Below is the uncorrected machine-read text of this chapter, intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text of each book. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.
Index A safety-net health services, 6â7, 136, 157, 300 Abortion rates, 92 shortcomings of current health system Abortion rights, 180â181 performance, 6, 299â300 Acceptable health care, 5, 299 sources of medical care, 168â172, Access to care 299â300 access to adolescent medicine specialists, specialty health services, 136â137, 166, 145 300 adolescent perceptions, 38 Accidental injury challenges for adolescent adolescent mortality, 53 subpopulations, 97 health objectives for adolescents, 55 cost of care and, 267 insurance coverage issues, 8, 302 dental care, 161 mortality, 53, 62â64 fragmentation of current health system patterns and trends, 6 as barrier to, 7, 300â301 Adolescence, defined, 2, 23, 25â27 health insurance and, 8, 265, 266â269, Adolescent health status 274, 285â286, 287, 288, 302 adolescent self-perceptions, 54 mental health services, 158 adolescent subpopulations, 96â115 objectives for adolescent health system, current state, 1, 17â18, 52, 54, 55â60, 5, 299 115, 296 population patterns and trends and, 6, definition, 8â9, 28, 52, 54, 302 17 determinants of, 3â4, 18â19, 28, 43â45, primary care, 135 54â55 provider participation in public mortality and morbidity patterns and insurance programs and, 285â286 trends, 53 racial/ethnic disparities, 137, 177 significance of, for adult health, 1, 3â4, recommendations for insurance system, 5â6, 17â18, 44, 52, 54, 60â61, 293, 12â13, 307â308 297 right to confidential access, 180â183 socioeconomic status and, 35 in rural areas, 34â35 See also Mental disorders; Mortality 329
330 INDEX Adolescent perceptions and understanding standardized screening practices, 198 access to care, 38 strategies for improving adolescent data collection, 22, 38 health service system, 197â202, 203 demographic differences in, 38â39 substance use, 201â202 mental health services, 39 Asthma of parental involvement in health care, limitations in normal daily activities due 38 to, 66 privacy and consent for care issues, 38, prevalence, 53, 66, 67, 71 42â43 risk factors, 66â67 self-perceived health, 54 Attention-deficit hyperactivity disorder, 72, substance use treatment, 39 73, 74, 202 Alcohol use addiction risk, 90 age at onset, 89â90 B associated risks, 88, 89 Behavioral health in adolescence mortality, 89 advantages of safety-net health services, motor vehicle accidents and, 84â85 7, 136, 157, 300 outcomes of adolescent health- current adolescent health status, 53â54 compromising behavior, 54 developmental significance, 3â4, 17â18, patterns and trends, 6, 87â88, 89, 90 44, 52, 54, 60â61, 197, 211, 297 preventive interventions, 30, 212 goals for improving adolescent health risks among homeless adolescents, 102 services system, 196 significance of, in adolescent health, 53, health management strategies in primary 91 care, 202â204 treatment needs, 163â164 monitoring, 204 American Academy of Pediatrics, 198, 222 morbidity, 84 American Medical Association, 198 patterns and trends, 6 Anxiety and anxiety disorders, 53, 72, 73, primary care assessment, 144 77 primary care reimbursement, 143â144 Appropriate health care, 5, 299 protective factors, 212 Assessment of adolescent health rationale for early assessment and barriers for vulnerable subpopulations, intervention, 197 202 recommendations for adolescent care goals for improving adolescent health provider training, 12, 307 services system, 195â196, 231 recommendations for improving primary Guidelines for Adolescent Preventive health care, 9â10, 305 Services, 145, 198â199, 248 recommendations for monitoring health in primary care, 144, 199â201 care system performance, 14â15, privacy and confidentiality in, 202 309â310 public insurance coverage of screening risks, 24â25 services, 278 shortcomings of current health system recommendations for adolescent care performance, 5â6, 7, 301 provider training, 12, 307 significance of, in adolescent health recommendations for monitoring health system, 3, 43â44, 211, 297 care system performance, 14â15, See also Risky behavior 309â310 Bisexual adolescents. See Lesbian, gay, recommendations for research, 14, 309 bisexual, or transgender adolescents reimbursement, 201 Board certification in adolescent medicine, screening tools, 172, 174â175, 197â199 254 shortcomings of current health system, Body piercing, 84 8â9, 172â175, 303â304
INDEX 331 Brain development, 25 Congenital anomalies, 64 Bullying behaviors, 87 Consent for care adolescent concerns, 42â43 adolescent utilization of health services C and, 178â179 current legal framework, 180â181 Cancer parental concerns, 42, 211 mortality, 64 policy formulation challenges, 42, 43 prevalence, 67â70 recommendations for, 11, 306 survival rate trends, 70 Consultation, specialty, 208 type distribution, 70 Contextual factors Case management determinants of adolescent health status, in community-based health centers, 3, 4, 18â19, 43â45, 54â55, 138, 297, 150â151 298 recommendations for health insurance recommendations for research, 14, 309 coverage, 13, 308 Continuing education for health providers, referral management, 208 255 Centers for Disease Control and Prevention, Contraception 253 adolescent patterns, 159 Chronic illness counseling, 159 associated conditions, 65 insurance coverage, 279, 280 causes in adolescence, 53 parental notification, 211 comorbidity, 65 right to access, 180 epidemiology, 65â66 Coordination of care implications for health care system, 66 adolescent primary care, 145, 146 mortality, 64 care management of specialty services, risks in foster care, 54, 98 206â207 See also Asthma; Cancer; Diabetes goals for improving adolescent health Community-based health centers services system, 194, 196 goals for improving adolescent health recommendations for improving, 9, services system, 195â196 10â11, 304, 305â306 innovative programs, 150, 226â228 regional approach to resource limitations, 151 management, 209 scope of services, 150 shortcomings of current system, 7, significance of, in adolescent health care 300â301 system, 150â151 strategies for improving adolescent Community-level public health interventions health service system, 206â207 disease prevention interventions in, 212 strengthening primary careâspecialty recommendations for improving, 10â11, care linkages, 207â210 305â306 Correctional facilities, 35 significance of, in adolescent health, 4, Cost of care 44, 195, 298 access to care and, 267 youth development promotion, 218 chronic health conditions, 66 Comorbidity dental care expenditures, 266 mental disorders, 72 insurance cost sharing arrangements, patterns and trends, 6 285â286 special health care needs, 65 Medicaid cost-sharing requirements, 277 Competency domains, 249â251 mental health services, 282 Conduct disorder, 72, 73, 74â75 recommendations for health insurance Confidentiality and privacy. See Privacy and system, 13, 308 confidentiality
332 INDEX D Development changes in adolescence, 24â25 Data collection developmental delays in foster care among homeless population, 99 children, 98â99 current health care system, 21â22 significance of adolescent experience recommendations for monitoring health for later development, 1, 3â4, 5â6, care system performance, 14â15, 17â18, 44, 52, 54, 60â61, 197, 211, 309â310 293, 296, 297 shortcomings of current health system, violent behavior risk, 85â86 8â9, 23, 294â295, 303â304 youth development promotion strategies, Definition of adolescence, 2, 23, 25â27 214â219 Definition of adolescent health status, 8â9, Diabetes 28, 296, 303 health outcomes in adulthood, 67 Dental care prevalence, 53, 67, 71 adolescent perceptions of access and Diet and nutrition quality, 38 adolescent consumption choices, 24â25 barriers to, 161 current adolescent intake, 94, 172 current adolescent health status, 53, current screening and counseling 79â82, 84 practice, 173 fragmentation of current health system food and beverage marketing, 31 as obstacle to, 7, 301 outcomes of adolescent health- insurance coverage and, 8, 265, 266, compromising behavior, 54 267â269, 271â272, 284â285, 302 risky eating behaviors, 94, 95 in juvenile justice system, 114 See also Obesity juvenile periodontitis, 83â84 Disease prevention linkage with primary care, 208â209 communication of behavioral health opportunities for health promotion in information, 211â213 dental practice, 161 fragmentation of current health system oral disease risk factors, 79 as obstacle to, 7, 300â301 parental educational attainment and, goals for improving adolescent health 162 services system, 196, 231 preventive interventions, 161, 214 insurance policies and practices and, 265 public insurance coverage, 277 in primary care settings, 145â146 recommendations for health insurance rationale, 172 coverage, 13, 308 recommendations for primary care, 10, recommendations for improving public 305 health system for adolescent care, in safety-net health services, 157 10â11, 305â306 shortcomings of current health system trauma risk, 84 performance, 7, 172â175, 301 trends, 82â83 strategies for improving, 211â214 unmet needs, 162 strengthening protective factors, 212 utilization, 161, 265, 269, 271â272 See also Health promotion; Preventive Depression interventions; Sexually transmitted among homeless adolescents, 103, 104 disease associated behaviors, 73, 74 current screening and counseling practice, 173 E pharmacotherapy, 202 prevalence, 72, 73â74 Early adolescence screening, 198 definition, 55 See also Mental disorders mortality patterns, 62
INDEX 333 Eating disorders, 75, 79, 110 recommendations for improving primary Education and training for health care care, 9, 304 professionals. See Provider education recommendations for research, 13â14, and training 309 Effective health services training grants, 251 family and adolescent participation and, Federal Interagency Forum on Child and 4, 298 Family Statistics, 14â15, 309â310 mental health services, 158 Fighting, 87 objectives for adolescent health system, Financial factors 5, 299 compensation for adolescent health care sexual and reproductive health clinics, specialists, 259 160 funding for adolescent care provider substance use treatment, 165 training programs, 12, 251, 253, 307 Electronic communication, 211â212, 224 funding for school-based health centers, Electronic health records 153â156 confidentiality, 223 recommendations for health insurance recommendations for, 10â11, 305â306 system, 13, 308 Emergency care recommendations for improving primary adolescent utilization, 6â7, 171, 300 health care, 10, 305 hospital-affiliated primary care and, 152 scope of, in adolescent health care, 4, shortcomings of current health system 44â45, 298 performance, 6â7, 300 strategies for improving immunization Equitable health care delivery, 5, 299 programs, 213 See also Cost of care Focus of adolescent health services, 7, 301 F Foster care system, adolescents in, 2â3, 35 abuse and neglect patterns, 97â98 Family health risks, 53, 54, 98â99 influence on adolescent health behavior, insurance coverage after departure, 272 38 mental health services, 73 one- and no-parent homes, 34 recommendations for health insurance parental involvement in adolescent care, coverage, 12â13, 307â308 confidentiality and, 221â222 recommendations for improving primary parental notification effects on health care, 9â10, 305 adolescent health care utilization, substance abuse risk, 163 178â179 See also Subpopulations of adolescents recommendations for adolescent Free time, 35â36 confidentiality and consent for care, 11, 306 role in preventive intervention, 212 G significance of, in adolescent health, 4, 44, 298 Gay adolescents. See Lesbian, gay, bisexual, Family medicine as model for adolescent or transgender adolescents care, 19 Gender differences Family planning services, 160, 279â280 adolescent health behaviors and Federal government attitudes, 38â39 confidentiality laws, 181â182 board certifications in adolescent recommendations for confidentiality and medicine, 254 consent policies in adolescent health demographic and population patterns, care, 11, 306 32, 35 recommendations for health insurance diabetes prevalence, 67 system, 12â13, 307â308 health care utilization, 171
334 INDEX mental disorder risk, 72â73, 74, 75 current models of care, 6â7, 19, 300 mortality patterns, 62 data sources on current state, 21â23 physical activity, 96 determinants of adolescent health status, seat belt use, 85 18â19, 28 sexual and reproductive health service family factors, 4, 298 utilization, 158â160 financial factors, 4, 298 sexually transmitted disease patterns, focus, 7, 301 77â78 objectives, 4â5, 138â140, 298â299 substance use, 76 perceptions and attitudes, 37â41 suicidal behavior or ideation, 77 policy factors, 4, 298 Group homes, 35 rationale for improving, 15, 310 Guidelines for Adolescent Preventive recommendations for improving, 10â11, Services, 145, 198â199, 248 305â306 recommendations for research, 13â14, 309 H research needs, 19â20, 294â295 safety-net services, 136 Health Insurance Portability and salient issues, 2, 20â21, 293â294 Accountability Act, 181â182 scope of settings and services, 3, 28â29, Health promotion 37, 299 conceptual evolution in adolescent sectors, 140â142 medicine, 37 shortcomings of current system, 1, 6â9, in dental and oral health care, 161 15, 18â19, 142, 293, 299â304, 310 fragmentation of current health system specialty care services, 136â137 as obstacle to, 7, 300â301 See also Improving adolescent health goals for improving adolescent health services system; Provider education services system, 196, 231 and training participants, 210 Healthy People 2010 objectives, 6, 55, 145, in primary care settings, 145â146, 147 196, 296 print and electronic resources for, Heart disease, 64 210â211 HIV/AIDS, 78, 101, 111 rationale, 172, 195 Homeless population, 2â3, 35 recommendations for monitoring health alcohol and substance use, 102 care system performance, 14â15, associated health risks, 99â100 309â310 data collection challenges, 99 recommendations for primary care, 10, mental health, 103â104 305 patterns and trends, 99 in safety-net health services, 157 physical and sexual abuse risk, 100 shortcomings of current health system recommendations for improving primary performance, 7, 137, 172â175, 301 health care, 9â10, 305 significance of intervention in risks for lesbian, gay, bisexual, or adolescence, 3â4, 17â18, 54, transgender adolescents in, 104â105 297â298 sexual activity and health, 100â102 strategies for improving adolescent See also Subpopulations of adolescents health service system, 210â212 Homicide Health system, adolescent care in access to weapons and, 86 behavioral and contextual framework, mortality, 53, 62, 64, 65 3â4, 43â45, 137â138, 297â298 victimization patterns, 87 community factors, 4, 298 Hospital-affiliated primary care, 151â152 conceptual and technical evolution, innovative programs for adolescent care, 36â37 228â229
INDEX 335 I mental health and substance abuse treatment insurance coverage, Immigrants, 2â3, 35, 105â107 281â283 access to care, 18 specialized units for adolescents, 167 insurance coverage disparities, 269â271, treatment teams, 167 272 Institutionalized adolescents insurance coverage patterns, 8, 302 population characteristics, 35 population patterns, 33 settings, 35 public insurance eligibility, 274 substance abuse risk, 163 recommendations for improving primary Insurance health care, 9â10, 305 age distribution of coverage patterns See also Subpopulations of adolescents among adolescents and young adults, Immunization. See Vaccination and 273, 288 immunization barriers to health care access, 8, 265, Improving adolescent health services system 266â269, 274, 285â286, 287, 288, care management of specialty services, 302 206â207 confidentiality protection, 223, 287 community role, 4, 195, 298 cost sharing, 285â286, 287 consideration of special needs and coverage patterns and trends, 8, 265, vulnerable populations, 9â10, 194, 269â272, 276â285, 288, 302 305 current sources and benefit plans, coordination of care, 194, 206â207, 276â278 231 definition of adolescence for, 26â27 family role, 4, 195, 298 dental services coverage, 284â285 goals, 194, 195â196, 231 eligibility, 272â273 health information technology, 223â225 employment characteristics and, health management strategies in primary 269â271, 272â273 care, 202â204 failure of eligible adolescents to enroll in immunization programs and policies, public programs, 8, 265, 273â276, 302 213â214 health risks related to lack of, 8, 265, implementation of strategies for, 266, 302 231â232 inpatient pregnancy expenses, 168 innovative programs, 225â231 mental health and substance abuse linkages between primary and specialty treatment coverage, 158â159, care, 207â210 280â284 participation and engagement for, 4, preventive services coverage, 278â279, 195, 298 286â287 personalized health services, 225 recent reform proposals, 42 prevention and health promotion, 194, recommendations for improving health 195, 210â212, 231 care system, 12â13, 307â308 privacy and confidentiality issues, 194 sexual and reproductive health services provider training, 255â258 coverage, 279â280 rationale, 1, 15, 18, 194â195, 293, 310 shortcomings of current health system, recommendations for, 9â15, 304â310 7, 18, 265, 276, 278, 287, 288, 300 referral practice, 204â206, 207â208 source of medical care and, 169â170 research needs, 232 strategies for increasing coverage, screening and assessment, 197â202, 203, 275â276 231 Internet youth development promotion, 214â219 harassment via, 87 Inpatient hospital care online health services, 224â225 adolescent utilization, 167â168 resources for medical education, 256â257
336 INDEX J M Juvenile justice system, adolescents in, 2â3, Managed care 35 adolescent utilization, 169 health risks, 53â54, 113, 114 carve outs, 205â206 mental disorder risk among, 113â114 confidentiality concerns, 287 mental health services, 73 recommendations for improving public population patterns, 113â114 health system for adolescent care, recommendations for health insurance 10â11, 305â306 coverage, 12â13, 307â308 Maternal and Child Health Block Grant, recommendations for improving primary 181 health care, 9â10, 305 Maternal and Child Health Bureau, 252, substance abuse risk, 163 258 victimization risk, 114 Medicaid See also Subpopulations of adolescents confidentiality of adolescent health care, 181, 287 coordination of care, 174 L cost-sharing requirements, 277, 285 covered services, 276â277, 278â280, Leadership Education in Adolescent Health, 281, 284 12, 307 current shortcomings in adolescent Lesbian, gay, bisexual, or transgender health care, 42 adolescents, 2â3, 173 eligibility, 272, 274 eating disorders among, 110 failure of eligible adolescents to enroll health-related data, 109 in, 273â276 in homeless population, 104â105 physician reimbursement, 285â286 population patterns, 108â109 pregnancy care, 168, 272 psychosocial stressors, 111 preventive care reimbursement, 287 recommendations for improving primary provider participation, 285â286 health care, 9â10, 305 recommendations, 12â13, 307â308 research challenges, 108 settings for adolescent medical care and, sexual health risks, 111 169 social stigma, 107â108 Mental disorders special issues for transgender teens, age of onset, 72, 77 112 among adolescents in juvenile justice substance abuse, 110 system, 113â114 suicidal behavior or ideation, 109â110 comorbidity, 72 violence victimization risk, 111 definition and clinical conceptualization, See also Subpopulations of adolescents 71 Licensing, certification and accreditation prevalence, 71â72, 73, 74, 75, 77, 157 adolescent medicine board certification, risk factors, 72â73 254 risk in adolescence, 53, 54 continuing education requirements, risks among homeless adolescents, 255 103â104 inconsistency in national system of, 260 risks in foster care, 98, 99 recommendations for, 11â12, 306â307 See also Mental health services; specific shortcomings of current system, 240, disorders 252, 260 Mental health services strategies for improving adolescent adolescent perceptions, 39 health care system, 255â256 confidentiality concerns of adolescents, 179
INDEX 337 effectiveness, 158 N evolution of costs and reimbursement, 282 National Adolescent Health Information fragmentation of current health system, Center, 257 7, 301 National Initiative to Improve Adolescent inpatient hospitalization, 168 Health, 29â30 insurance and reimbursement, 8, Nurses, 247â248 157â158, 280â284, 286, 302 online, 224â225 primary care reimbursement, 143â144 O public insurance coverage, 277, 286 Obesity racial differences in service delivery in adulthood, 94 settings, 73 associated health risks, 93, 94 recommendations for health insurance associated psychosocial risks, 93 coverage, 13, 308 current screening and counseling recommendations for improving public practice, 173 health system for adolescent care, electronic entertainment and, 35â36 10â11, 305â306 health management strategies in primary in schools, 206 care, 203 screening, 172â173 insurance coverage issues, 8, 302 shortcomings of current health system, objectives for adolescent health, 55 7, 158, 172â173, 301 patterns and trends, 6, 53, 93â94, 95 specialty consultation approach, 208 prevention, 30â31 substance abuse risk, 163 Objectives for adolescent health system, unmet needs, 158 4â5, 6, 135, 298â299 workforce, 157 application, 139 See also Mental disorders; Specialty care components, 138â140 services framework for evaluation of adolescent Models of care, 6â7, 19â20, 36â37, 300 health service models, 195 criteria for evaluating, 195 recommendations for health insurance Mortality coverage, 13, 308 adolescent risk, 53 recommendations for research agenda, in adulthood, adolescent health-related 13â14, 309 behaviors and, 54 shortcomings of current health system causes, 53, 62â64, 65, 172 performance, 55 patterns and trends, 6, 62â65 shortcomings of current service delivery Motivational interviewing, 203 models, 6â7, 296, 299â300 Motor vehicle accidents Office of Technology Assessment, 29 adolescent mortality, 53 Oral health. See Dental care alcohol use and, 84â85 causes of risky driving, 84 injury outcomes, 53 P mortality, 62, 65, 84 objectives for adolescent health, 55 Parental educational attainment, dental patterns and trends, 6 health and, 162 prevention strategies, 31 Pediatric care, 19 seat belt use and, 85 Perceptions and attitudes about adolescent sleepiness as cause of, 85 health adolescentsâ, 22, 38â39, 136 adolescentsâ self-perceived health status, 54
338 INDEX data sources, 22 associated risks, 91 health care providers, 40â41 consent for care and confidentiality laws, historical evolution, 23â24 180 parentsâ perspectives, 39â40 fetal loss rates, 92â93 perceptions of drug use, 90 health objectives for adolescents, 55 significance of, 37â38 incidence, 91 Personalized health services, 225 inpatient hospital utilization, 167â168 Pharmacists, 41 insurance reimbursement, 168 Pharmacotherapy oral disease risk and, 79 cost of medications as barrier to, 267 patterns and trends, 6, 53, 91â92 medication management, 202â203 risks among homeless, 101, 102 Physical activity Preventive interventions electronic entertainment and, 35â36 current insurance coverage and health and, 95 reimbursement, 278â279, 286â287 objectives for adolescent health, 55 disincentives for insurance providers, outcomes of adolescent health- 286â287 compromising behavior, 54 health management strategies in primary patterns and trends, 6, 95â96 care, 203 PIPPAH, 258 interaction and coordination among Policy making social service sectors, 174 privacy and confidentiality issues, 42, rationale, 195 43, 302 recommendations for health insurance recommendations for improving coverage, 13, 308 adolescent health care, 10â11, screening and assessment, 197â202 305â306 seat belt use, 85 shortcomings of current policy shortcomings of current health system environment, 41â42 performance, 137 significance of, in adolescent health care, See also Disease prevention; Health 4, 45, 298 promotion taxes to discourage alcohol and tobacco Primary care consumption, 212 adolescent medicine specialists, 144â145 See also Federal government; State behavioral health assessment and government monitoring, 144, 204 Poor families, 2â3 in community-based health centers, access to care, 6, 17, 18, 33â34, 97 150â151 chronic health condition risk, 65â67 goals for improving adolescent health insurance coverage, 8, 265, 275â276, services system, 195â196, 231 302 health management strategies, 202â204 Medicaid cost-sharing requirements, 277 hospital-affiliated, 151â152 population patterns, 34 medication management, 202â203 racial/ethnic patterns, 6, 34, 296 private office-based, 143â147 recommendations for health insurance providerâpatient relationship in, coverage, 13, 308 203â204 recommendations for improving primary recommendations for improving, 9â10, health care, 9â10, 305 305 See also Socioeconomic status recommendations for research, 14, 309 Population-based health care delivery, 210 referrals to specialty care, 204â206, Population patterns and trends, 6, 17, 207â208 32â33, 34â35, 97, 296 reimbursement, 143â144, 145, 146, 201 Pregnancy, dental care in, 272 safety-net programs, 143â147 Pregnancy in adolescence school-based, 152â156 abortion rates, 92 scope of services, 142, 143
INDEX 339 settings for, 143 importance of, for adolescent health care shortcomings of current health system system, 4, 44, 240â241, 261, 298 performance, 6, 18, 135, 145â147 innovative programs, 240, 256â258 specialty care linkages, 142, 157, interdisciplinary programs, 12, 252â253, 207â210 307 strategies for improving adolescent leadership programs, 252â253 health services system, 199â201, 231 levels of expertise in adolescent Privacy and confidentiality medicine, 245â246 adolescent candor and, 178 master degree programs, 255 adolescent concerns, 38, 42â43 patient simulations, 256 adolescent utilization of health services postresidency fellowships, 253â254 and, 177â179, 219, 220, 300â301 primary care physicians, 144â145 adult protections, 219 provider attitudes and beliefs, 41, conceptual approaches to adolescent 246â248 care, 219â220 recommendations for, 11â12, 306â307 consent for care law and, 180â181 recommendations for research, 14, 309 electronic health records and, 223 for screening and counseling, 174 insurance issues, 223, 287 shortcomings of current health system, legal framework, 181â183, 219 8, 240, 241, 244, 246â248, 249, parental concerns, 42 258, 302â303 parental involvement in adolescent care, for specialty care services, 167 221â222 substance abuse treatment, 164â165 policies of health care professional train-the-trainer programs, 256â257 organizations, 222 See also Licensing, certification and policy issues, 42, 43, 302 accreditation provider attitudes and beliefs, 43, 219, Providerâpatient relationship 301 adolescent primary care, 145 provider communication with adolescentsâ confidentiality beliefs and, adolescent, 220 177â178 recommendations for, 11, 306 clinical significance, 203â204 sexual and reproductive health service confidentiality discussions, 220 utilization and, 160 participation and engagement, 4, 195, significance of, in adolescent health care, 298 137, 183, 219, 301â302 provider perception, 41 Protective factors, 212 recommendations for adolescent care Provider education and training provider training, 12, 307 adolescent medicine specialists, 144â145, Provider performance measurement 252â255 primary care services, 10, 305 certification standards, 255â256 recommendations for monitoring health challenges, 258â261 care system performance, 14â15, competency domains, 249â251 309â310 conceptual evolution, 243â244 recommendations for research, 13â14, continuing education, 255 309 current models, 252â256 standards and guidelines, 248 doctoral programs, 255 See also Licensing, certification and economic disincentives, 259 accreditation funding for training programs, 12, 251, Psychosocial functioning 253, 307 changes in adolescence, 24, 25 future demand and supply, 244â245 dating violence, 86â87 goals, 241, 261 individual differences in adolescents, 41
340 INDEX risks for lesbian, gay, bisexual, or quality of care and, 137 transgender adolescents, 107â108, recommendations for improving primary 111 health care, 9â10, 305 See also Mental disorders; Mental health sexual and reproductive health service services utilization, 159 sexually transmitted disease patterns, 77â78, 79 Q suicidal behavior or ideation, 77 tobacco use, 89 Quality of care violent crime victimization, 87 adolescent primary care, obstacles to, See also Subpopulations of adolescents 145 Referrals impediments to, in current adolescent goals for improving adolescent health health system, 18â19 services system, 195â196 insurance and, 8, 265, 302 strategies for improving, 204â206, racial/ethnic disparities, 137 207â208 in safety-net settings, 7, 300 substance abuse, from schools, 162â163 U.S. health system, 31 Regional resource management, 209 Reimbursement care management, 206 R immunization policies, 213 Race/ethnicity mental health services, 157â158 access to care and, 6, 17, 18, 33, 97, preventive care, 287 137, 296 private office-based primary care, adolescent health status patterns and 143â144, 145, 146 trends, 53 provider participation in public adolescent pregnancy, 53, 91, 92â93 insurance programs and, 285â286 alcohol and substance use and, 76, 85, recommendations for health insurance 90 system, 13, 308 asthma prevalence, 66 for screening and counseling, 174, 201 cancer incidence and survival, 70 Research diabetes prevalence, 67 current shortcomings, 19â20, 294â295 disparities in health care delivery, for improving adolescent health services 177â178 system, 232 insurance coverage patterns and notable past work, 29â31 disparities, 8, 265, 269â271, 272, recommendations for, 13â14, 309 302 recommendations for monitoring health mental disorder risk, 73 care system performance, 14â15, mental health service delivery settings, 309â310 73 See also Data collection mortality patterns, 62, 64 Risky behavior obese and overweight patterns in adolescent morbidity, 53 adolescence, 93 assessment, 201â202 oral health care needs, 79â82, 83, 162 comorbidity risk, 6 parental attitudes toward sexual current screening and counseling behavior and sexual health, 40 practice, 173 physical activity patterns, 96 health management strategies in primary population patterns and trends, 6, 17, care, 202â204 32â33, 97, 296 morbidity, 84 poverty and, 6, 34, 296 normal adolescent development and, 24, provider workforce diversity, 242â243 25
INDEX 341 oral disease risk, 79 significance of, in adolescent health care primary care intervention, 147 syste, 152 rationale for early identification and sponsors, 153 intervention, 197 strengths and weaknesses, 6â7, 299â300 scope of, 53, 115 substance abuse referrals from, 162â163 screening strategies, 197â201 School-based insurance coverage, 276 significance of, in adolescent health, 3â4, Sex education, 40, 158 5â6, 17â18, 52, 54, 91, 115, 172, Sexual abuse risk for homeless adolescents, 197, 211, 296, 297 100 unsupervised nonschool hours and, 35 Sexual and reproductive health See also Alcohol use; Behavioral health adolescent utilization of health services, in adolescence; Sexually transmitted 158â160 disease; Substance abuse among lesbian, gay, bisexual, or Rural areas transgender adolescents, 111 access to care, 34, 97 current insurance coverage, 279â280 agricultural workers, 106â107 current screening and counseling obese and overweight patterns in practice, 173 adolescence, 93â94 dating violence, 86â87 physical activity patterns in, 96 effectiveness of clinic services, 160 population patterns and trends, 34â35, family influences on adolescent health 97 behavior, 38 fragmentation of current health system, 7, 301 S guidance and counseling, 158 information technology, 224 Safety-net providers objectives for adolescent health, 55 advantages of, in adolescent care, 7, outcomes of adolescent health- 136, 156â157, 300 compromising behavior, 54 community-based health centers, parental attitudes and perceptions, 40 150â151 primary care reimbursement, 143â144 current research base, 147 privacy concerns of adolescents, 160, definition and characteristics, 147 178â179 quality of care, 7, 156, 300 public insurance coverage, 277 recommendations for improving, 9, 304 recommendations for health insurance scope of care settings, 147 coverage, 13, 308 shortcomings of current health system recommendations for improving public performance, 6â7, 299â300 health system for adolescent care, significance of, in adolescent health care 10â11, 305â306 system, 7, 156, 300 right to access to health care, 180â181 School-based health centers risks among homeless adolescents, characteristics, 153 100â102 clients, 152 risks for lesbian, gay, bisexual, or funding, 153â156 transgender adolescents, 105 in innovative integrated health risky behaviors, 77 programs, 226â227 sexual activity of adolescents, 40, 77 mental health services, 206 shortcomings of current health system number of, 152 performance, 7, 301 quality of care, 7, 300 Sexually transmitted disease rationale, 152, 153 consent for care and confidentiality laws, services, 153 180
342 INDEX current insurance coverage for screening, provider preparation for, 167 279, 280 purpose, 142 patterns and trends among adolescents, recommendations for improving, 9, 304 53, 77â79 regional resource management, 209 risk, 77 scope of, for adolescent care, 242 risk for adolescents in juvenile justice service agreements, 209 system, 114 shortcomings of current system, risks among homeless adolescents, 100, 166â167 101â102 strategies for improving referral practice, risks for lesbian, gay, bisexual, or 204â206, 207â208 transgender adolescents, 111 See also Dental care; Mental health screening for, 198 services; Sexual and reproductive Single-parent families, 34, 38 health; Substance abuse treatment Sleep patterns, 85 Standards of care Society for Adolescent Medicine, 210â211, competency domains, 249â251 213, 222 provider implementation and adherence, Sociocultural context 248â249 perception and status of adolescents, recommendations for, 13â14, 309 23â24 screening practices, 198 significance of, in health care delivery, State Childrenâs Health Insurance Program 28 confidentiality of adolescent health care, Socioeconomic status 181, 287 adolescent health status and, 35 covered services, 277, 279, 280, emergency department admissions and, 281â283, 284â285 168 current shortcomings in adolescent insurance coverage patterns and health care, 42 disparities, 8, 269â271, 272, 302 dental care coverage, 267 insurance eligibility, 272â273, 274â275 eligibility, 272, 274 mental disorder risk, 72 failure of eligible adolescents to enroll mortality patterns, 64 in, 273â276 significance of, as adolescent health provider participation, 285â286 factor, 4, 298 recommendations for, 12â13, 307â308 See also Poor families reimbursement rates, 169 Solution-focused interviewing, 203 State government Special health care needs, 65. See also confidentiality laws, 182â183 Chronic illness interaction and coordination among Specialists, adolescent medicine, 144â145 social service sectors, 174 Specialty care services recommendations for health insurance access, 136â137, 166, 300 system, 12â13, 307â308 adolescent medicine board certification, recommendations for improving primary 254 care, 9, 304 adolescent perceptions, 136 Subpopulations of adolescents care management, 206â207 advantages of school-based health care competency domains, 250â251 delivery, 153 consultation, 208 barriers to assessment, 202 directories, 205 comorbidity risk, 6, 296 economic disincentives for adolescent goals for improving adolescent health health care specialists, 259 services system, 196 goals for improving adolescent health insurance coverage disparities, 269â271 services system, 196 population patterns, 35 primary care and, 142, 157, 207â210 primary care services, 146
INDEX 343 public perceptions and attitudes, 37 confidentiality concerns of adolescents, recommendations for adolescent care 179 provider training, 12, 307 consent for care and confidentiality laws, recommendations for health insurance 180 system, 12â13, 307â308 current insurance coverage, 280â284 recommendations for improving primary effectiveness, 165â166 health care, 9â10, 305 fragmentation of current health system recommendations for monitoring health as obstacle to, 7, 301 care system performance, 14â15, insurance coverage issues, 8, 302 309â310 need, 163â164 safety-net health care, 150 outcome indicators, 164 scope, 2â3, 27 public insurance coverage, 277 special needs and vulnerabilities, 4, 6, recommendations for health insurance 18, 27, 52, 96â97, 296, 298 coverage, 13, 308 unmet oral health needs, 162 recommendations for improving public See also Foster care system, adolescents health system for adolescent care, in; Homeless population; Immigrants; 10â11, 305â306 Juvenile justice system, adolescents relapse risk, 165â166 in; Lesbian, gay, bisexual, or schools as referral sources, 162â163 transgender adolescents; Poor shortcomings of current system, families 164â165 Substance abuse See also Specialty care services; among adolescents in juvenile justice Substance abuse system, 113â114 Suicidal behavior or ideation among lesbian, gay, bisexual, or access to weapons and, 86 transgender adolescents, 110 alcohol use and, 89 associated risks, 88 among lesbian, gay, bisexual, or clinical disorders, 75â76 transgender adolescents, 109â110 current screening practice, 173 depression and, 73 depression and, 74 mortality, 53, 62, 65, 77 health management strategies in primary prevalence, 77 care, 203 risks among homeless adolescents, 104 mental disorder risk, 72 screening for, 198 outcomes of adolescent health- compromising behavior, 54 patterns and trends, 76, 87, 90â91 T racial/ethnic differences in emergency Technology, health information, 10â11, room screening, 176 223â225, 305â306 risk in institutional settings, 163 Text messaging, 211â212, 224 risks among homeless adolescents, 102, Time use patterns, adolescent, 35â36 103 Title X, 181 risks in foster care, 98 Tobacco use screening and assessment, 198, dependency, 76 201â202 health consequences, 89 significance of, as adolescent health risk, mortality, 54, 88 53, 91 oral disease risk, 79 See also Substance abuse treatment patterns and trends, 6, 88, 89, 172 Substance abuse treatment secondhand smoke exposure, 88â89 adolescent attitudes and perceptions, 39 significance of, in adolescent health, 53, adolescent-specific provider certification, 91 164â165 strategies for discouraging, 212
344 INDEX Training and education for health care Violent behavior professional. See Provider education adolescent victims, 86â87, 105 and training dating violence, 86â87 Transgender adolescents. See Lesbian, gay, developmental patterns, 85â86 bisexual, or transgender adolescents victimization risk for lesbian, gay, bisexual, or transgender adolescents, 111 U See also Homicide U.S. Preventive Services Task Force, 199 Utilization of health care resources W confidentiality concerns of adolescents and, 177â179, 219, 220, 300â301 Weapons access and use, 53, 86 emergency care, 6â7, 171, 300 Workforce, health care insurance coverage and, 8, 265, 266, current structure and capacity, 242â246 267â269, 272, 285, 302 diversity rationale, 242â243 sources of care, 168â172, 299â300 need for multidisciplinary approach to adolescent care, 242, 249 shortcomings of current system, 240 V supply concerns, 244â245 See also Provider education and training Vaccination and immunization, 143, 213â214, 278â279