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Opportunities to Improve Adolescent Health and Wellbeing Through Medical Education and Delivery of Quality Preventive Care. J Adolesc Health 2022; 71:383-384. [PMID: 36122998 DOI: 10.1016/j.jadohealth.2022.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 06/24/2022] [Indexed: 11/23/2022]
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Bhattad S, Mohite R, Singh N. Growth and development in children with rheumatic diseases: Maintaining a balance between drugs and disease activity. INDIAN JOURNAL OF RHEUMATOLOGY 2022. [DOI: 10.4103/injr.injr_54_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Ferrin SN, Grout RW, Lewis Gilbert A, Wilkinson TA, Cheng ER, Downs SM, Aalsma MC. Caregiver Comfort in Adolescents Independently Completing Screening Tablet-Based Questionnaires at Primary Care Visits. J Adolesc Health 2019; 65:799-804. [PMID: 31522906 PMCID: PMC7358079 DOI: 10.1016/j.jadohealth.2019.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 06/18/2019] [Accepted: 07/10/2019] [Indexed: 12/20/2022]
Abstract
PURPOSE The objective of this study was to assess caregiver comfort regarding adolescent completion of computerized health screening questionnaires created for adolescents. METHODS We conducted a mixed-method, cross-sectional survey of caregivers of adolescent patients (n = 104) aged 12-18 years who had a medical visit between June 2017 and August 2017. Topics assessed included who completed the questionnaire, caregiver comfort and concern regarding questionnaire data, and caregiver reasons for involvement in completing the questionnaire. A one-way analysis of variance was used to compare the age of the adolescent and caregiver involvement in the questionnaire. RESULTS The majority of adolescents (64%) reported independent completion of the questionnaire. Thirteen percent of caregivers completed the questionnaire with no involvement of the adolescent and 23% reported that caregivers and adolescents completed the questionnaire in tandem. The majority of caregivers (84%) were comfortable with adolescents completing the questionnaire. A variety of reasons were identified for caregivers completing the questionnaire (time constraints, 22%; adolescent requested caregiver help, 19%; caregiver desired to answer questions, 14%; caregiver did not realize that the questionnaire was intended for the adolescent, 11%; caregiver believed that the adolescent was too young to respond alone, 11%). Caregiver comfort with adolescent completing the questionnaire increase with age. CONCLUSION We found the reason most caregivers gave for completing the questionnaires were related to clinic processes (e.g. time constraints). Caregivers were more likely to complete the questionnaire with younger adolescents. Thus, pediatricians should consider how to best prepare families for initial questionnaires in primary care.
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Affiliation(s)
- Stephanie N. Ferrin
- Division of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Randall W. Grout
- Children’s Health Services Research, Indiana University School of Medicine, Indianapolis, Indiana,Regenstrief Institute, Inc., Indianapolis, Indiana
| | - Amy Lewis Gilbert
- Children’s Health Services Research, Indiana University School of Medicine, Indianapolis, Indiana
| | - Tracey A. Wilkinson
- Children’s Health Services Research, Indiana University School of Medicine, Indianapolis, Indiana
| | - Erika R. Cheng
- Children’s Health Services Research, Indiana University School of Medicine, Indianapolis, Indiana
| | - Stephen M. Downs
- Children’s Health Services Research, Indiana University School of Medicine, Indianapolis, Indiana,Regenstrief Institute, Inc., Indianapolis, Indiana
| | - Matthew C. Aalsma
- Adolescent Behavioral Health Research Program, Division of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, Indiana
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Darling-Fisher CS, Salerno J, Dahlem CHY, Martyn KK. The Rapid Assessment for Adolescent Preventive Services (RAAPS): providers' assessment of its usefulness in their clinical practice settings. J Pediatr Health Care 2014; 28:217-26. [PMID: 23623541 DOI: 10.1016/j.pedhc.2013.03.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Revised: 02/28/2013] [Accepted: 03/07/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The purpose of this study was to evaluate health providers' use of the Rapid Assessment for Adolescent Preventive Services (RAAPS) screening tool to identify adolescent high-risk behaviors, its ease of use and efficiency, and its impact on provider/patient discussions of sensitive risk behaviors. METHOD This mixed methods descriptive study used an online survey to assess providers' use of the RAAPS and their perspectives on its implementation and effect on adolescent-provider communication. The survey was completed by providers from a variety of settings across the United States (N = 201). RESULTS Quantitative and qualitative analyses indicated that the RAAPS facilitated identification of risk behaviors and risk discussions and provided efficient and consistent assessments; 86% of providers believed that the RAAPS positively influenced their practice. DISCUSSION Adoption of the RAAPS in practice settings could lead to more effective adolescent preventive services by giving providers a tool to systematically assess and identify adolescents at risk. Implementation of RAAPS offers health providers an efficient, consistent, and "adolescent friendly" way to identify risky behaviors and open the discussion needed to tailor interventions to meet their needs.
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Fallucco EM, Conlon MK, Gale G, Constantino JN, Glowinski AL. Use of a standardized patient paradigm to enhance proficiency in risk assessment for adolescent depression and suicide. J Adolesc Health 2012; 51:66-72. [PMID: 22727079 DOI: 10.1016/j.jadohealth.2011.12.026] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Revised: 12/19/2011] [Accepted: 12/20/2011] [Indexed: 11/16/2022]
Abstract
PURPOSE Although routine adolescent depression and suicide risk assessment (ADSRA) is recommended, primary care physician (PCP) ADSRA training is needed for successful ADSRA implementation. This study examined the effect of an intervention using standardized patients (SPs) on PCP ADSRA confidence, knowledge, and practices. METHODS The intervention consisted of a 60-minute seminar followed by a 60-minute SP session to practice ADSRA skills in simulated clinical situations. INTERVENTION PCPs (n = 46) completed pre- and postintervention assessments. Untrained PCPs interested in the intervention (n = 58) also completed assessments. Assessments evaluated ADSRA self-reported confidence and practices and objectively assessed knowledge. The main outcomes were (1) changes in pre-/postintervention PCP ADSRA confidence and knowledge, and (2) ADSRA practices in untrained versus postintervention PCPs. RESULTS Compared with untrained PCPs, PCPs 5-10 months postintervention were more likely to screen most adolescents for depression (40% vs. 22%, p = .05), to use a depression screening tool (50% vs. 19%, p = .001), to have diagnosed at least one adolescent with depression in the past 3 months (96% vs. 78%, p = .013), and to have screened depressed adolescents for suicide risk factors, including access to weapons (51% vs. 25%; p = .007) or an impulsive violence history (27% vs. 11%; p = .037). PCP confidence and knowledge about depression assessment and treatment also significantly improved postintervention. CONCLUSIONS This study supports the use of an SP intervention to improve PCP ADSRA confidence, knowledge, and practices. Widespread implementation of similar educational efforts has the potential to dramatically improve adolescent morbidity and mortality.
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Affiliation(s)
- Elise M Fallucco
- Division of Psychology and Psychiatry, Nemours Children's Clinic, Jacksonville, FL 32207, USA.
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Sanci L. Clinical preventive services for adolescents: facing the challenge of proving "an ounce of prevention is worth a pound of cure". J Adolesc Health 2011; 49:450-2. [PMID: 22018557 DOI: 10.1016/j.jadohealth.2011.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Accepted: 09/06/2011] [Indexed: 11/19/2022]
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Hammond WP, Matthews D, Mohottige D, Agyemang A, Corbie-Smith G. Masculinity, medical mistrust, and preventive health services delays among community-dwelling African-American men. J Gen Intern Med 2010; 25:1300-8. [PMID: 20714819 PMCID: PMC2988156 DOI: 10.1007/s11606-010-1481-z] [Citation(s) in RCA: 138] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2009] [Revised: 03/12/2010] [Accepted: 07/22/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND The contribution of masculinity to men's healthcare use has gained increased public health interest; however, few studies have examined this association among African-American men, who delay healthcare more often, define masculinity differently, and report higher levels of medical mistrust than non-Hispanic White men. OBJECTIVE To examine associations between traditional masculinity norms, medical mistrust, and preventive health services delays. DESIGN AND PARTICIPANTS A cross-sectional analysis using data from 610 African-American men age 20 and older recruited primarily from barbershops in the North, South, Midwest, and West regions of the U.S. (2003-2009). MEASUREMENTS Independent variables were endorsement of traditional masculinity norms around self-reliance, salience of traditional masculinity norms, and medical mistrust. Dependent variables were self-reported delays in three preventive health services: routine check-ups, blood pressure screenings, and cholesterol screenings. We controlled for socio-demography, healthcare access, and health status. RESULTS After final adjustment, men with a greater endorsement of traditional masculinity norms around self-reliance (OR: 0.77; 95% CI: 0.60-0.98) were significantly less likely to delay blood pressure screening. This relationship became non-significant when a longer BP screening delay interval was used. Higher levels of traditional masculinity identity salience were associated with a decreased likelihood of delaying cholesterol screening (OR: 0.62; 95% CI: 0.45-0.86). African-American men with higher medical mistrust were significantly more likely to delay routine check-ups (OR: 2.64; 95% CI: 1.34-5.20), blood pressure (OR: 3.03; 95% CI: 1.45-6.32), and cholesterol screenings (OR: 2.09; 95% CI: 1.03-4.23). CONCLUSIONS Contrary to previous research, higher traditional masculinity is associated with decreased delays in African-American men's blood pressure and cholesterol screening. Routine check-up delays are more attributable to medical mistrust. Building on African-American men's potential to frame preventive services utilization as a demonstration, as opposed to, denial of masculinity and implementing policies to reduce biases in healthcare delivery that increase mistrust, may be viable strategies to eliminate disparities in African-American male healthcare utilization.
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Affiliation(s)
- Wizdom Powell Hammond
- Department of Health Behavior and Health Education, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, NC 27599-7440, USA.
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Hammond WP, Matthews D, Corbie-Smith G. Psychosocial factors associated with routine health examination scheduling and receipt among African American men. J Natl Med Assoc 2010; 102:276-89. [PMID: 20437735 DOI: 10.1016/s0027-9684(15)30600-3] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
INTRODUCTION African American men often fail to obtain routine health examinations, which increases the probability of disease detection, yet little is known about psychosocial factors that motivate scheduling and receipt among this group. METHODS We used the Andersen model and theory of reasoned action as frameworks to evaluate the relative contribution of psychosocial factors to self-reported routine health examination scheduling and receipt in a cross-sectional sample of African American men (N = 386) recruited from barbershops (65.3%) and academic institutions/events (34.7%) in Michigan, Georgia, and North Carolina between 2003-2004 and 2007-2009. Participants completed measures assessing demographic factors, physical/mental health status, traditional male role norms, health-promoting male subjective norms, health value, and medical mistrust. Pearson's chi(2), analysis of variance, and multivariate logistic regression analyses were used to investigate associations between these study factors and routine health examination scheduling and receipt in the past year. RESULTS After final adjustment, the odds of scheduling a routine health examination were increased for men with a usual source of care (OR, 5.48; 95% CI, 3.06-9.78) and more health-promoting male subjective norms exposure (OR, 1.46; 95% CI, 1.02-2.04). Higher medical mistrust (OR, 0.26;; 95% CI, 0.09-0.76) and traditional male role norms (OR, 0.71; 95% CI, 0.52-0.98) reduced the odds of routine health examination receipt. The odds of routine health examination receipt were increased among men who were older (OR=1.05; 95% CI, 1.01-1.10), had a usual source of care (OR, 2.91; 95% CI, 1.54-5.51) and reported more male subjective norms exposure (OR, 1.51; 95% CI, 1.02-2.22). CONCLUSIONS Improving African American men's uptake of routine health examinations will require addressing medical mistrust, mitigating traditional masculine concerns about disclosing vulnerability, and leveraging male social networks.
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Affiliation(s)
- Wizdom Powell Hammond
- Department of Social Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7440 USA.
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Adolescent preventive health care: what do parents want? J Pediatr 2009; 155:689-94.e1. [PMID: 19643441 DOI: 10.1016/j.jpeds.2009.05.029] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2008] [Revised: 03/28/2009] [Accepted: 05/19/2009] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To understand parental opinions about which topics should be discussed during adolescent preventive health visits and how best to incorporate adolescent confidentiality into these visits. STUDY DESIGN Cross-sectional, web-based survey of a national sample of 1025 parents of adolescents. RESULTS Response rate was 71%. From a list of 18 possible topics, the 3 most frequently selected as being "very important for the doctor to discuss during adolescent well child examinations" were "diet/nutrition" (75%), "exercise/sports" (67%), and "physical changes of puberty" (60%). There was variability in topic popularity by parents' race/ethnicity and gender and by adolescents' age, health status, and gender. Most parents (66%) believed it was "very/somewhat" important for adolescents to have private time with the doctor during these visits, yet a substantial proportion of parents (46%) preferred that the doctor disclose to them the confidential information obtained during these private encounters. CONCLUSIONS Parents find numerous topics important for discussion during well adolescent health care visits suggesting that parents might value a broad range of preventive care services for adolescents. However, some parents appear conflicted about incorporating adolescent confidentiality into prevention-focused visits.
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Aina OF, Olorunshola DA. Alcohol and substance use portrayals in Nigerian video tapes: an analysis of 479 films and implications for public drug education. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2009; 28:63-71. [PMID: 18644765 DOI: 10.2190/iq.28.1.f] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
There is an observed increasing trend of substance use among the adolescents and young adults. One of the important aetiologies is "modeling" especially from popular artists portraying their use to the viewing public over the electronic media. Indigenous films on video tapes acted in English or "Yoruba" (a popular Nigerian language) were randomly selected from various retail outlets in Lagos for viewing. The settings were the Ikorodu and Ipaja suburbs of Lagos. The viewing audience in each center was made up of a researcher and two adolescent secondary school students. They were to make notes on each film with scenes of substance use, type, and nature of use. A total of 479 video tapes were studied over a 6 month period, of which 268 (55.9%) contained scenes portraying the use of one or more substances. Two hundred forty-seven (51.6%, N = 479) depicted the use of only one type of substance and the rest, 21 (4.3%, N = 479), portrayed the use of multiple substances. The commonest substance portrayed to be used was alcohol, 197 (41.1%, N = 479), followed by tobacco, 81 (16.9%, N = 479). Cannabis was shown to be used in only 3 (0.6%, N = 479); Cocaine and Heroin in 8 (1.6%, N = 479) of the films. There was no statistically significant difference on substance use portrayal between the home movies acted in English and Yoruba (chi2 = 32.8; df = 7 at p > or = 0.05). A significant number of films on video tapes in Nigeria portrayed substance use which could act as triggers or reinforcement for substance use among the viewing audience, especially adolescents and young adults. The need to censor video tapes on substance use portrayal was advocated.
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McFee RB. Gulf war servicemen and servicewomen: the long road home and the role of health care professionals to enhance the troops' health and healing. Dis Mon 2008; 54:265-333. [PMID: 18440371 PMCID: PMC7089602 DOI: 10.1016/j.disamonth.2008.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Broder KR, Cohn AC, Schwartz B, Klein JD, Fisher MM, Fishbein DB, Mijalski C, Burstein GR, Vernon-Smiley ME, McCauley MM, Wibbelsman CJ. Adolescent immunizations and other clinical preventive services: a needle and a hook? Pediatrics 2008; 121 Suppl 1:S25-34. [PMID: 18174318 DOI: 10.1542/peds.2007-1115d] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Advances in technology have led to development of new vaccines for adolescents, but these vaccines will be added to a crowded schedule of recommended adolescent clinical preventive services. We reviewed adolescent clinical preventive health care guidelines and patterns of adolescent clinical preventive service delivery and assessed how new adolescent vaccines might affect health care visits and the delivery of other clinical preventive services. Our analysis suggests that new adolescent immunization recommendations are likely to improve adolescent health, both as a "needle" and a "hook." As a needle, the immunization will enhance an adolescent's health by preventing vaccine-preventable diseases during adolescence and adulthood. It also will likely be a hook to bring adolescents (and their parents) into the clinic for adolescent health care visits, during which other clinical preventive services can be provided. We also speculate that new adolescent immunization recommendations might increase the proportion and quality of other clinical preventive services delivered during health care visits. The factor most likely to diminish the positive influence of immunizations on delivery of other clinical preventive services is the additional visit time required for vaccine counseling and administration. Immunizations may "crowd out" delivery of other clinical preventive services during visits or reduce the quality of the clinical preventive service delivery. Complementary strategies to mitigate these effects might include prioritizing clinical preventive services with a strong evidence base for effectiveness, spreading clinical preventive services out over several visits, and withholding selected clinical preventive services during a visit if the prevention activity is effectively covered at the community level. Studies are needed to evaluate the effect of new immunizations on adolescent preventive health care visits, delivery of clinical preventive services, and health outcomes.
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Affiliation(s)
- Karen R Broder
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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Packham JC. Overview of the psychosocial concerns of young adults with juvenile arthritis. Musculoskeletal Care 2007; 2:6-16. [PMID: 17041964 DOI: 10.1002/msc.52] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Young adults who develop juvenile idiopathic arthritis in childhood have a significant risk of long-term morbidity and continuing disease activity in adulthood. The impact of a physically restricting and painful chronic illness can make the transition from adolescence to adulthood more challenging. In this overview of the psychological and social impact of juvenile arthritis on young adults, particular attention is given to those areas that are of concern to this age group. The transition from adolescence to adulthood can be detrimentally affected not only by the attitudes of peers and parents, but also by the attitudes of the individual with arthritis. Chronic arthritis, including juvenile arthritis, is related to increased rates of anxiety and depression. In the face of functional restriction, pain, and poor body image, social and sexual relationships may be harder to develop and maintain. The family of the young adult may also be affected on many levels. Employment and financial security are common and well-founded concerns of young disabled adults.
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Affiliation(s)
- Jon C Packham
- Staffordshire Rheumatology Centre, Haywood Hospital, Stoke-on-Trent
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Sterling S, Kohn C, Lu Y, Weisner C. Pathways to chemical dependency treatment for adolescents in an HMO. J Psychoactive Drugs 2005; 36:439-53. [PMID: 15751482 DOI: 10.1080/02791072.2004.10524427] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
This study examines pathways to chemical dependency (CD) treatment for adolescents in a prepaid health plan, including factors influencing treatment referral and access. Data were collected from 419 adolescent CD treatment intakes ages 13 to 18 in a large, private health plan. The study examines predictors of referral from different sources and of mental health treatment prior to CD treatment. Referral patterns, problem severity, and psychiatric comorbidity differed by gender. Being male (p < .05) and higher scores on the Youth Self-Report (YSR) externalizing scale (p < .01) predicted a justice system referral. Using more types of substances predicted referral by medical and mental health providers (p < .05) and self-referral (p < .01). Higher YSR internalizing scores predicted referral from mental health (p < .01) and self-referral (p <.01). Being White versus African American (p < .05) or Latino (p < .01), older (p < .05), and having higher YSR internalizing scores (p < .05), a conduct disorder (p < .01), or a family member with a substance use problem (p < .01) predicted a mental health visit prior to CD intake. The findings raise questions regarding the role of health plans, clinicians, families, schools, and community agencies in referring and treating adolescents with substance use problems. They suggest that improved coordination of care may promote more integrated treatment practices, which could decrease substance use, mental health, and medical problem severity.
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Affiliation(s)
- Stacy Sterling
- Division of Research, Kaiser Permanente Northern California, Oakland, California 94612-2403, USA
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Abstract
PURPOSE To create a data management system that: (1) standardizes antecedent, program, and outcome variables relevant to the shared goals of adolescent-oriented maternity programs while allowing users to add variables pertaining to unique aspects of their work; (2) cues providers to physiologic and psychosocial characteristics that predispose teenagers to adverse pregnancy and parenting outcomes, (3) standardizes patient care by guiding providers through adolescent-oriented prenatal, postpartum, and well baby visits, and (4) establishes the infrastructure to collect data from a nationally representative sample of pregnant and parenting teens. METHOD We adapted a powerful, state-of-the-art relational database framework (Microsoft Access 2000) to create an easy-to-use data management system-The Electronic Report on Adolescent Pregnancy (ERAP)-that requires minimal training to use on a personal computer. RESULTS ERAP is designed to meet the administrative and analytic needs of adolescent-oriented maternity programs. It consists of six linked core data tables (teen, pregnancy, prenatal visits, child, interconception interval, and interconception interval visits), that allow users to analyze data from these multiple views while preserving the family structure. In addition, the database standardizes methods for collecting and storing the information and automatically computing the variables needed to monitor and evaluate an adolescent-oriented maternity program. Since by adding variables and appending supplementary tables, users can modify the core database to accommodate unique aspects of their programs and/or research, ERAP is also an ideal conduit for translating research findings into clinical practice. Similarly, because ERAP actually structures the care patients receive, the database provides the infrastructure needed to develop and implement best practice guidelines for treating teen-headed families. Finally, the confidentiality of all subject data is assured because ERAP is password-protected and automatically prepares files for batched external analyses by removing personal identifiers. CONCLUSIONS ERAP provides the infrastructure needed to create a teen-pregnancy databank at the national level and an efficient patient monitoring system at the program level. By standardizing variable definitions and data collection techniques, serving as a repository for data collected at multiple sites, and tracking the multidisciplinary aspects of the care patients receive, ERAP has the potential to facilitate collaboration between adolescent-oriented maternity programs, increase the scientific rigor of teen pregnancy research, and improve the quality of care individual teen-headed families receive by prompting compliance with best practice guidelines.
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Affiliation(s)
- Jeanelle Sheeder
- Department of Pediatrics, University of Colorado Health Sciences Center, Denver, Colorado 80218, USA.
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Harrison PA, Beebe TJ, Park E, Rancone J. The adolescent health review: test of a computerized screening tool in school-based clinics. THE JOURNAL OF SCHOOL HEALTH 2003; 73:15-20. [PMID: 12621719 DOI: 10.1111/j.1746-1561.2003.tb06553.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
This study tested the viability of a stand-alone screening process in school-based health centers, and gauged its acceptance by patients and providers. The study also examined the prevalence of a variety of health risks disclosed in response to a new screening instrument and the relationship between these health risks and the stated purpose for the clinic visit. Seven school-based clinics located in six high schools and one alternative school in an urban school district participated in the study; 692 patients (83% female, 67% minority) completed the Adolescent Health Review (AHR), a multidimensional screening instrument that addressed 14 risk domains. The AHR was computerized for administration, scoring, and report generation. Females reported risk in significantly more domains than males (4.2 vs. 3.2; t = 4.5, p < .0001), including higher risk in family interaction problems, a history of physical or sexual abuse, emotional distress, suicidal behavior, marijuana use, and sexual activity. Significantly more males than females reported violent behavior. Risk rates were high regardless of stated purpose for the clinic visit. According to clinic staff, use of the AHR increased routine screening and the process was well accepted by patients and providers. Providers benefited from the opportunity to discuss risks with patients by using the printed reports to facilitate conversation and develop health care plans.
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Affiliation(s)
- Patricia A Harrison
- Minneapolis Dept. of Health and Family Support, 250 South Fourth St., Suite 510, Minneapolis, MN 55415-1384, USA.
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White PH. Transition: a future promise for children and adolescents with special health care needs and disabilities. Rheum Dis Clin North Am 2002; 28:687-703, viii. [PMID: 12380376 DOI: 10.1016/s0889-857x(02)00020-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Transitions are a part of everyone's life experience. Most young people with special health care needs and disabilities (SHCN/D) become independent partners in adult society, but some need deliberate guidance and support. This latter group is growing in number. Through a new consensus statement from the American Academy of Pediatrics and the U.S. Federal Government (Healthy People 2010), society is recognizing the need to assist young people with SHCN/D in attaining their potential in adulthood. This article discusses the growing number of young people with SHCN/D, their desires for their transition, the definition and areas of transition that should be addressed, and the key elements of successful transition programs. The article ends with a suggested list of actions a health care professional can undertake to foster a successful transition and a selected list of helpful resources for health professionals, families, and young people with SHCN/D.
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Affiliation(s)
- Patience H White
- Adolescent Employment Readiness Center, Children's National Medical Center, 111 Michigan Avenue NW, Suite 1300, Washington, DC 20010, USA.
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Affiliation(s)
- D M Hall
- Community Sciences Building, Northern General Hospital, Sheffield S5 7QA, UK
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Abstract
Sexual activity during adolescence may represent a risk for young women's quality of life as well as their health. This practice can result in early pregnancy, abortion, AIDS and other sexually transmitted diseases. The need for sexual education in order to identify and prevent the risk factors of an unwanted pregnancy during adolescence becomes increasingly clearer. In order to accomplish this purpose all segments of society shall be convened. If the goal is educating, informing or, even better, forming, then the school stands out from among the other reference groups because this is its essential role. A few basic principles should be established for the success of the educators' actions. Perhaps the most important one being not only to base sexual education on the use of preservatives and contraceptive methods, but rather on rescuing the individual as a result of his/her own actions. This favors the development of a sense of citizenship, respect, commitment, self-care and care for others.
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Affiliation(s)
- M I Saito
- Unidade de Adolescentes do Instituto da Criança, Universidade de São Paulo, Brazil
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Abstract
Today, there are significant risks to the health of teenagers. Drugs (tobacco, alcohol, steroids and others), sex (pregnancy, STDs, date rape), nutrition (obesity and eating disorders), and violence (abuse, fighting) are unfortunately a part of many teens' lives. These risks increase throughout the teen years. Since each risk has a strong behavioral component, we hope to modify the behavior and minimize the risk. Prevention and health promotion are an important part of health care for teens. Primary care providers, such as family physicians, are in an excellent position to provide teen preventative care that is comprehensive and specific to the needs of each teen.
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Affiliation(s)
- C J Reif
- Department of Family and Community Medicine, Regions Hospital, St. Paul, MN, USA
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