Month: October 2012

Putting RAAPS into Practice in Louisiana

Help us in welcoming Primary Care Providers for a Healthy Feliciana, Inc. (PCPFHF) to the RAAPS community!

PCPFHF s a 501(c) 3 not-for-profit organization that has served the residents of East Feliciana Parish since 1999, and West Baton Rouge Parish since 2008, providing quality, affordable health care regardless of ability to pay. PCPFHF is comprised of two stand alone clinics (one in Clinton, Louisiana, and one in Port Allen, Louisiana), and operates four school-based health clinics in East Feliciana.  PCPFHF, Inc. additionally directs 20 social worker offices in two other parish school systems.   All PCPFHF Health Centers are Federally Qualified Health Centers and Primary Care Medical Homes.

PCPFHF’s school-based health clinics and school sites are now utilizing RAAPS.  Prior to RAAPS, social workers were using a different traditional hard copy risk assessment.  Barriers arose while utilizing the old adolescent assessment, noting that it was time consuming to score and data was solely being hand counted for reporting purposes.   A lack of student comprehension of the questions proved to be an obstacle that was difficult to overcome.

Now, PCPFHF is successfully using RAAPS and has even licensed the RAAPS content into their electronic health record.  RAAPS can improve efficiency and effectiveness and decrease barriers in your health center, too!

Did you know?

RAAPS web application is accessible on all web enabled devices, including mobile devices. It has been found that when adolescents take surveys electronically, they answer questions more honestly and openly. The web-based application of RAAPS has many notable features:

  • – Adolescents with reading difficulties can listen and respond to the questions through an audio option (English as well as other languages available).
  • – RAAPS is available in the web application in a variety of languages with the completed survey appearing in English for professional review.
  • – Comprehensive data analyses are available on RAAPS to reveal individual and group trends and allow immediate follow up.
  • – RAAPS is HIPAA compliant, with an electronic medical record option!
  • – RAAPS meets many NCQA key components for patient-centered medical home (PCMH).  View more information on PCMH and how RAAPS can meet the PCMH vision.

Contact us today if you have any questions about how to effectively integrate RAAPS into your practice!

Putting RAAPS into Practice: Mental Health & School Setting

Shamara, age 14, is referred by a teacher for appearing unusually sad and inattentive in class. She arrives with her pass from class and is greeted by the secretary. She is set up at a small desk with a computer and the RAAPS survey up on the screen. The secretary explains confidentiality and corresponding instructions. Shamara agrees to answer all questions as honestly as possible.

The completed RAAPS survey is accessed and viewed by the counselor, this allows the counselor to get a snapshot of the issues that are going on for Shamara before they start talking. After reviewing the form, the counselor walks the teen to a private office. She uses the RAAPS survey as a guide in speaking with Shamara, making for an easy conversation starter. Sharmara’s answers on the RAAPS reveal that she has serious issues or worries at home or at school and that she has seriously thought about killing herself, tried to kill herself, or purposely cut, burned or otherwise hurt herself.

As the counselor talks with Shamara about her concerns, it’s revealed that the teen’s mother is terminally ill. The counselor develops rapport through continued conversation. Shamara admits that she has also started cutting her left arm “to feel better” and is wearing long sleeve shirts so that the cuts are not visible. No one else knows that she is cutting. Shamara is counseled on her feelings and offered continued counseling support for grief and loss issues. Alternative adults are discussed as support for Shamara when she is not in school. A contract is developed to stop cutting and use alternative outlets for grief reactions. They negotiate who will be notified of her cutting behaviors and become a part of the support for Shamara. An upcoming grief and loss group is also described to her.

RAAPS has allowed the counselor to screen for multiple risks in a short amount of time and to focus in on the issues affecting this student’s mood.

Learn more about RAAPS by checking out our website: www.raaps.org.  Read the previous blog posts about the research behind the RAAPS questions.  If you have any questions, please contact us for more information.

Putting RAAPS into Practice: Primary Care Setting

The next series of posts will feature ways that providers across the country use RAAPS.

“Sam,” age 17, presents for an annual asthma checkup. He arrives with his mother and greets the receptionist, who invites him to wait in the teen area of the waiting room. As he browses through brochures and magazines geared toward teens, a medical assistant approaches Sam and offers him the RAAPS survey on a handheld computer. Sam is led to an area with a privacy screen and the medical assistant explains confidentiality laws and corresponding instructions. She finishes by asking Sam to honestly answer each question as it appears on the computer.

Sam completes the RAAPS survey and hands the computer to the receptionist. Soon a staff member comes into the waiting area and calls Sam’s name. She asks Sam’s mother to stay in the waiting room for the first part of Sam’s visits, and she escorts Sam to the examination room.

The health provider (HP) enters the exam room with Sam’s completed RAAP on her computer. She explains to Sam that she is interested in his physical and mental well being, and that the survey offers a tool for discussing all aspects of his current health. The HP invites Sam to discuss any other concerns he may have in addition to his asthma.

In a short time frame, the HP is able to briefly review each risk behavior Sam has identified in the survey. She learns that Sam has been sexually active for 1 year, and that he has used condoms inconsistently. She counsels Sam about safer sex behaviors and develops an action plan for limiting sexual partners and consistently using condoms. The HP also discusses testing for sexually transmitted infections, and Sam considers this for a future appointment.

Sam also identifies feelings of sadness. He shares that he feels sad 2 to 3 days per week and relates these feelings to friends and school pressures. He is concerned about getting into the “right” college. Sam reports no past or current suicidal ideation.

The HP counsels Sam about ways to improve his mood through journaling and exercise. She also gives him a teen-specific resource card with community resource information.

The HP then asks Sam’s mother to join them in the exam room. The remainder of the visit is directed toward the assessment and management of Sam’s asthma. The HP ends the visit by encouraging open communication between Sam and his parents.

 Learn more about RAAPS by checking out our website: www.raaps.org.  Check out our previous posts about the research behind the RAAPS questions.  If you have any questions, please contact us for more information.

Research Behind the RAAPS Questions (Question #21)

Do you have at least one adult family member or other adult that you can talk to about anything?

A key to successful adjustment in adolescence is to have supportive relationships that protect adolescents from the effects of stressors.  Social support from parents plays a protective role for adolescents, mitigating the effects of stress and other risk factors. Adolescents may seem distant or preoccupied with peer groups, however; the family is still home base in the changing world of middle adolescence, and core family values continue to exert a significant and stabilizing influence.

Did you know?

Youth who reported non-parents (romantic partners or peers) as their primary support system, were more likely than those who reported parents as their primary social support to show behavioral and emotional problems.

Try these messages with youth:

  • –  Not everyone has a strong relationship with family members or another adult.  This does not mean you are alone and it does not mean you should keep your problems and worries to yourself.  Talking to a trusted adult about your problems can be very helpful.  They may have good advice or resources to help you work through your problems.
  • –  Don’t be afraid to reach out to a neighbor, teacher, coach, health professional or school counselor.  If you can’t talk face to face, there is always the phone and email to stay in contact.  Everyone needs a trusted adult to talk to.  There are adults out there who care about you and want to help however they can.

 

 

 

Research Behind the RAAPS Questions (Question #20)

Have you ever seriously thought about killing yourself, tried to kill yourself, or have you purposely cut, burned or otherwise hurt yourself?

Suicide among young people continues to be a serious problem. Suicide is the third leading cause of death among U.S. youth and accounts for 7% of all deaths among youth ages 10-14 and 12% of all deaths among youth ages 15-19.

Did you know?

  • –  Females are disproportionately affected, and attempt to commit suicide more often than males, however; males complete suicide attempts at a rate more than five times that of females.
  • –  Four out of five teens that attempt suicide give clear warnings to parents, friends, and other trusted individuals.
  • –  American Indians/Alaskan Natives are also disproportionately affected by suicide. This group has the highest suicide rates for adolescents (33.3/100,000), followed by Non-Hispanic Caucasian youth (14.6/100,000), Non-Hispanic African American (10.0/100,000), Hispanics (9.7/100,000), and Asian Pacific Islanders (8.9/100,000).

Self-injury appears to have become more popular lately, especially in adolescents. Adolescents may self-mutilate to take risks, rebel, reject their parents’ values, state their individuality, or to be accepted. Others do so out of desperation or anger, to seek attention, or to show their desperation or suicidal thoughts. In the U.S., it is estimated that one in every 200 girls between the ages 13-19 cut themselves regularly. Those who cut comprise about 70% of teen girls who self-injure.

Try these messages with youth:

“Not everyone has a strong relationship with family members or another adult.  This does not mean you are alone and it does not mean you should keep your problems and worries to yourself.  Talking to a trusted adult about your problems can be very helpful.  They may have good advice or resources to help you work through your problems.”

“Don’t be afraid!  Everyone needs a trusted adult to talk to.  Think about reaching out to a neighbor, teacher, coach, health professional or school counselor.  If you can’t talk face to face, there is always the phone and email to stay in contact.  There are adults out there who care about you and want to help however they can.”

Resources for youth:

–  Teen Central is an anonymous help-line web site for teens.  It has been developed by experts in teen counseling and psychology.

–  The Substance Abuse and Mental Health Services Administration (SAMHSA) launched the Mental Health Campaign for Mental Health Recovery to encourage, educate, and inspire people between 18 and 25 to support their friends who are experiencing mental health problems.  The What a Difference a Friend Makes is a site designed for those with mental illness and their friends.