Schools and Health Our Nation's Investment (1997) / Chapter Skim
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Appendix E
Appendix E
Pages 416-429
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From page 416... ...
This health crisis requires a fundamental change in the emphasis of adolescent services a change whereby a greater number of services are directed at the primary and secondary prevention of major health threats facing today's youth. School and community organizations have responded to the need for change by increasing health education programming.
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From page 417... ...
· One recommendation pertains to the use of immunizations for the primary prevention of selected infectious diseases. The topics or health conditions addressed by GAPS are: · promoting parents' ability to respond to the health needs of their adolescents; · promoting adjustment to puberty and adolescence; · promoting safety and injury prevention; · promoting physical fitness; · promoting healthy dietary habits and preventing eating disorders and obesity; · promoting healthy psychosocial adjustment and preventing the negative health consequences of sexual behaviors; · preventing hypertension; · preventing hyperlipidemia; · preventing the use of tobacco products; · preventing the use and abuse of alcohol and other drugs; · preventing severe or recurrent depression and suicide; · preventing physical, sexual, and emotional abuse; · preventing learning problems; and · preventing infectious diseases.
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From page 418... ...
emphasize annual clinical preventive services visits that address both the developmental and psychosocial aspects of health, in addition to traditional biomedical conditions. These recommendations were developed by the American Medical Association with contributions from a Scientific Advisory Panel, comprised of national experts as well as representatives of primary care medical organizations and the health insurance industry.
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From page 419... ...
The rapid behavioral changes that occur during adolescence require frequent visits to screen for health risk behaviors and to provide health guidance. To ensure that providers obtain accurate information and deliver health guidance appropriate for each adolescent, GAPS recommends that services be tailored to the individual and that information shared by the adolescent during the medical visit remain confidential.
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From page 420... ...
GAPS recommends that adolescents receive health guidance annually to help them cope with developmental challenges, develop and maintain healthy lifestyles, improve diet and fitness, and prevent injury. In addition, GAPS recommends health guidance be given to parents and guardians of adolescents to help them respond appropriately to the health needs of their adolescent.
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From page 421... ...
Health guidance for sexual responsibility includes the following: · counseling that abstinence from sexual intercourse is the most effective way to prevent pregnancy and sexually transmissible diseases (STDs) , including HIV infection; · counseling on how HIV infection is transmitted, the dangers of the disease, and the fact that latex condoms are effective in preventing STDs, including HIV infection; · reinforcement of responsible sexual behavior for adolescents who are not currently sexually active and for those who are using birth control and condoms appropriately; · counseling on the need to protect themselves and their partners from pregnancy; STDs, including HIV infection; and sexual exploitation.
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From page 422... ...
Adolescents with BP values between the 90th and 95th percentiles should be assessed for obesity and their blood pressure monitored every six months. Recommendation 12: Selected adolescents should be screened to determine their risk of developing hyperlipidemia and adult coronary heart disease, following the protocol developed by the Expert Panel on Blood Cholesterol Levels in Children and Adolescents.
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From page 423... ...
· Adolescents with a body mass index (BMI) equal to or greater than the 95th percentile for age and gender are overweight and should have an in-depth dietary and health assessment to determine psychosocial morbidity and risk for future cardiovascular disease.
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From page 424... ...
· Adolescents who use alcohol and other drugs should also be asked about their sexual behavior and their use of birth control products. Recommendation 16: All adolescents should be asked annually about involvement in sexual behaviors that may result in unintended pregnancy and STDs, including HIV infection.
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From page 425... ...
or confirmatory test. · Risk status includes having used intravenous drugs, having had other STD infections, having lived in an area with a high prevalence of STDs and HIV infection, having had more than one sexual partner in the last six months, having exchanged sex for drugs or money, being male and having engaged in sex with other males, or having had a sexual partner who is at risk for HIV infection.
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From page 426... ...
· Health providers should be aware of local laws about the reporting of abuse to appropriate state officials, in addition to ethical and legal issues regarding how to protect the confidentiality of the adolescent patient. · Adolescents who report emotional or psychosocial sequelae should be referred to a psychiatrist or other mental health professional for evaluation and treatment.
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From page 427... ...
These include learning disability, attention deficit hyperactivity disorder, medical problems, abuse, family dysfunction, mental disorder, or alcohol or other drug use. · This assessment, and the subsequent management plan, should be coordinated with school personnel and with the adolescent's parents or caregivers.
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From page 428... ...
infection should also be vaccinated. Major risk factors for acquisition of HBV infection in adolescents include multiple sex partners, intravenous drug abuse, living in areas with increased rates of parenteral drug abuse, teenage pregnancy, and/or sexually transmitted diseases.
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From page 429... ...
health risk behaviors. Annual visits permit early detection of health problems and offer an opportunity to provide health education and develop a therapeutic relationship.
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