Category: Putting RAAPS into Practice

The Top 5 Worst Reasons Why…

We help providers, professionals, and parents, identify and reduce risk behaviors among youth and young adults. So you might imagine that in our line of work that we’ve “heard it all.”

And yes, we’ve heard a lot, but it’s not the stories and information that young people share that shocks us. It’s what we hear from youth-centric organizations (provider groups, schools, health departments…) about why they don’t screen for risk behaviors that we find flat out scary.

Here are the top 5 worst reasons we’ve heard…so far.

1. If we know about a risk we’ll be responsible to take action. At it’s core, we believe that this reason isn’t just about liability – it’s about the fear of what happens if something goes wrong. Think past that initial reaction – and it becomes obvious that we’d all feel equally terrible (and potentially, even as liable) if something goes wrong (such as an overdose, a suicide attempt, unreported abuse or bullying…) and we didn’t know about it in advance. No one is expecting you to be the expert at every risk or situation. Identifying risks in advance allows youth to “get it off their chest” and you to provide resources and when necessary referrals to the right experts who can help to prevent bad things from getting worse – or maybe even from happening at all.

2. We don’t have the time. It’s true, you always need more time. Our company was founded by a clinician with years of experience in busy pediatric and adolescent practices. Finding practical solutions that minimize impact on time and workflow is at the heart of everything we do. Did you know that in less than 5 minutes RAAPS identifies the risks that contribute most to preventable illness and death in young people aged 9 to 24? Even in the tightest of workflows in organizations that run like clockwork you’ll find a 5-minute window of wait time for the patient – why not put that time to (really meaningful) use?

3. We don’t have the money. You’ve heard that expression: “If it’s important you’ll find a way. If it’s not you’ll find an excuse.” To be fair, we think this reason is more about priorities than excuses. There are so many competing priorities for organizations that serve youth it’s hard for anything new to find it’s way to the top of the list. Think about the things that do get prioritized: vaccines; assessments of height, weight and blood pressure; current medications and allergies… Why do these things sift to the top? They save lives. Now think about this CDC statistic: risk behaviors are responsible for 3 out of 4 (75%) of all preventable deaths and illness in youth. Risk screening saves lives. And the cost? One month of access to the RAAPS system costs the same as a single case of coffee pods or printing paper. Really, we think it’s all about the priorities.

4. We don’t want to upset parents. That’s cool. Honestly, neither do we, but realistically how upset do you think parents will be if there is an uptick in bullying, an increase in youth carrying weapons, or a widespread incidence of sexual abuse that could have been identified with standardized screening? As providers of risk identification and reduction tools we have time-tested, proven strategies and resources for helping parents understand risk screening – why it’s important and how it helps. And trust us, that’s an easier conversation to have proactively than reactively.

5. We don’t know what to say. There’s no doubt: conversations about risk are uncomfortable. But did you know that having a trusted adult to confide in is one of the single most important mitigating factors in reducing youth risk? Just by being present and starting the conversation you’ve helped. So take the next step. If you are uncomfortable with discussing certain topics – get help. Participate in a workshop on adolescent-focused motivational interviewing; choose a risk screening system that offers built in health education so all youth get the same information (every time); and make sure that system provides you with evidence-based messages and talking points to help get the conversation started. Because let’s be real – saving a life significantly outweighs one uncomfortable conversation.

Getting to “Why?”

How boot-camp took us back to the future.

Our team recently went through a strategic planning “boot-camp” as part of a grant requirement.  A mandatory part of the exercise was justifying our value…what do we bring to the table, how do we help?

This was definitely a test.   Our short answers, in rapid succession:

  • “Because 75% of serious illness and death in youth is preventable…”
  • “Because nearly half of all youth who commit suicide visited a healthcare provider within the previous month…”
  • “Umm…because it’s the right thing to do?”

We were pushed further: “What is in it for your users – the healthcare provider, the professional working with youth?  How are you helping them?”

Ahhh – there it was, the lightbulb moment!

Preventing avoidable illness and death in youth is our mission – it’s the reason why we do what we do.  It’s the same mission that drives most of us in this work.

But making it as easy as possible for providers and professionals, to identify and counsel youth on the risky behaviors that drive our mission…making it painless…THAT is the reason behind WHY we’ve created every single solution and service we offer.

It’s the reason why RAAPS was created in the first place.  It was our first “tool”. RAAPS was developed to solve all of the workflow and practice management issues that get in the way of your mission:

  • Validated, short-format. Why? Your time is short – RAAPS has been proven to identify the most significant risks – in minutes.
  • Why? To ensure every youth is screened the same way – with the same questions – every time.
  • Tablet / smartphone delivery. Why? Youth engage honestly with technology – you don’t have to “ask” all of the questions – instead you can use your time to follow up on the risks identified.
  • Prioritized, evidence-based talking points. Why?  To make it easier to get the conversation started specific to the risks identified – we all have different experience and comfort levels with risk topics.

Yes, we could go on…  but back to boot-camp.  It was a great experience – if for no other reason than it reminded us of why we continue to develop our technology… facilitate the adolescent-focused MI trainings… write the books…. Why we got started and where we are going into the future – as we achieve our mission together with all of you!

Why RAAPS?

RAAPS versus GAPS and other homegrown risk screening tools

People pose the “why?” question every day. Why should I invest the time, energy and resources into an adolescent risk screening and counseling technology? We may be biased, but our answer is simple: why not?

Before we dive into the several reasons why thousands of sites nationwide find tremendous value of integrating RAAPS into their practice or program, here is the 140-character, tweet-friendly definition of RAAPS: a standardized, validated risk assessment and behavior change counseling tool to support health professionals working with adolescents.

In simplified language, we make it easy for health professionals to do their job. We partner with clinicians, counselors and other providers who are passionate about improving adolescent health. Our partners—like school-based health centers, pediatric offices, sexual health clinics, schools, etc.—operate within a preventative-oriented culture (not crisis-oriented) and genuinely care about identifying risks, improving outcomes and changing lives. It’s not for the faint of heart.

RAAPS can make you money

“Say what?!” (Please excuse our language. Sometimes we find the way teens speak kind of catchy.) Yes, our leading risk assessments can save you money. How?

  • RAAPS dramatically improves the productivity of your existing staff and the effectiveness of your operations. You will no longer have to sit face-to-face with your patient, ask the sometimes-awkward questions, record the data, then figure out how to best counsel the patient to promote positive behavior change. RAAPS saves a provider’s time by flagging potential risk behaviors and offering health message talking points to guide the conversation.
  • By using a standardized, validated tool (RAAPS) to screen adolescents each month, the cloud-based system may be able to pay for itself. Assuming an average insurance reimbursement rate of $5 per administration, your sites would need to use the system with only 10 patients per month in order to recover the cost of using the system. #winning

RAAPS’ real-time tracking and easy to use reporting measures outcomes

Can your risk screening tool do this? If it’s not RAAPS, the answer is likely no. Access to individual and population data allows you to identify trends and assess your intervention effectiveness. Plus, data gathered can be helpful when applying for grants and gaining additional funding.

RAAPS asks the right questions

The risk landscape is always changing and unfortunately widening, which is why we continue to update or modify our questions to elicit honest responses from teens. Other risk screening tools, such as GAPS, hasn’t been updated since the early 2000’s. The way teens speak and the risks they’re involved in have changed drastically since the era of Boy Meets World and Backstreet Boys. At Possibilities for Change, we continue to identify issues and areas that are harmful to a teen’s health and well-being. One of the many beautiful things about RAAPS is that all questions are scientifically validated—and we used teens to help us refine the actual questions so that they were more understandable and relevant! Unlike most homegrown tools, the RAAPS youth-friendly patient portal includes audio and bilingual health messages features to increase health literacy.

The 21-question RAAPS assessment falls within seven risk categories identified by the CDC as contributing to adolescent morbidity and mortality. The Society for Adolescent Health and Medicine has our back, citing RAAPS as one of their important resources, handouts, toolkits and treatment protocols for healthcare providers to use in their practices.

In our fast-paced, technology-driven world, the manner and method of how we ask is just as important as what we ask. When it comes to discussions around things like sexual behavior and alcohol use, teens are more honest and comfortable answering to a tablet or other technology than an adult. The assessment takes about 5 minutes to complete—a better alternative to other assessments out there that take more than a half hour. Ain’t nobody got time for that! (We warned you.)

Learn more about RAAPS at possibilitiesforchange.com or drop us a line at info@pos4chg.org.

Putting RAAPS into Practice: MI Department of Community Health

The Michigan Department of Community Health oversees the Child and Adolescent Health Center (CAHC) program which provides funding and administrative oversight to 70 school-based and school-linked health centers across the state. Michigan has the fourth largest school-based health center program in the country, with centers located in medically underserved areas in order to care for the state’s most vulnerable children and teens.

Carrie Tarry is the Manager of the Adolescent and School Health Unit for the Michigan Department of Community Health. In this role, Carrie oversees many programs including teen pregnancy prevention, health education, coordinated school health, school nursing and the CAHCs.

These school-based and school-linked health centers (CAHCs) are primary care settings, located either within or close to a school. In addition to managing physical health, the centers offer a wide continuum of health-related screenings and services such as: mental health care, dietary guidance, health education and risk reduction, oral healthcare, and insurance enrollment assistance. Carrie likes to say “Anything you can get in a pediatrician’s office you are able to get at a school based health center, plus more.”

In Michigan, State-funded CAHCs are required to administer a risk assessment on all patients by the third visit that the teen makes to that center. This is a state-based rule for the CAHCs and it is also a best practice recommendation and guideline nationally.

Access to the data was especially important to the state of Michigan – particularly the ability to review data across multiple CAHCs. Carrie says “We ran the school-based health center program for 15 years and never had risk data about the teens accessing care. We could not report on their overall risks or the progress that we were making in changing behaviors. We could not compare our CAHCs or help them match their programs to the needs of their teen patients.”

Carrie further explains “We had 60+ centers identifying risk behaviors and no way to collect, consolidate, and report the data on those adolescent populations. We didn’t have any population data because it was all sitting in patient charts. We wanted to paint a clear picture for ourselves and the CAHCs about what the needs of the teens accessing these centers. We wanted to be able to look at data for differences between rural and urban centers, for regional – like between the Upper Peninsula and Detroit, for race/ethnicity differences, and income disparity differences. We immediately saw the value of the data.”

And the state is using this newly gathered data, on the “real issues” teens are struggling with, to tailor program offerings. Carrie explains “We wanted to make sure that centers direct their programs towards the needs of the patients coming into the center. If most teens are saying that they have depression or that they need sexual health information – we wanted to ask the centers ‘Do you have programs around those areas?’” Carrie states that the number of centers who actually use RAAPS is a testament to the support of the product.

Finally Carrie hopes that RAAPS is used even more on a national basis, saying: “It would be huge for school-based health centers across the country to have aggregate data on the teen populations we serve and to be able to show the differences we are making in changing their risky behaviors over time. Getting more comparative data on a national level would be icing on the cake.”

Read more about the Michigan Department of Community Health and how they put RAAPS into practice by viewing their case study.

Contact us today with questions about how to effectively integrate RAAPS into your practice!

Putting RAAPS into Practice: Henry Ford Health System in Detroit, MI

More than 15,000 services are delivered annually to metro-Detroit students and community members through the Henry Ford School-Based and Community Health Program.  In 1991, its first school based health center opened in Detroit’s Hutchins Middle School. It has grown to include 9 school and community settings across metro Detroit.

Mary Serowoky, a nurse practitioner, is clinic coordinator for the state-funded school based health center at Southwestern High School in Detroit.  This center serves adolescents between the ages of 10 and 21.

All adolescents seen in Southwestern’s center complete a risk assessment annually.  Serowoky, who’s worked in school-based health for a decade, has used risk assessment tools her entire career.  She knew the paper-based, lengthy forms were tedious and difficult for teens to complete — and for medical providers to review.

Implementation “was super-easy,” Serowoky said.  Training took 10 minutes.  Then, it was a matter of determining where youth would complete the assessment and how providers would access and use it.  A medical assistant, care manager, and clinical therapist all use RAAPS data to support the teen patients.

Serowoky says the RAAPS’ electronic features make it a “must have.”  Teens complete RAAPS faster, more thoroughly and more honestly than they did the former, longer, paper assessment.  Health providers supporting a given teen can access that teen’s results, review results more efficiently, and there’s consistent information across the entire patient population.  What’s more, RAAPS’ multilingual capabilities are invaluable to students who, in Southwestern’s case, need Spanish or French versions.

RAAPS produces comprehensive reports that Serowoky uses to evaluate top risk areas.  She catalogs behaviors by race and gender to advance the team’s understanding of patients, and she will compare the population to a national peer group using RAAPS data.  “We love that this is electronic since we can pull all the reports and we have a database of all the kids.  This is really good for us,” Serowoky said.

Read more about Henry Ford Health System and how they put RAAPS into practice by viewing their case study.

Contact us today with questions about how to effectively integrate RAAPS into your practice!