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Transcript
Rena
Large
>> Good afternoon.
I'm Rena Large, Senior Project Director at the Association of Maternal and Child
Health Programs or AMCHP.
Welcome to our program, an opportunity for us to introduce the "Conceptual
Framework for Adolescent Health" and discuss its application at the state
level. Along for connection instructions all people should have received this
framework in its final format. If not we'll be able to forward it to you after
the program. We're joined today by two speakers, Sally Fogerty from the Massachusetts
Department of Health, and Marilyn Lanphier, coordinator of Adolescent Health
Services at the Oklahoma State Department of Health. I'll be providing an overview
of the framework. We'll then have the presenters and then followed by questions.
Before
we begin our presentation I want to alert you to two things you'll see on your
screen. The first is the power point presentation that will advance automatically
during the presentation. The second is the message center on the right hand
of your screen. During our broadcast you can submit live text messages to us
for the question and answer portion of our program. If we don't respond immediately
to a question, we will either be submitting your questions to our speakers or
one of our staff will contact you after the broadcast. And so let me begin.
The conceptual framework and our speakers today represent an effort between AMCHP and the State Adolescent Health Coordinators Network. They established a partnership to strengthen adolescent health programs in state health agencies. The first product of this partnership is the product of our WebCast today. The framework was developed. It was a consensus document representing network leaders and other experts in the field. It also draws on three important consensus documents reflecting key objectives, performance measures and indicators for adolescent health and definitions of key terms including adolescent youth development of the it is to be reviewed and revised over time to reflect changing needs. We recognize it does not exhaust all the possibilities for achieving our vision. It does, however, provide a theoretical basis for addressing adolescent health and other organizations.
The
framework is organized around key concepts that establish a basis for addressing
adolescent health. It begins with a discussion of the importance of focusing
on adolescent health and the need for this document. It emphasizes that while
the health and well-being of all age groups is important, the developmental
nature of adolescence needs to consideration and needs for this population.
The framework also recognizes that families, parents appeared communities play
on important role in healthy adolescent development. The underlying assumption
of this framework and the AMCHP network partnership is that public health has
a critical role to play in assessing and addressing the health of adolescence.
This framework is organized around the concept of a public health services and
incorporates family development and youth philosophy throughout the document.
These
three concepts -- core public health functions, family involvement and youth
development -- are the basis for seven guiding principles presented in the framework.
These principles reflect key considerations for any adolescent health program.
All of which should be based on strong data, particularly adolescent-specific
data on risks, assets and protective factors at the individual, family and community
levels.
Now
allow me to introduce once again Sally Fogerty, Assistant Commissioner for the
Bureau of Family and Community Health at the Massachusetts Department of Health.
She'll share a relationship adolescent health to state maternal and child health
and family health programs.
Sally
Fogerty
>> Thank you, Rena.
I'm delighted to join with you and Marilyn in this WebCast this afternoon. As
a Title V director and President-elect of AMCHP I've been privileged to participate
in this joint effort between AMCHP and the state adolescent coordinator network
where we could develop this model and really model the development of a partnership
and the relationship between the MCH Title V directors and the state adolescent
coordinateors. Much of that relationship we've envisioned to occur at the state
level. And basically what we've done, I think, in developing and creating this
framework is developed as a guide for all of us at the state level to use.
To
me the strongest piece of it is that it puts in place a collaboration to support
and strengthen effective adolescent health programs within each one of our states.
I think as we all know, adolescent health is an integral part of family health.
And it really deals with that unique period of an individual's life when the
adolescents are going through a major transition. A period of risk taking and
a period where much of the future behaviors that we all have were established.
And it is a period that I think we've all learned that if we can have the right
programs and the right focus, we can encourage healthy behaviors and growth
in such a way as to provide a foundation for strong successful adults. I'm also
pleased that we've built off of the youth development philosophy, which articulates
the assets and competencies and environmental factors so critical to the development
of adolescents. And I think even more important is for us to realize the important
role and the important focus we bring to youth development, in that in most
of the critiques around youth development there seems to be a feeling that the
role of families and parents is ignored.
And yet one of the firm foundations of Title V, MCH program and the children
with special health care needs programs and our adolescent programs is assuring
that the important role of families or parents is recognized and integrated
into programs and services. I also think that the key piece in bringing adolescent
health forward and keeping it within a public health perspective is the need
that we have to focus on health promotion, disease prevention and youth development.
And looking at how those can be integrated together. For most of us in family
health and MCH and Title V programs, we have been fortunate enough to have our
adolescent coordinators or programs co-located with us. I think that as we look
at this framework, what we have is the ability to go back and look and strengthen
our existing programs and to assure the critical linkages with special populations
such as children with special health care needs. I think even in our program
where we've had a strong adolescent coordinator and a strong adolescent health
program, we always have to remember that some of our special populations need
to have a special focus. And we can't forget and I guess I would go back to
say that with some of our children with special health care needs programs,
without our adolescent program those programs sometimes forget that the child
becomes an adolescent. And becomes a young adult and may need to have a special
focus.
The
framework as you see it encourages each Title V program to establish that focal
point for adolescence and to identify at least one individual as an adolescent
health coordinator who will be responsible for assuring that the adolescent
focus is within each program based on the principles that Rena talked about
earlier and that are outlined within this framework. It adopts and builds on
the ten essential public health services. It has adapted those so that they
have an adolescent focus. It utilizes the adolescent health coordinator to support
and enhance efforts to assure that adolescent health is addressed in all of
the program areas. It assures linkage between programs and agencies, both within
our same public health agencies and outside those agencies. It's also, I think,
key to assisting our Title V programs in public health departments in meeting
the 2010 critical objectives for adolescence and the core measures in the block
grant. Probably the piece that's most important is that when you go back and
look at the block grants that have been submitted in the past there is over
160 additional state and territorial performance measures. I think that if we
are going to meet those performance measures, as well as the 2010 objective
and core measures we can only do it if we work off a framework such as this
to really establish strong adolescent programs.
And at this point let me turn it over to Marilyn, who is going to talk more
about the role of the adolescent coordinator and this important relationship
between the MCH programs and the adolescent coordinator.
Marilyn Lanphier
>> This is really an honor to be here to share this framework and this
-- it is such a pleasure to be here and show what our partnership has been with
AMCHP. I'm President of the State Adolescent Health Coordinator's Network. Our
mission is to provide leadership for adolescent health and youth development,
to advocate for improvement of adolescent health and well-being and to inform
and consult on adolescent health issues. As you can tell from this, we really
are focused on improving the health of adolescents. In the majority of the states
and territories have a person in their state health departments that are designated
as an adolescent health program coordinator.
It's
interesting, though, the roles of these coordinators are have different in each
of these states. So this conceptual framework an opportunity at the state level
to look at it to give us a basis or kind of a guide for us to develop, implement
and let our adolescent health programs grow.
As I mentioned, because of our successful partnership of AMCHP and the network,
it's been a real pleasure that we can then take this down to the state level
and work with the adolescent coordinator and the Title V directors. One thing
that is interesting with this is that about 50% of the adolescent coordinators,
there is a turnover of about 50% about every two years. Well, this means that
new people need to be oriented. This means new job descriptions, this means
where do you go from here. So this particular conceptual framework and the partnership
will certainly help with defining what the role would be, how do you get at
the integration and coordination of existing efforts that address adolescence
and how do you promote and development new policies, programs and services that
address adolescent health issues. This is very exciting because it gives us
all a basis for developing this and, of course, our goal is to improve adolescent
health at the state level.
Rena Large
>> Thank you, Sally and Marilyn.
As demonstrated by both of your comments, this framework is very important.
It's a crucial document for Maternal and Child Health and family health programs
as well as state health coordinators. It establishes that we have for the future
of adolescent health in general and within state family health and MCH programs.
It also establishes a vision for the continued work of the AMCHP network partnership
to strengthen state capacity to support effective adolescent health programs.
To bring this vision that we have to the states, the partnership has developed
goals and objectives based on the framework to help strengthen state capacity
to support adolescent health programs over the next three to five years. They
form the partnership's policy agenda for adolescent health that combines our
work. The next and possibly most important step in bringing an operationalizing
the framework as a living tool is bringing its theories and principles to the
state level. We recognize key elements must be in place to support effective
adolescent health programs. These key elements include organizational.
AMCHP and the network are currently gathering research and examples of these
elements to develop a plan for bringing this vision to the states and we're
hosting a follow-up program this Friday, August 23, to go into more detail about
that project and how you can participate in the development. Both the policy
agenda and the core capacities project are based on and will compliment the
conceptual framework. These tools reflect a consensus of AMCHP and the network's
leadership and will be reviewed and revised over time to reflect changing research
and needs. At this time I would like to open up the floor to our participants.
The message center to the right of your screen allows you to present live questions
to our presenters. If we don't offer an answer to a question we'll follow up
with you after the broadcast. And we would be happy to take any questions at
this time. We do have one question from the audience, Marilyn and Sally related
to youth development and that is from Caroline in Georgia. And Caroline says
in Georgia public health ties adolescent health and youth development together
in their family health branch. Do you have other examples that join those two
together or are your states doing this?
Sally
Fogerty
>> Yes. We've tied those both together also. We have also linked with
the broader efforts which are done in our executive office of health and Human
Services in relationship to youth development and I think that the tying of
those together has made a much stronger program base for us.
Marilyn Lanphier
>> There are a number of states that are in a variety of levels of tying
both of those together. For example Alaska has been doing it for a number of
years. And there are a number of other states that are doing some. Minnesota
has done some and -- but I think everybody seems to be in various stages of
tying that together. It seems like a real wellness kind of attitude or a wellness
direction rather than focusing in on the illness. So it really is a wonderful
opportunity to tie those together.
Rena
Large
>> Thank you.
Another question from the audience is related to other topics that are within
the conceptual framework. Can you tell us a little more of any specific issues
like mental health or adolescent reproductive health if there are any specific
issues included in the framework?
I can answer that as the moderator. There are some issues touched on within
the framework within some of the principles and visions that are stated. But
primarily the framework is a vision and a framework for infrastructure. For
partnerships, family involvement, things that need to be in place before specific
topics are addressed. It is our vision and as presented in this framework is
that these basic things need to be in place before any other topics can be addressed.
Do we have any other questions from our participants today?
Marilyn Lanphier
>> Rena, let me add on just a little bit to what you just talked about.
We really, in developing this conceptual framework, it was important that we
looked at all of the adolescent health issues. So mental health and reproductive
health was very much on our minds all the time. As you can see, some of the
language that it is important that, you know, that adolescents are healthy in
many different ways. And so I think we did -- again it was a general kind of
thing, as you referred to, but it certainly did -- it was a focus for all of
us.
Sally Fogerty
>> I think what it does is it addresses those as both Marilyn and Rena
said, in a general way in here allowing for people to go on and look at how
they may build on sort of that general framework as your program might move
a little bit more in one direction or another direction during any period of
time. For instance, our program right now, because of some new funding that
came in, is really developing a strong initiative around suicide and suicide
prevention, which has really allowed us to link back into our substance abuse
programs and tobacco programs and to really look at all the protective factors
that are laid out for each one of those risk-taking behaviors. So this framework
allows you to build and to move into any of the other specific areas you might
want to strengthen a focus in.
Rena Large
>> Thank you. Another question from our participants is, why did the partnership
choose the age range of 10-24 to define adolescence?
Marilyn Lanphier
>> We talked a lot about that. Because the norms in many ways are do you
decide 10-17, 10 to 21, 10 to 24. Because we looked at some of the data available.
Some of the new twists on who the adolescents really are, we chose to use that
broad scan. Adolescents are generally thought of as 10 to 17 and 10 to 18. It
varies according to program lines. We decided this was an opportunity to spread
that area or to at least look at either what was happening during adolescence
or programs with the young adult of 21 to 24, what were the implications for
what happened in adolescence that affected them and caused major health problems
in that young adult population.
Sally Fogerty
>> I think it was felt that it was important to give the broadest age
span and to really make sure that we were inclusive so that states may select
a more narrow age span. But we would really, in the framework, we have really
recommended that people not forget that young adult age group, which so frequently
is left out of many of our programs. I think also if you look at some of our
special need populations, one of the -- some of the major issues come as those
individuals are turning 22 and they have to make significant changes from a
more pediatric, adolescent specialty focus into the adult world.
Rena Large
>> Thank you. We have another question from our audience and that is,
how do you bring together various adolescent health efforts that are going on
across the board? I'm assuming within this framework how do we address adolescent
health efforts going on across the board.
Sally Fogerty
>> The adolescent coordinators and the state adolescent health programs
always have to look at a variety of health problems of the adolescent population
and that is always entailed as being able to work with mental health agencies,
juvenile justice agencies, whatever, because -- because it isn't just -- that
cannot be a focus just within one agency.
So that's one reason that we wrote the conceptual framework and from that standpoint
that a lot of coordination efforts and partnerships are essential to improve
the health of the adolescents within our states.
Rena Large
>> Thank you. We have another question related to 21 critical adolescent
health objectives from the Healthy People 2010 objectives. Related to how the
framework addresses and incorporates the objectives. I will answer that question
in just saying that the framework actually provides some theory and background
and information for justifying and planning adolescent health programs and it
really is the structure that helps states to address the 21 critical objectives
and we didn't go into specific objectives within the framework or specific topics
within the framework because there has been a lot done and is a lot going on
related to that and we wanted to have something to compliment it and not necessarily
create an additional document on the same topic.
Do we have any other questions from our audience today? Okay. If you do have
questions later, we can certainly respond to them personally after the broadcast.
I want to thank our participants who submitted questions and also to our presenters
for this informative question and answer period.
Our final charge to today's participants and the next steps in this process
are simple. We would like you to take this framework and working jointly in
your state, use it as a guide to develop and enhance the linkage with and relationship
between adolescent health and Title V programs. As Sally mentioned, this includes
maternal and child health as well as children with special health care needs
programs. The theories and the concepts presented in the framework provide a
common focal point, a common starting ground against which we can measure our
existing programs, develop new ones, improve our adolescent health efforts.
In addition to our hope that you will begin using this framework in your state
and sharing it with others who couldn't join us today we invite you to provide
feedback on today's program and to participate in upcoming related events and
opportunities.
The first of these opportunities is this Friday, August 23, when AMCHP and the
network will host an audio conference on the core capacities project. Information
on that call can also be found on AMCHP's website where the WebCast information
is located. And the audio portion of this program and power point presentation
will be archived on AMCHP's website within the next week and that website address
is www.amchp.org. Contact us for more information
on these projects and instructions for connecting for Friday's call. Thank you
for joining us and thank you Marilyn and Sally for sharing your perspectives
with us today.