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Suggested Citation:"Front Matter." National Research Council and Institute of Medicine. 2007. Challenges in Adolescent Health Care: Workshop Report. Washington, DC: The National Academies Press. doi: 10.17226/12031.
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CHALLENGES IN ADOLESCENT HEALTH CARE

Workshop Report

Committee on Adolescent Health Care Services and Models of Care for Treatment, Prevention, and Healthy Development

Board on Children, Youth, and Families

Division of Behavioral and Social Sciences and Education

NATIONAL RESEARCH COUNCIL AND INSTITUTE OF MEDICINE OF THE NATIONAL ACADEMIES

THE NATIONAL ACADEMIES PRESS

Washington, D.C.
www.nap.edu

Suggested Citation:"Front Matter." National Research Council and Institute of Medicine. 2007. Challenges in Adolescent Health Care: Workshop Report. Washington, DC: The National Academies Press. doi: 10.17226/12031.
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THE NATIONAL ACADEMIES PRESS

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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

This study was supported by Contract/Grant No. 14356 between the National Academy of Sciences and The Atlantic Philanthropies. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the views of the organizations or agencies that provided support for the project.

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Suggested citation: National Research Council and Institute of Medicine. (2007). Challenges in Adolescent Health Care: Workshop Report. Committee on Adolescent Health Care Services and Models of Care for Treatment, Prevention, and Healthy Development. Board on Children, Youth, and Families, Division of Behavioral and Social Sciences and Education. Washington, DC: The National Academies Press.

Suggested Citation:"Front Matter." National Research Council and Institute of Medicine. 2007. Challenges in Adolescent Health Care: Workshop Report. Washington, DC: The National Academies Press. doi: 10.17226/12031.
×

THE NATIONAL ACADEMIES

Advisers to the Nation on Science, Engineering, and Medicine


The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.


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www.national-academies.org

Suggested Citation:"Front Matter." National Research Council and Institute of Medicine. 2007. Challenges in Adolescent Health Care: Workshop Report. Washington, DC: The National Academies Press. doi: 10.17226/12031.
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Suggested Citation:"Front Matter." National Research Council and Institute of Medicine. 2007. Challenges in Adolescent Health Care: Workshop Report. Washington, DC: The National Academies Press. doi: 10.17226/12031.
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COMMITTEE ON ADOLESCENT HEALTH CARE SERVICES AND MODELS OF CARE FOR TREATMENT, PREVENTION, AND HEALTHY DEVELOPMENT

ROBERT S. LAWRENCE (Chair),

Bloomberg School of Public Health, The Johns Hopkins University

LINDA H. BEARINGER,

School of Nursing, University of Minnesota

SHAY BILCHIK,

Center for Juvenile Justice Reform and Systems Integration, Georgetown University

SARAH S. BROWN,

The National Campaign to Prevent Teen Pregnancy, Washington, DC

LAURIE CHASSIN,

Department of Psychology, Arizona State University, Tempe

NANCY NEVELOFF DUBLER,

Montefiore Medical Center, New York

BURTON L. EDELSTEIN,

College of Dental Medicine, Columbia University

HARRIETTE FOX,

Maternal and Child Health Policy Research Center, Washington, DC

CHARLES E. IRWIN, JR.,

School of Medicine, University of California, San Francisco

KELLY J. KELLEHER,

Columbus Children’s Research Institute, The Ohio State University

GENEVIEVE M. KENNEY,

Urban Institute, Washington, DC

JULIA GRAHAM LEAR,

School of Public Health and Health Services, Department of Prevention and Community Health, The George Washington University

EDUARDO R. OCHOA, JR.,

Section of General Pediatrics, Arkansas Children’s Hospital, Little Rock

FREDERICK P. RIVARA,

Department of Pediatrics, University of Washington, Seattle

VINOD K. SAHNEY,

Blue Cross and Blue Shield of Massachusetts, Boston

MARK A. SCHUSTER, RAND,

Santa Monica, California, and Departments of Pediatrics and Health Services, University of California, Los Angeles

LONNIE SHERROD,

Department of Psychology, Fordham University

MATTHEW STAGNER,

Chapin Hall Center for Children, The University of Chicago

LESLIE R. WALKER,

Children’s Hospital and Regional Medical Center, Seattle

THOMAS G. DeWITT (liaison from the Board on Children, Youth, and Families),

Cincinnati Children’s Hospital Medical Center

Suggested Citation:"Front Matter." National Research Council and Institute of Medicine. 2007. Challenges in Adolescent Health Care: Workshop Report. Washington, DC: The National Academies Press. doi: 10.17226/12031.
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JENNIFER APPLETON GOOTMAN, Study Director

ALEXANDRA BEATTY, Rapporteur

LESLIE J. SIM, Program Officer

WENDY KEENAN, Program Associate

APRIL HIGGINS, Senior Program Assistant (until July 2007)

REINE Y. HOMAWOO, Senior Program Assistant (from August 2007)

Suggested Citation:"Front Matter." National Research Council and Institute of Medicine. 2007. Challenges in Adolescent Health Care: Workshop Report. Washington, DC: The National Academies Press. doi: 10.17226/12031.
×

BOARD ON CHILDREN, YOUTH, AND FAMILIES

BERNARD GUYER (Chair),

Bloomberg School of Public Health, The Johns Hopkins University

BARBARA L. WOLFE (Vice Chair),

Department of Economics and Population Health Sciences, University of Wisconsin

WILLIAM R. BEARDSLEE,

Department of Psychiatry, Children’s Hospital, Boston

LINDA MARIE BURTON,

Sociology Department, Duke University

P. LINDSAY CHASE-LANSDALE,

Institute for Policy Research, Northwestern University

BRENDA ESKENAZI,

School of Public Health, University of California, Berkeley

CHRISTINE C. FERGUSON,

School of Public Health and Health Services, The George Washington University

WILLIAM T. GREENOUGH,

Department of Psychology, University of Illinois

RUBY HEARN,

Robert Wood Johnson Foundation (emeritus), Princeton, NJ

BETSY LOZOFF,

Center for Human Growth and Development, University of Michigan

SUSAN G. MILLSTEIN,

Division of Adolescent Medicine, University of California, San Francisco

CHARLES A. NELSON,

Laboratory of Cognitive Neuroscience, Children’s Hospital, Boston

ELENA O. NIGHTINGALE,

Institute of Medicine, The National Academies, Washington, DC

PATRICIA O’CAMPO,

Centre for Research on Inner City Health, St. Michael’s Hospital, Toronto

LAURENCE D. STEINBERG,

Department of Psychology, Temple University

ELLEN A. WARTELLA,

Office of the Executive Vice Chancellor and Provost, University of California, Riverside

MICHAEL ZUBKOFF,

Department of Community and Family Medicine, Dartmouth Medical School

ROSEMARY CHALK, Board Director

WENDY KEENAN, Program Associate

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Suggested Citation:"Front Matter." National Research Council and Institute of Medicine. 2007. Challenges in Adolescent Health Care: Workshop Report. Washington, DC: The National Academies Press. doi: 10.17226/12031.
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Preface

The Committee on Adolescent Health Care Services and Models of Care for Treatment, Prevention, and Healthy Development was formed by the National Academies in May 2006, with funding from The Atlantic Philanthropies, to study adolescent health care services in the United States and develop policy and research recommendations that highlight critical health care needs, promising service models, and components of care that may strengthen and improve health care services for youth and contribute to healthy adolescent development. This report summarizes the presentations and discussion at two one-day workshops organized as a part of the work of this committee. These workshops were an effort to take stock of the current knowledge base on adolescent health care services, settings, and systems; to incorporate personal experiences; and to help inform the work of the committee.

In November 2006 the committee convened a community forum to elicit the views of those who use and those who provide adolescent health care, with the goal of revealing gaps in current delivery mechanisms through perspectives from people who work with vulnerable populations of adolescents, individuals who work in different settings and systems that deliver health care to adolescents, and young adults themselves. In addition, the forum invited public stakeholders to present their views. In January 2007 the committee convened a workshop to examine the research base on the organization and delivery of adolescent health care services by (1) reviewing the state of adolescent health care systems, (2) identifying quality features of an adolescent health care system, (3) reviewing

Suggested Citation:"Front Matter." National Research Council and Institute of Medicine. 2007. Challenges in Adolescent Health Care: Workshop Report. Washington, DC: The National Academies Press. doi: 10.17226/12031.
×

the evidence base on specific service delivery models or systems of care, and (4) identifying the evidence base of health care delivery to vulnerable populations of adolescents.

Given the limitations of both time and scope, the workshops could not address all issues that are certainly critical. It is our hope, however, that this report helps illuminate important issues in adolescent health care and begins unraveling this challenging and multifaceted area of study. Individual presentations from both workshops are available at http://www.bocyf.org/.

We are grateful for the contributions of the expert presenters, speakers, and discussants who contributed to the meeting (see the appendixes for the workshop agendas and list of participants). Special appreciation also goes to the committee members who volunteered their time and intellectual efforts to shape the workshop programs and identify themes and contributors. In addition, we give special thanks to Alexandra Beatty, who prepared a comprehensive draft of the workshop report, Leslie Sim and Jennifer Gootman, who directed the planning and workshop preparation and the production of the final publication, April Higgins and Wendy Keenan, who assisted with preparation of meetings and workshop, and Matthew McDonough, who assisted with running the workshops. Although the workshop report was prepared by the committee, it does not represent findings or recommendations that can be attributed to the committee members.

This workshop report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the Report Review Committee of the National Research Council. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We thank the following individuals for their review of this report: Trina Anglin, Office of Adolescent Health, Health Resources and Services Administration, Rockville, MD; Claire D. Brindis, National Adolescent Health Information Center, Institute for Health Policy Studies, University of California, San Francisco; Denise Dougherty, Child Health and Quality Improvement, Agency for Healthcare Research and Quality, Gaithersburg, MD; Jack C. Ebeler, Ebeler Consulting, Reston, VA; Elizabeth Feldman, Pediatric/ Adolescent Coordinator, UIC/Illinois Masonic Family Practice Residency, University of Illinois College of Medicine; Alan Shapiro, Community Pediatrics and South Bronx Children and Family Health Center, Monte-

Suggested Citation:"Front Matter." National Research Council and Institute of Medicine. 2007. Challenges in Adolescent Health Care: Workshop Report. Washington, DC: The National Academies Press. doi: 10.17226/12031.
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fiore Medical Group, New York, NY; and Joshua M. Sharfstein, Health Commissioner’s Office, City of Baltimore, MD.

Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the report nor did they see the final draft of the report before its release. The review of this report was overseen by Robert Graham, Department of Family Medicine, University of Cincinnati College of Medicine. Appointed by the National Research Council, he was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the author(s) and the institution.


Robert S. Lawrence, Chair

Committee on Adolescent Health Care

Services and Models of Care for Treatment, Prevention, and Healthy Development

Suggested Citation:"Front Matter." National Research Council and Institute of Medicine. 2007. Challenges in Adolescent Health Care: Workshop Report. Washington, DC: The National Academies Press. doi: 10.17226/12031.
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Challenges in Adolescent Health Care: Workshop Report Get This Book
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Several positive and negative lifelong behaviors are established during adolescence including diet and exercise, sexual conduct, practices related to oral health, smoking, drinking, and the use if legal and illegal substances. The complex issues that adolescents deal with on a daily basis can turn into health problems that persist throughout adulthood. Unfortunately the adolescents who are frequently the most disconnected from routine health care services - those who lack insurance and family support - are often those at greatest risk for multiple and chronic health problems. Therefore, those that are responsible for delivering health care services to adolescents must address the health conditions that require immediate attention while preparing young people to adopt practices that can help improve their future health status and prevent unhealthy behaviors.

Challenges in Adolescent Health Care studies adolescent health care in the United States, highlights critical health care needs, and identifies service models and components of care that may strengthen and improve health care services, settings, and systems for adolescents. The book explores the nature of adolescent challenges and how they reflect larger societal issues such as poverty, crime and the prevalence of violence. These issues, in addition to lack of comprehensive health coverage, dysfunctional families and the lack of support systems, make providing adequate health care incredibly challenging.

Challenges in Adolescent Health Care defines high-quality health care, identifies the strengths and weaknesses of various service models and explores various training programs. The book recommends that health care providers must be sensitive to socioeconomic factors and incorporate health care in a broad array of settings including schools, neighborhoods and community centers.

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