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Young MA, Thompson K, Lewin J, Holland L. A framework for youth-friendly genetic counseling. J Community Genet 2019; 11:161-170. [PMID: 31691103 DOI: 10.1007/s12687-019-00439-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 10/02/2019] [Indexed: 12/29/2022] Open
Abstract
Young people represent a unique cohort in the context of both healthcare and genetic risk. Genetic counselors have long recognized and documented the challenges of working with young people and their families compared with working with older adults. Challenges for health professionals include engagement with the young person, communication, developmentally appropriate psychosocial assessment, and working with the young person and their family. Likewise, young people also report experiencing challenges within the genetic counseling process. In response to these challenges, and increasing numbers of young people presenting for genetic testing, genetic counselors at the Parkville Familial Cancer Centre (Peter MacCallum Cancer Centre, Australia) formed a collaboration with the ONTrac at Peter Mac Victorian Adolescent & Young Adult Cancer Service. Consisting of a multidisciplinary expert panel who provide care to young people with cancer and their families, the collaboration identified the need to develop an evidence-based framework to ensure the delivery of youth-friendly care and support for young people and their families facing genetic risk. To guide this work, a working party comprising of experts in genetic counseling, adolescent and young adult (AYA) oncology, adolescent health, clinical ethics, and clinical research was established. A literature review was undertaken and based on expert and consumer input and feedback, a consensus-based framework for youth-friendly genetic counseling was developed over several stages. This paper describes the evidence base supporting the development of this framework, the process of development, and the resulting framework of youth-friendly genetic counseling.
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Affiliation(s)
- Mary-Anne Young
- Kinghorn Centre for Clinical Genomics, Garvan Institute of Medical Research, 370 Victoria St Darlinghurst, Sydney, NSW, 2010, Australia. .,Parkville Familial Cancer Centre, Melbourne, Victoria, Australia.
| | - Kate Thompson
- ONTrac at Peter Mac Victorian Adolescent and Young Adult Cancer Service, Melbourne, Victoria, Australia.,The University of Melbourne, Melbourne, Victoria, Australia
| | - Jeremy Lewin
- ONTrac at Peter Mac Victorian Adolescent and Young Adult Cancer Service, Melbourne, Victoria, Australia.,Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lucy Holland
- Queensland University of Technology, Brisbane, Queensland, Australia.,The University of Newcastle, Newcastle, New South Wales, Australia
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Weiss C, Elouard Y, Gerold J, Merten S. Training in youth-friendly service provision improves nurses' competency level in the Great Lakes Region. Int J Public Health 2018; 63:753-763. [PMID: 29730719 DOI: 10.1007/s00038-018-1106-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 04/16/2018] [Accepted: 04/17/2018] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES This survey investigates whether relevant training and availability of guidelines improve self-reported competencies of nurses in the provision of youth-friendly sexual and reproductive health services in South-Kivu Province in the Democratic Republic of the Congo, Burundi, and Rwanda. METHODS A quantitative baseline survey was conducted among nurses in randomly selected health facilities. Nurses providing youth-friendly sexual and reproductive health services were asked to self-rate their competencies with regards to technical knowledge, clinical, and communication skills. In South-Kivu, Burundi, and Rwanda, 135, 131, and 99 nurses were interviewed, respectively. RESULTS Overall differences of service and guideline availability and self-rated competencies can be observed between the three countries. In two countries, more than one in five nurses considered themselves to be only somewhat or not confident to counsel young people. Nurses from Rwanda showed the highest level of competencies followed by Burundi and South-Kivu. Lack of training in youth-friendly health services or family planning showed significant associations with reporting feeling somehow or not competent. CONCLUSIONS The lack of training, supervision, and guidelines expressed by the nurses is of great concern. Competency-based training in youth-friendly health services is an important approach in improving nurses' competency level.
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Affiliation(s)
- Carine Weiss
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Yajna Elouard
- Swiss Centre for International Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Jana Gerold
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,Swiss Centre for International Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Sonja Merten
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
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Kokotailo PK, Baltag V, Sawyer SM. Educating and Training the Future Adolescent Health Workforce. J Adolesc Health 2018; 62:511-524. [PMID: 29472128 DOI: 10.1016/j.jadohealth.2017.11.299] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 10/23/2017] [Accepted: 11/14/2017] [Indexed: 10/18/2022]
Abstract
Unprecedented attention is now focused on adolescents with growing appreciation of their disease burden and of the opportunities of investing in adolescent health. New investments are required to build the technical capacity for policy, programming, research, and clinical care across the world, especially in resource-poor settings where most adolescents live. Strategies to educate and train the future workforce are needed. Competency-based education and training is the standard of education in preservice (undergraduate and postgraduate) health education and medical specialty training. Yet competency is difficult to quantify and standardize, as are the processes that underpin competency-based education and training. The primary objective of this review was to identify how quality education in adolescent health and medicine is determined. This information was used to inform the development of a conceptual framework for institutions teaching adolescent health, which can be used to assess the quality of teaching and learning and to monitor the implementation of these adolescent health competencies. Specific teaching modalities and assessment tools that have been used to teach adolescent health are described to exemplify how an educational program can be delivered and assessed. This framework is a step toward the development of a more adolescent-competent health workforce.
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Affiliation(s)
- Patricia K Kokotailo
- Department of Pediatrics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin.
| | - Valentina Baltag
- World Health Organization, Department of Maternal, Newborn, Child and Adolescent Health, Geneva, Switzerland
| | - Susan M Sawyer
- Centre for Adolescent Health, Royal Children's Hospital; Department of Paediatrics, The University of Melbourne; Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
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Hassan A, Maza JCR, Teich HG, Guerra EHC. Caring for adolescents in Guatemala: provider perspectives. Int J Adolesc Med Health 2017; 32:/j/ijamh.ahead-of-print/ijamh-2017-0121/ijamh-2017-0121.xml. [PMID: 28949929 DOI: 10.1515/ijamh-2017-0121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 08/13/2017] [Indexed: 06/07/2023]
Abstract
Purpose Today's generation of adolescents is the largest in history, creating a major challenge for low and middle income countries faced with the necessity of addressing their growing healthcare needs. Our objective was to assess the extent to which health care providers in Guatemala are trained, knowledgeable and feel comfortable providing services to adolescents. Methods A sample of 20 medical providers were recruited from the School of Medicine at San Carlos University and its affiliated hospitals. Providers were interviewed face-to-face for 30-40 min using a semi-structured guide exploring their training, knowledge, skills and experience in adolescent health care. Recruitment continued until thematic saturation was reached. Interviews were recorded and transcribed verbatim, and then analyzed for emergent themes using principles of framework analysis. Results The provider's mean age was 33.7 years [standard deviation (SD) = 10.2]. Most were female (65%) and practiced medicine in a metropolitan location. Results revealed the presence of five major themes: (1) Need for dedicated adolescent health services; (2) Presence of a multitude of barriers to providing adolescent health care; (3) Perceived comfort level in communicating with adolescents; (4) Limited knowledge of current adolescent specific services, programs, and guidelines; and (5) Gaps in medical education and training. Conclusion Providers recognize the need for increased and dedicated adolescent health care services. There is strong support for the creation of a credentialed national adolescent health training program.
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Affiliation(s)
- Areej Hassan
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 300 Longwood Avenue,Boston, MA, USA, Phone: 617-355-6334, Fax: 617-730-0184
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Juan Carlos Reyes Maza
- Hospital General San Juan de Dios, Guatemala City, Guatemala
- Universidad de San Carlos de Guatemala, Guatemala City, Guatemala
| | - Hayley G Teich
- Boston Children's Hospital, Deparment of Global Health, Boston, MA, United States of America
| | - Erwin H Calgua Guerra
- Universidad de San Carlos de Guatemala, Guatemala City, Guatemala
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Sawyer SM, Farrant B, Hall A, Kennedy A, Payne D, Steinbeck K, Vogel V. Adolescent and young adult medicine in Australia and New Zealand: towards specialist accreditation. Int J Adolesc Med Health 2016; 28:253-261. [PMID: 26115493 DOI: 10.1515/ijamh-2016-5006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Accepted: 02/22/2015] [Indexed: 06/04/2023]
Abstract
In Australia and New Zealand, a critical mass of academic and clinical leadership in Adolescent Medicine has helped advance models of clinical services, drive investments in teaching and training, and strengthen research capacity over the past 30 years. There is growing recognition of the importance of influencing the training of adult physicians as well as paediatricians. The Royal Australasian College of Physicians (RACP) is responsible for overseeing all aspects of specialist physician training across the two countries. Following advocacy from adolescent physicians, the RACP is advancing a three-tier strategy to build greater specialist capacity and sustain leadership in adolescent and young adult medicine (AYAM). The first tier of the strategy supports universal training in adolescent and young adult health and medicine for all basic trainees in paediatric and adult medicine through an online training resource. The second and third tiers support advanced training in AYAM for specialist practice, based on an advanced training curriculum that has been approved by the RACP. The second tier is dual training; advanced trainees can undertake 2 years training in AYAM and 2 years training in another area of specialist practice. The third tier consists of 3 years of advanced training in AYAM. The RACP is currently seeking formal recognition from the Australian Government to have AYAM accredited, a process that will be subsequently undertaken in New Zealand. The RACP is expectant that the accreditation of specialist AYAM physicians will promote sustained academic and clinical leadership in AYAM to the benefit of future generations of young Australasians.
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Représentations de la médecine de l’adolescent chez les futurs pédiatres. Arch Pediatr 2016; 23:695-705. [DOI: 10.1016/j.arcped.2016.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 02/28/2016] [Accepted: 04/22/2016] [Indexed: 11/23/2022]
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Joukhadar N, Bourget G, Manos S, Mann K, Hatchette J, Blake K. Skills for Interviewing Adolescent Patients: Sustainability of Structured Feedback in Undergraduate Education on Performance in Residency. J Grad Med Educ 2016; 8:422-5. [PMID: 27413448 PMCID: PMC4936863 DOI: 10.4300/jgme-d-15-00297.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Effective adolescent (10 to 19 years) interviewing by physicians is an essential skill that many trainees can find challenging. OBJECTIVE We assessed whether structured adolescent interviewing using standardized patients (SPs) and feedback in undergraduate medical education (UME) has a sustained effect on residents' skills. METHODS Postgraduate year (PGY) 1 residents conducted interviews with a SP adolescent-mother pair. The SPs independently scored each PGY-1 interview using the structured communication adolescent guide (SCAG). Unpaired t tests were conducted comparing "Total-Item" and "Global" scores of PGY-1s who received structured SP adolescent interviewing with feedback in UME ("structured training" group) to those who had not ("no structured training" group). RESULTS PGY-1s in the structured training group (n = 23) received significantly higher mean Total-Item scores from both the SP adolescent (40.78 ± 7.04 and 32.41 ± 10.12, respectively; P = .001) and the SP mother (40.48 ± 7.90 and 33.34 ± 10.90, respectively; P = .01) than those without structured training (n = 29). Statistically significant results favoring PGY-1s with prior training were also seen with the SP adolescent and mother total Global SCAG scores. CONCLUSIONS Structured training in adolescent interviewing with SPs and feedback in UME appears to have a sustained effect on residents' adolescent interviewing skills. PGY-1s will interview adolescents and may benefit from structured adolescent SP interviewing with feedback, especially individuals who did not have this experience during their medical school training.
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Affiliation(s)
| | | | | | | | | | - Kim Blake
- Corresponding author: Kim Blake, MD, IWK Health Centre, 5850 University Avenue, Halifax, Nova Scotia B3K 6R8 Canada, 902.470.6499, fax 902.470.6913,
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Patton GC, Sawyer SM, Santelli JS, Ross DA, Afifi R, Allen NB, Arora M, Azzopardi P, Baldwin W, Bonell C, Kakuma R, Kennedy E, Mahon J, McGovern T, Mokdad AH, Patel V, Petroni S, Reavley N, Taiwo K, Waldfogel J, Wickremarathne D, Barroso C, Bhutta Z, Fatusi AO, Mattoo A, Diers J, Fang J, Ferguson J, Ssewamala F, Viner RM. Our future: a Lancet commission on adolescent health and wellbeing. Lancet 2016; 387:2423-78. [PMID: 27174304 PMCID: PMC5832967 DOI: 10.1016/s0140-6736(16)00579-1] [Citation(s) in RCA: 1760] [Impact Index Per Article: 220.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- George C Patton
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health, Royal Children's Hospital, Parkville, Melbourne, VIC, Australia.
| | - Susan M Sawyer
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health, Royal Children's Hospital, Parkville, Melbourne, VIC, Australia; Murdoch Childrens Research Institute, Columbia University, New York, NY, USA
| | - John S Santelli
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | - David A Ross
- World Health Organization, Geneva, Switzerland; London School of Hygiene & Tropical Medicine, London, UK
| | - Rima Afifi
- Department of Health Promotion and Community Health, American University of Beirut, Beirut, Lebanon
| | - Nicholas B Allen
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia; University of Oregon, Eugene, OR, USA
| | - Monika Arora
- Public Health Foundation of India, New Delhi, India
| | - Peter Azzopardi
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health, Royal Children's Hospital, Parkville, Melbourne, VIC, Australia
| | | | | | - Ritsuko Kakuma
- School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | | | | | - Terry McGovern
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Ali H Mokdad
- Institute of Health Metrics and Evaluation, University of Washinton, Seattle, WA, USA
| | - Vikram Patel
- London School of Hygiene & Tropical Medicine, London, UK; Public Health Foundation of India, New Delhi, India
| | - Suzanne Petroni
- International Centre for Research on Women, Washington, DC, USA
| | - Nicola Reavley
- School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | | | - Jane Waldfogel
- School of Social Work, Columbia University, New York, NY, USA
| | | | | | - Zulfiqar Bhutta
- University of Toronto, Toronto, ON, Canada; Aga Khan University, Karachi, Pakistan
| | | | - Amitabh Mattoo
- Australia India Centre, University of Melbourne, Melbourne, VIC, Australia; Jawaharlal Nehru University, New Delhi, India
| | | | - Jing Fang
- Kunming Medical University, Kunming, China
| | - Jane Ferguson
- London School of Hygiene & Tropical Medicine, London, UK
| | | | - Russell M Viner
- Institute of Child Health, University College London, London, UK
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