaders spend time telling their own positive self-narratives and practicing actual help-seeking pathways with caring adults in their life. Also critical to their success is an ongoing commitment to program evaluation. Over the past decade Sources of Strength has been rigorously evaluated, and among other designations, in 2011 was listed on SAMHSA’s National Registry of Evidence-based Programs and Practices (NREPP).

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TAG in Action: Teen Health and Success Partnership
GOAL: The Teen Health and Success Partnership (THSP) at the University of Rochester offers young people the chance to learn valuable job and life skills, connect with mentors, and access educational support.

The Game Plan
THSP provides employment opportunities and helps prepare youth for careers in health care, academic settings, and research while promoting well-being. Through its Be Employed Be Successful program, THSP works to improve the roughly 50 percent high school graduation rate for youth in the Rochester City School District. Youth in the program work at the University of Rochester and receive multiple services including career shadowing opportunities, college preparation assistance, free tutoring, life skills development, access to programs to improve wellness, career coaching, and job training. This program has helped more than 200 youth graduate from high school and transition to college, vocational school, or full-time employment. The program is helping youth improve outcomes: 100 percent graduate from high school; 79 percent enroll in college or vocational school; and 63 percent have been promoted at work.

THSP also collaborates with the Rochester City School District’s Leadership Academy for Young Men on a program to improve the high school graduation rates for African American males and Latino males in the school district. Young Men of Rochester: UR BOLD (Building Outstanding Leadership & Distinction) provides much-needed support and services to help teen males experience success in high school and prepare for college and employment. UR BOLD offers participating youth opportunities for mentoring, seminars on skill-building, visits to the University of Rochester college campus to deepen their understanding of what college is like, and connections to resources that support personal development and career success.

The Winning Plays
THSP was recently awarded the 2015 Hilary E.C. Millar Award for Innovative Approaches to Adolescent Health Care by the Society for Adolescent Health and Medicine for its valuable contributions to the well-being of youth in Rochester. Upon receiving this award, Suzanne M. Piotrowski, M.D., clinical associate professor in the Department of Family Medicine at the University of Rochester and director of THSP stated: “This is a replicable model of community collaboration to promote the health, academic success and gainful employment of urban youth. Rochester’s THSP youth are changing the startlingly chronic poverty and school failure statistics of Rochester.”

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TAG in Action: The Power of One Coach
GOAL: Marc Berk, a volunteer baseball coach in Gaithersburg, Maryland, started a small project to remove a barrier to youth participation in sports leagues: fee waivers. By simplifying the fee waiver process, Berk’s project increased youth sports participation in his community.

The Inspiration
While on vacation in New York, Marc Berk, a volunteer baseball coach in Gaithersburg, Maryland, noticed that those who could not pay the requested fee at museums had to explain why. Berk realized that this process may feel demeaning to people who could not afford the fee, and he decided to look into the fee waiver process for youth sports in his community.

Taking Action
Having coached youth baseball for more than two decades, Berk believes deeply in the value of kids participating in sports that include all youth. In 1997 Berk donated his inheritance from his grandparents and created the Sam and Claire Rosen Sports Fund, a permanent fund that provides sports equipment, supplies, and associated fees to youth in need. Berk saw that this relatively small amount of flexible funding enabled the city to increase low-income youth’s participation in sports leagues.

Following the museum incident, Berk wondered if the $40-$50 registration fee for sports leagues created an additional barrier to youth participation. Drawing on his experience as a health policy researcher, Berk submitted a proposal to the Robert Wood Johnson Foundation to fund a small project to test whether simplifying the registration waiver process would increase participation. Although very different from his other studies, Berk believed this project was important to the youth in his community.

Making A Difference
Berk’s instincts were correct. A simple change to the waiver process, which permitted a family to request a waiver with no explanation, increased waiver requests by 1200 percent. Overall participation increased by 31 percent, and for children attending high-poverty schools, participation jumped nearly 80 percent. Furthermore, despite the lack of a verification process, there was little evidence of program abuse; 85 percent of residents still paid the full registration fee. Better yet, children who received the waivers had high rates of participation in games and practices.

Although this approach may not be feasible in all communities due to funding constraints or the need for accountability of public funds, Berk believes that other policies could increase participation in youth sports. For example, waiver policies can clearly state the likelihood of getting approved; waivers could be tied to other eligibility criteria such as free and reduced lunch; or applicants could be connected with a contact person, hopefully bilingual, to speak with about waivers. The benefits of such efforts are clear to Berk. As he explained, “There is nothing better than getting kids together on sports teams. It creates bonds, develops leadership skills, and supports both physical and mental health."

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TAG in Action: The Power of One College Student
GOAL: Rodney Smith, a student at Alabama A&M University, started Raising Men Lawn Care Service to help his community raise youth to become positive adults. Through the organization, young people volunteer to provide lawn care services to those without the ability or means to maintain their lawns.

The Inspiration
On his way home from school one day, Rodney Smith, a student at Alabama A&M University, saw an elderly man struggling to mow his lawn and decided to help. Smith set a goal to mow 40 lawns for those without the ability or means to do it themselves. Exceeding expectations, he reached his goal within a month and ultimately completed 100 lawns. Smith saw the positive impact volunteering had on his life, and he realized that something as simple as yard maintenance could help his community raise boys that would become positive adults.

Taking Action
After completing the 100 lawns, Rodney started the Raising Men. Young men and young women volunteer to provide lawn care services to the elderly, disabled, veterans and single mothers. They mow, rake leaves or shovel snow. The first few lawns often seem like work to the youth, but Smith noticed that once a volunteer mows their fifth lawn they are energized and often request more work. He developed an incentive for youth similar to the karate belt system. The volunteers receive different colored t-shirts as they reach milestones of providing lawn services to 10, 20, 30, 40 or 50 people. The highest level, 50, is a black shirt.

To date, about 60 youth and young adults have volunteered for Raising Men in the Huntsville, Alabama area. Raising Men has also started chapters across seven states and in Smith’s home country of Bermuda. A few months ago, Smith decided to expand his reach even further and issued a “50-lawn challenge” to kids worldwide via Facebook. Kids can sign up by sending a picture mowing their first lawn. As they reach a particular milestone, Smith sends them the corresponding t-shirt. Once they hit 50 lawns, he will personally fly to deliver their black shirt. Already, two young people have surpassed 50 yards and gone on reach 100. More than 120 youth have signed up nationwide.

Making A Difference
Smith says that Raising Men is able to keep youth on a positive path by helping them gain a sense of accomplishment, self-esteem, moral value and purpose. “After having such a great experience myself, I wanted to show kids that helping people is cool. I wanted to mentor and demonstrate the importance of giving back to community. I’m able to help, and if you are able, then you should do something to make a difference for someone else. And you can even do it through a lawn mower!”

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TAG in Action: The SPOT
GOAL: The SPOT (Supporting Positive Opportunities for Teens) is a comprehensive health and social services center that serves young people ages 13 to 24 in St. Louis, Missouri. The program’s vision is “Youth partnering with community for social justice and health.”

The Game Plan
The SPOT provides free, confidential medical care, mental health and substance abuse counseling, and case management services to any young person who needs them. In addition, The SPOT also provides a safe place for teens to hang out. Youth can drop in from 1-5 pm in the afternoons to use a computer, take a shower, or grab a snack.

The SPOT was established in 2008 when Washington University School of Medicine’s Division of Adolescent Medicine and the Project ARK HIV program for children, youth, and women observed rising rates of HIV, STDs and other preventable diseases among young people. The teams saw an opportunity to intervene to help kids medically and psychologically. Project ARK and leadership from Adolescent Medicine learned that successful programs for high-risk youth were all grounded in a positive youth development approach and provided comprehensive, low barrier access to services.

The SPOT staff is comprised of people who are passionate about working with teens and young adults. They receive training in delivering trauma-informed services and in using a positive youth development approach. The staff is also committed to early screening for STDs and other preventable diseases and connecting youth to any services they need.

The Winning Plays
Youth were engaged in every aspect of The SPOT’s development. Youth Leaders worked with the architect and interior designer to create a welcoming and youth-friendly space. Youth helped determine the array of services offered and even interviewed job applicants. Staff expected to serve 500 youth in the first year of operation, but they reached 500 in the first quarter and now serve about 3,200 youth annually. The SPOT’s Executive Director, Kim Donica, gives credit to the young people. “The youth leaders made a huge difference. We gained their trust and then they told their friends. Youth hear about us by word of mouth. Their first visit is often because they really need something, but they return because they trust us and know The SPOT is a safe place.”

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TAG in Action: Trauma-Informed School Learning Collaborative
GOAL: The New Orleans Trauma-Informed School Learning Collaborative provides support to schools as they transform their climate to become trauma sensitive and build their capacity to implement, sustain, and improve the delivery of trauma-focused services.

The Game Plan
The Trauma-Informed School Learning Collaborative (TISLC) was created to address the high rates of acute and chronic trauma experienced by youth throughout New Orleans. The collaborative brought together a diverse group of partners from social work, psychology, education, public health, mental health, and research. The partners committed to move beyond training individuals; rather, they intend to build the capacity of organizations to effectively address trauma in their daily practices.

Five New Orleans schools, including three primary schools and three high schools, partnered with TISLC. Utilizing the Substance Abuse and Mental Health Services Administration’s (SAMHSA) framework for addressing trauma, the schools are reshaping their policies, procedures, and practices to: a) realize the prevalence and impact of trauma; b) recognize the signs of trauma and the need for learning supports for traumatized students; and c) respond to avoid re-traumatization by integrating principles of trauma-informed care into the classroom and responding to their own self-care needs. For example, one school’s zero-tolerance suspension-expulsion requirements were eliminated and replaced with more flexible procedures that address the root of a youth’s misbehavior. Students also got involved and learned how to support each other and be good friends by asking questions and listening when others seem sad or angry. Importantly, the schools collect both process and outcome data related to their implementation and engage in ongoing data-based decision-making.

The Winning Plays
TISLC’s work — in the schools and among the collaborative partners — is based upon SAMHSA’s six principles of trauma-informed schools: safety; trustworthiness and transparency; peer support; collaboration and mutuality; empowerment voice and choice; and cultural humility. Courtney Baker, Assistant Professor of Psychology at Tulane University, explained, “We’re not implementing a program. It’s a framework that is based on evidence. School leaders use the framework and then do what makes sense for their community. What’s exciting is that each school has taken a very different approach, yet they are all moving towards same goal. The flexibility and adaptability is so important because, just like each young person is unique, each of our schools is really unique.”

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TAG in Action: U.S. Soccer Foundation
GOAL: The U.S. Soccer Foundation’s Safe Places to Play and Soccer for Success programs help communities address childhood obesity and juvenile delinquency and increase options for safe afterschool programming.

The Game Plan
Through the Safe Places to Play program, the Foundation has helped to create and develop more than 1,100 soccer fields across the country in order to give kids safe and accessible areas to play. Safe Places to Play transforms abandoned courts, empty schoolyards, and small vacant lots into state-of-the-art soccer fields. The program is built on the belief that every child should be able to play soccer without being concerned for his or her safety. Through grants to underserved communities, Safe Places to Play helps communities address the common challenge in underserved areas of inadequate places for youth to play and be active. The grants help cover the costs of design, construction, surfacing, and enhancement.

Through its Soccer for Success program the Foundation partners with community-based organizations to provide a free afterschool option for youth that ensures kids from kindergarten through 8th grade are physically active for the recommended 60 minutes per day. They also learn about eating right and other ways to stay healthy, and they gain important decision-making and relationship skills from their interactions with coach-mentors and peers. Soccer for Success’ lessons don’t stop on the field. Coach-mentors meet with families regularly to educate parents and guardians about how to embrace an active and healthy lifestyle and nurture their child’s personal growth. A recent study found that children who participated in Soccer for Success significantly improved their Body Mass Index (BMI) percentile, waist circumference and aerobic capability compared to children in other afterschool programs in the same neighborhoods.

The Winning Plays
The U.S. Soccer Foundation’s efforts on behalf of children go beyond simply seeking to expand the availability of soccer programs and fields. As the U.S. Soccer Foundation describes, making soccer accessible to youth has a broader purpose: “We view soccer as a powerful vehicle for social change. By supporting the development of places to play, places to grow and places to learn, our goal is to ensure that children in underserved communities have easy and affordable access to quality soccer programs that support their physical and personal development.”

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TAG in Action: West Virginia Adolescent Health Initiative
GOAL: The West Virginia Adolescent Health Initiative supports collaborative, community-based efforts designed to develop the assets youth need to thrive and become successful.

The Game Plan
The West Virginia Adolescent Health Initiative (AHI) supports a dedicated network of eight Regional Adolescent Health Coordinators. The coordinators provide technical assistance to youth, parents, teachers, health care professionals, regional networks, and civic groups on improving adolescent health. AHI has fully embraced the Search Institute’s “Developmental Assets for Adolescents,” which identifies 40 positive experiences and qualities that allow children and youth to thrive. AHI offers asset presentations, facilitates community-building asset initiatives, and works with schools to administer the Search Institute’s asset survey.

AHI is committed to responding to the needs of youth and communities throughout West Virginia. In 2016, AHI developed and administered a survey to gather input from youth and parents on its programmatic efforts. The survey also inquired about the need to address bullying and cyberbullying — an issue that was raised by youth. In total, more than 4,500 individuals responded to the survey, including 3,131 youth and 1,450 parents. AHI shared the survey results with Students Against Destructive Decisions (SADD), a key partner organization. Based on the results, SADD Youth Leaders designed a statewide anti-bullying campaign called “You’ve Been Heard” and also filmed a video that was featured at the campaign’s launch in January 2017.

The Winning Plays
The survey of youth and their parents provided a solid foundation for launching a statewide campaign. The Regional Adolescent Health Coordinators played a big role in the survey’s success. Working with community partners, AHI found multiple ways to distribute the survey, including through West Virginia’s TAG Facebook page and other social media outlets, at meetings of youth groups, and through other community-based organizations. In their survey responses, youth expressed frustration with adults not listening to them or not taking them seriously about bullying. “It would be nice if parents, adults and teachers would take bullying seriously,” one respondent wrote. “It isn't a joke. We know the difference between friends kidding and actually being bullied. STOP treating us like we don’t!”

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TAG in Action: Youth ALIVE! Caught in the Crossfire
GOAL: The Caught in the Crossfire program meets young victims of violence at their hospital bedsides in order to prevent retaliatory violence, offer practical help, and provide a path toward safety and healing.

The Game Plan
Caught in the Crossfire (CiC) is a hospital-based violence intervention program based in Oakland, California. The nonprofit organization, Youth ALIVE!, delivers CiC as part of an array of violence prevention, intervention, and healing programs. Youth ALIVE! was founded on the belief that youth from the city’s most violent neighborhoods have the power to change things for the better. The CiC program was created in the early 1990’s by a young man, Sherman Spears, who was himself violently injured. Sherman realized that while the hospital was equipped to care for his physical wounds, it was not equipped to address the emotional wounds that he and his family experienced. Sherman also understood that becoming a victim of violence created a “teachable moment,” a time that youth are particularly open to learning and making positive changes.

Building on these teachable moments, CiC’s trained intervention specialists and case managers to work with young victims to address both their immediate need for violence intervention and ongoing service needs as they recover. The first of its kind, CiC has been replicated across the country. In 2009, Youth ALIVE! and its partners established the National Network of Hospital-based Violence Intervention Programs in order to share knowledge, promote best practices, and collaborate on research. Over the years, the evidence supporting hospital-based violence intervention programs (HVIPs) has grown. Evaluations of CiC and other HVIPs have demonstrated an array of cost-saving outcomes including reduced likelihood of reinjury or readmittance to a hospital, and reduced future involvement with the criminal justice system.

The Winning Plays
Anne Marks, Executive Director of Youth ALIVE! shared that, “Caught in the Crossfire, and all of our Youth ALIVE! programs, are based on the lived experiences of youth. We start there and then we hold ourselves accountable for outcomes. It’s important that our staff come from the community we serve. It means our CiC interventionists can offer victims understanding while also providing them with practical approaches to addressing their physical and emotional safety. Trauma is a contagion. Without intervention, 44 percent of people who get shot will be shot again in five years. We recognize that we need to provide young victims with the space, time, and support to heal."

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