lescent health care, health promotion, and adolescent development services? What service approaches show significant promise in offering primary care as well as prevention, treatment, and health promotion services for adolescents with special health care needs and for selected adolescent populations?

  • Organizational Settings and Strategies. What organizational settings, finance strategies, and communication technologies promote engagement with, access to, and use of health services by adolescents? Are there important differences in the use and outcomes of different service models among selected adolescent populations on the basis of such characteristics as social class, urbanicity, ethnicity, gender, sexual orientation, age, special health care needs, and risk status?

  • Adolescent Health System Supports. What policies, mechanisms, and contexts promote high-quality health services for adolescents? What innovative strategies have been developed to address such concerns as decision making, privacy, confidentiality, consent, and parental notification in adolescent health care settings? What strategies help adolescents engage with and navigate the health care system, especially those at significant risk for health disorders in such areas as sexual and reproductive health, substance use, mental health, violence, and diet? What barriers impede the optimal provision of adolescent health services?

  • Adolescent Health Care Providers. What kinds of training programs for health care providers are necessary to improve the quality of health care for adolescent populations?

CHALLENGES, LIMITATIONS, AND SUCCESSES

The committee was challenged in addressing the above issues because (1) the relevant data and scientific literature are limited in a number of key areas; (2) a broad diversity of profiles characterizes adolescents aged 10–19 in the United States; (3) the health status of adolescents is defined by multiple measures, including not only traditional measures of mortality and morbidity, but also behavioral characteristics; (4) health services for adolescents comprise a series of individual services delivered in myriad settings and through varied institutional structures, with limited common goals and no coherent, organizing system; (5) evaluation of health services for adolescents has been limited, and there is no agreed-upon set of standards within the field of adolescent health with which to evaluate the success of individual programs or compare services and service models; and (6) information on issues related to the adolescent health workforce,



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