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Adolescent Health Services: Missing Opportunities
plex needs of this age group. As Henry Kempe stated at the 1976 opening meeting of the Task Force on Pediatric Education, “All who care about children must care deeply about the education of those who provide their health services” (Cohen, 1984, p. 791). Education of the workforce is essential to the provision of health services for adolescents that are accessible, acceptable, appropriate, effective, and equitable in accordance with the framework set forth in Chapter 3. This chapter focuses on the contextual characteristic of provider skills and examines issues related to the adolescent health workforce.
At all levels of professional education, providers in all disciplines serving adolescents need to be equipped to work effectively with this age group. They must be attuned to the nature of adolescents’ health problems, as well as have in their clinical repertoire a range of effective strategies for risk assessment, disease prevention, care coordination, treatment, and health promotion. Current evidence, some of which is presented in this chapter, suggests this is currently not the case—that is, the skills of many providers working with adolescents are inadequate. Whether providers report on their own perceptions of their competencies or adolescents describe the health services they have received, data reveal significant gaps in achieving the goal of a well-equipped workforce ready to meet the health needs of adolescents. In other words, too few health care providers in practice feel prepared to work with adolescents, even with regard to some of the most common health problems in this population, and the quality of services being provided has suffered as a result. Given the adolescent health issues and health service needs presented in Chapters 2, 3, and 4, an important goal for the training of health care providers is for all those who will offer health services for adolescents in their practices to enter the workforce equipped to work effectively with this age group.
This chapter begins by reviewing the composition of the current workforce providing adolescent health care services. It then examines gaps in the training of these providers and means that can be used to ensure their competence. The discussion turns next to some current models for training that show promise for imparting the knowledge and skills that need to be mastered by those who work with adolescents. Beyond basic-level training (i.e., educational programs for entry into a profession), specialists, educators, and scholars require advanced-level training that will prepare them to teach others entering the workforce and equip them to conduct research that will expand the evidence base supporting adolescent health care practice. The discussion therefore includes strategies for ensuring the training of adequate numbers of advanced-level adolescent specialists, educators, and scholars. The chapter then reviews challenges to training an adequate adolescent health care workforce. It should be noted that this chapter was not intended as a comprehensive review of education, training, and certi-