Tag: Adolescent heath

Creating a judgement free zone…

Most professionals who work with youth try to approach each interaction with an open mind.  Research shows this is an important step to making youth feel comfortable.  What else goes into creating a safe place for youth to share?  Some of the steps are obvious – but we think a few may surprise you!  Here are 5 critical steps to creating a truly judgement-free zone…

  1. Know the law! Confidentiality laws and minor consent vary from state to state.  The first step to ensuring a youth-friendly approach is understanding the confidentiality laws in your state.  Next is implementing a workflow that integrates and accommodates these laws (including processes for everything from notification of test results to insurance billing).  It is imperative that youth understand their rights, and what will or won’t be shared with their parents.  Explaining and sharing this information goes a long way towards building trust.
  2. Be non-verbal! Well – just for the assessment, anyway.  When a risk assessment is delivered verbally, it’s our nature to jump in and talk about each risk as soon as it is identified – making it hard to get to every question.  More importantly, it’s just not in a teen’s nature to be forthcoming about risk when asked questions face-to-face.  Research shows youth respond most honestly when screened with technology – but if that is not an option, then old-school pen and paper is the next best thing.
  3. Standardize your approach! There’s a reason why every leading youth health organization recommends a validated, standardized risk assessment. As humans we have subconscious biases and deeply held personal beliefs that can influence our approach to risk screening.  This can be especially prevalent with home-grown risk assessments that are cobbled together with “select” questions pulled from a number of different tools.   A validated, standardized screening tool eliminates individual (or even organizational) culture bias and ensures all youth are screened the same way, every time.
  4. No shoulder surfing! It catches many parents off guard when their “baby” is suddenly old enough to complete a risk assessment on their own.  You may find them peering “helpfully” over their tween or teen’s shoulder.  It’s important to provide youth with a private space to complete a risk assessment.  This is an essential step in increasing honesty in youth response.  Engaging and educating parents is also important. They need to be reassured of the importance of this step in their son or daughter’s development.
  5. Watch your body! It’s easy to get so focused on youth that we forget what’s happening with our own body language.  Young people are very sensitive to non-verbals – and they are looking for any signs that you might be judging them (however unintentional those signs may be on our part!)  So avoid little things like crossing your arms, narrowing your eyes, or raising an eyebrow.  (And the same rules apply to your tone and speech.)

For more information, the Society for Adolescent Health and Medicine has some helpful resources on confidentiality and this case study highlights effective adolescent workflows across three very different settings.

Click here to learn more about RAAPS – a standardized, validated, and technology-based risk screening system developed especially for youth (and the providers and professionals that work with them)

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.

Sex Ed 101: Here’s what we’ve learned so far…

The last year and a half has been very eventful here at P4C – we launched RAAPS 2.0 with a complete platform upgrade…  AND we released our first new product since our company was founded: the Adolescent Counseling Technology or “ACT” for Sexual Health (and our release of ACT for Tobacco is just around the corner).

With over a year of youth completing ACT for Sexual Health – we took a moment to analyze the data and reflect on what we’ve learned so far.  We were shaken at some of the findings and wanted to share them with you!

Our first ‘schooling’ came in the data.  We expected higher rates of risk among sexually active youth – but the levels are honestly staggering (and disquieting).

Among sexually active youth who were assessed and counseled by the ACT for Sexual Health system:

  • 19% have been in an abusive relationship in the last 12 months and 16% report being forced to participate in unwanted sexual activity
  • Nearly 1 in 4 (23%) had a partner who refused to use condoms or prevented the youth from using birth control
  • And 16% of youth report having bartered sex (for a place to stay, phone, alcohol or drugs, money or something else) – this number was much higher than any of us involved in the research and development of ACT had anticipated – and a growing trend that should be on the radar of all providers and professionals working with youth.

Schooling number two?  ACT solves different problems depending on the setting. We reached out to the providers and professionals using ACT – ranging from experienced sexual health gurus to novices and newbies.  We were interested in finding out the different ways organizations are using ACT SH to solve their problems related to engaging youth and supporting them in healthy decision making:

  • SBHCs are using ACT to open the door to more in-depth, in-person dialogue and counseling with sexually active youth and they are using the population-level data for reporting and to guide programming
  • Primary care and pediatric practices are using the electronic counseling to ensure sexually active youth are provided evidence-based, standardized education (a challenge in time-crunched practices where providers often have varying levels of experience and comfort levels with sex-related risk topics)
  • Health Departments are leveraging the technology to provide STI counseling and follow-up on a sustainable scale that wasn’t previously possible with lean staffing and limited funding
  • Youth and school programs use ACT to identify the myriad of sexual health services youth need and provide appropriate referrals and resources.

And finally – when it comes to adolescent sexual health:  standardization, scalability & sustainability really matter.  Building on the previous points – for providers and professionals working with youth to reduce sexual health risks ACT provides the ability to provide evidence-based, standardized counseling across a broad population, essential in today’s time-crunched, underfunded world.  For many of the organizations we work with who depend on grant-funding, ACT for Sexual Health is providing an affordable, sustainable intervention to bridge funding fluctuations.

Are you using ACT for Sexual Health?  If so, please weigh in and tell us your Sex Ed story!

Want to learn more?  Click here to schedule a call to find out more about ACT SH works in organizations like yours.

Top 5 Reasons to Invest in Adolescent Health

Global investments in adolescent health harvests significant economic gains

Recently headlines broke across all consumer and health media outlets that signified the importance of investing in teen health from a global financial perspective. Like any other professional who is in the landscape of improving adolescent health, this kind of global attention and correlation between teen health and the economy gets me excited!

The news referenced a study that highlighted a small investment in “empowering and protecting the world’s 1 billion adolescents can bring a 10-fold return.” Here’s what it said:

“Improving the physical, mental and sexual health of kids aged 10 to 19 – at a cost equivalent to US$4.60 per person per year – could result in a 10-fold economic return by preventing 12 million deaths and more than 30 million unwanted pregnancies.”

I can think of 1,000 reasons to invest in adolescent health, but here are my top 5:

  1. With fewer teens giving birth each year, a country’s young dependent population grows smaller in relation to the working-age population, creating a window of opportunity for rapid economic growth.
  2. Keeping teens safe and encouraging them to make smart decisions can help to break the spread of poverty and disadvantage across generations.
  3. The rapid physical, cognitive and psychosocial growth and development that takes place during adolescence influences an individual for the rest of his or her life.
  4. In three out of four cases of serious injury or death in adolescents, the common causes are preventable. Support in healthy decision-making will help set a pattern of healthy lifestyles and reduce morbidity, disability and premature mortality later in adulthood.
  5. This generation of adolescents will transform all our futures!

How you can take action!

  • The key to improving adolescent health is operating from a prevention mentality versus a crisis approach. Investing in a risk identification assessment tool will address the early onset of behaviors that can grow to be potentially harmful. Plus, RAAPS, a globally-recognized, evidence-based, standardized risk screening and behavior change counseling tool can pay for itself with the proper reimbursement codes.
  • When it comes to talking with teens about sexual health, things can get awkward. That’s why we developed ACT Sexual Health, a virtual health educator where teens respond to assessment questions on a tablet or other technology device and receive sexual health education specifically tailored to them. Upon completion, ACT generates a personalized safer sex action plan, health messages and customized referral sources.
  • Risk behaviors account for the majority of teen injury and premature death. In the face of these challenges, health professionals and parents need concrete, actionable strategies for productive discussions about risky behaviors. Teen Speak is a how-to guide for real talks with teens to foster strong relationships and trust-building during the most formative time in their lives.

Talking Sex with Teens: Community Health Centers ACT for Change

Today’s adolescents are engaging in risky sexual behaviors at earlier ages than ever before, resulting in nearly 250,000 teen births in 2014 and nearly 10 million new sexually transmitted infections annually. Sexually transmitted infections are a significant public health problem in the United States and of particular concern in the adolescent and young adult population. A big factor contributing to the spike is that often times, teens are reluctant to discuss their sexual health with their care team since information about sexual health related behaviors and risk factors has the potential to appear in care summaries, patient portals, insurance explanation of benefits and the like—all which adolescent and young adult patients worry can be viewed by parents and guardians. The lack of communication results in an increased risk for undiagnosed and untreated STIs, missed opportunities for behavioral health interventions, including guidance on managing risk and addressing social determinants of health, and increased disease burden in the community.

In order to improve sexual health screening and behavioral counseling in primary care, Possibilities for Change teamed up with the National Association of Community Health Centers (NACHC), the Health Center Network of New York (HCNNY), and four participating health centers across New Jersey and New York for a pilot project using the ACT Sexual Health System.

With today’s earlier onset of sexual activity comes an increased incidence of high-risk behaviors such as:

  • Early sexual intercourse (before the age of 13 years)
  • Multiple sexual partners (history of 4 or more lifetime partners)
  • Inconsistent condom and contraceptive use
  • Drug or alcohol use prior to sex

Research suggests that several key factors have a significant influence on sexual decision-making including: substance use prior to sex, depression and low self-esteem, homelessness, school failure, sexting, and history of abuse and dating violence. Our nation’s public health institutions have recognized the need to improve adolescent health care in the United States and are calling attention to this important issue. The Institute of Medicine (IOM), National Research Council, Pediatric Health 2011 Report concluded that “improving health outcomes for adolescents is essential to achieving a healthy future for the nation.”

In 2014, the Journal of the American Medical Association published a study that reported one-third of all adolescent health maintenance exams were completed without any discussion of sexual health. For those providers who did introduce the subject, an average of 36 seconds was spent discussing sexual health. It was concluded that strategies need to be utilized to engage adolescents in open discussions around sexuality, promoting healthy sexual development and decision-making:

  • Prioritize adolescent sexual health and ensure that all adolescents are screened and counseled on their risk behaviors using standardized, validated tools – according to nationally-recognized guidelines;
  • Become educated and aware of the inter-relationship between adolescent sexual health, high risk behaviors, and other population disparities;
  • Participate in continuing education on effective adolescent counseling strategies that will actively engage youth in the behavior change process (such as Motivational Interviewing);
  • Develop policies and processes to ensure adolescent engagement and comfort with disclosure of sexual feelings, behaviors and experiences; and
  • Address necessary workflow modifications to ensure risk screening and behavioral counseling is consistently incorporated.

To learn more about the disparities and behaviors that contribute most to sexual risk and how primary care practices and school-based health centers can meet the needs of adolescents to positively impact their sexual health, download and view the recorded webinar.

How do you talk to adolescents about safe sex decisions? Share your experiences in the comments below!