Hot Topics & Special Sessions

Our Hot Topics Presentations and Special Sessions are included in the SAHM 2021 Virtual Annual Meeting Recordings package. 

Recorded Hot Topics Presentations

Special Sessions 

  • International Roundtable Discussion
  • Healthysexual: Health & Sex Belong Together

Recorded Hot Topics Presentations

Hot Topics sessions are one of the most popular components of SAHM annual meetings. This year, there are three sessions, each consisting of three fifteen minute presentations on today’s hottest topics in adolescent health.  

Hot Topics Presentations I 

Telehealth and Adolescents: Perspectives and Promising Practices
Lauren Eileen Geary, MPH, American Academy of Pediatrics

Description: Early in the COVID-19 pandemic, clinicians had to pivot to provide services via telehealth to reduce risk of infection through in-person visits. In response to the pandemic, the American Academy of Pediatrics was awarded a grant from the Maternal and Child Health Bureau to support clinicians, families, and patients with telehealth utilization, with a focus on diverse and underserved communities. The advisory group for this project included representation from the Society for Adolescent Health and Medicine. Additionally, a diverse panel of young adults (18-26) was convened to advise on project activities.

This session will present results from this project’s comprehensive needs assessment designed to identify needs, gaps, and promising practices in telehealth during and after the pandemic. The session will also identify promising practices as well as tools/resources to support the needs of adolescents via telehealth during and beyond the pandemic.

Needs assessment activities included an analysis of primary and secondary data. Primary data collection included focus groups and key informant interviews with young adults, families/caregivers of adolescents, and clinicians who care for adolescents and young adults. Participants included members of diverse and underserved communities, as well as those with and without special health care needs. Findings identify needs and preferences of young adults as well as clinicians related to telehealth utilization, and highlight information related to privacy, confidentiality, patient/family experience, and health system needs. Additional data collected throughout the project includes data from a quality improvement project and queries received via a technical assistance email address.

Learning Objectives:

  1. Understand the unique telehealth needs and preferences of adolescents and young adults, including privacy/confidentiality needs, disparities in access to care, positive and challenging telehealth experiences, and health system needs.
  2. Describe rapid changes in the delivery of care for adolescents via telehealth implemented by clinicians during the COVID-19 pandemic. 
  3. Identify promising practices in adolescent health promotion via telehealth and opportunities for telehealth implementation for this population beyond the COVID-19 pandemic.

Examining Adolescent Privacy and Confidentiality in the New Landscape of Telehealth
Bianca A. Allison, MD, MPH, University of North Carolina at Chapel Hill; Martha F. Perry, MD, University of North Carolina at Chapel Hill; Lisa Mikesell, PhD, Rutgers University 

Description: The COVID-19 pandemic stimulated a sudden shift in care delivery models from in person to telehealth. However, our understanding of the adolescent experience with telehealth is very limited, particularly as relates to privacy and confidentiality.

This session will:

  1. Summarize the current literature as it relates to adolescent privacy and confidentiality and explore the impact of telehealth on privacy and confidentiality.
  2. Introduce findings from a cross-sectional mixed methods study currently underway examining adolescent and parent perceptions of privacy and confidentiality during telehealth visits, conducted from September 2020 to February 2020.
  3. Explore future directions for research, policy and practice changes to improve delivery of confidential adolescent telehealth services while maintaining a therapeutic alliance between providers, adolescents, and their parents.

This presentation is timely given the global impact of COVID-19 and the likely persistence of telehealth utilization. In order to map an agenda to transform the future of adolescent health in this changing landscape, it is important to include a focus on adolescent confidentiality, which is an essential foundation of adolescent health service delivery. As a result of attending this session, participants of all disciplines and backgrounds will gain a greater understanding of the current and future state of telehealth as it relates to confidential adolescent health services, and learn best practices to help providers ensure private and confidential telehealth services.

Learning Objectives:

  1. Analyze the current state of literature around adolescent privacy and confidentiality, particularly as relates to telehealth care delivery
  2. Describe adolescent patients’ and parents’ perceptions of privacy and the therapeutic alliance established during telehealth visits
  3. Examine future directions for changes in clinical practice and policy as well as next steps in research to improve the provision of confidential health services for adolescents using telehealth

Exploring SAHMS position paper: Preventing Firearm Violence in Youth through Evidence-Informed Strategies.
Eric J. Sigel, MD, University of Colorado School of Medicine

Description: Epidemiology of Firearm Violence: In 2017, 7,939 United States adolescents and young adults (AYA) aged 12-24 died from firearm injuries, including 4,486 homicides and 3,128 suicides: the highest firearm mortality rate since the early 1990’s. Firearms now outpace motor vehicles as the leading mechanism of death for 12-24-year-olds – a rate of 14.3/100,000, compared to 12.6/100,000 for motor vehicles. An additional 40,073 AYA suffered non-fatal firearm injuries.

SAHM Position Paper: In response to this ongoing crisis, SAHM issued a new position paper in 2020 updating recommendations that SAHM members can adopt with the goal of decreasing the health impact of firearms on AYA. This presentation will review the salient recommendations, which include evidence-based clinical approaches, effective legislation proven to decrease firearm mortality, school and community approaches, calling on the government to increase funding for firearm research, and to encourage providers to increase their knowledge base.

Specific clinical tools to address firearm violence include screening youth and parents for firearm access, delivering a safe storage message, and distributing locking devices through the clinic setting. The topic of firearm violence directly reflects the conference theme- Mapping an Agenda to Transform the Future of Adolescent Health- as the entire focus of the position statement seeks to mitigate the risk firearms- the leading cause of death in AYA- pose to the health and well-being of those we serve. Though recognized as a uniquely US issue, international attendees will also learn approaches that may also be effective in the countries they reside in.

Learning Objectives: 

  1. Describe the current epidemiology of firearm violence affecting 12-24 year olds 
  2. Identify the specific recommendations made in the 9-point SAHM position paper (2020) on Firearm Violence that outlines a comprehensive approach to addressing the impact of firearm violence 
  3. Integrate effective clinical tools into practice that will decrease morbidity and mortality from firearm violence 

Hot Topics Workshop – COVID, Schools, and Public Health:  Aligning Science, Education, Economics, and Politics
Moderator: Gregg Montalto, MD, MPH, Lurie Children’s Hospital
Presenters: Allison Malloy, MD, MSc, Uniformed Services University; Sabrina Kitaka, MD, Makerere University

Reopening schools is not a one-size-fits-all endeavor.  Virology, epidemiology, public health, mental health, structural inequities, economics, and politics are on a Venn diagram, and their overlap and relative importance – which is community-dependent – will inevitably influence our ability to get adolescents back into schools safely.  During this session, two experts from two different countries will discuss how they might apply the current science while developing evidence-based strategies to support teachers and their students.  Questions, answers, experience, and ideas are encouraged by our presenters and audience alike.

Hot Topics Presentations II

It’s a Reality: Self-Sourced Medication Abortion and the Adolescent Patient
Mindy Brittner, MD, MS, Icahn School of Medicine at Mount Sinai/ The Institute for Family Health; Jennifer Karlin, MD, PhD, University of California Davis School of Medicine; April Lockley, DO, Public Health Solutions Sexual and Reproductive Health Centers

Description: Self-sourced/managed medication abortion (SSMA) describes the increasingly common practice of using FDA approved medications (misoprostol, with or without mifepristone) to end a pregnancy without supervision by a medical provider.
Adolescents and young adults (AYA) face unique barriers to obtaining abortion through the formal medical system, including parental notification/consent requirements, scheduling challenges, and state legal restrictions, all of which may make SSMA a compelling option. In fact, a 2018 study found that 41% of those seeking information about SSMA online were under the age of 17. These challenges have been greatly exacerbated by the COVID-19 pandemic, in which many states deemed abortion a non-essential service, pausing all access, and conditions led demand for SSMA to soar.

We present lessons learned by providers who have staffed an anonymous new hotline since November 2019, offering advice and support to predominantly AYA using SSMA. We present thematic analysis of the calls/texts from AYA to illustrate common questions and concerns AYA have when seeking abortion outside the medical system.

Professionals who provide a broad range of services to AYA may become aware of, and feel conflicted when, AYA disclose use of SSMA, with concerns about safety and legal ramifications. We will address these valid concerns in the context of the available evidence from settings around the globe on the safety and efficacy of SSMA, and the conceptual frameworks for understanding this practice (e.g. harm reduction, reproductive justice). We offer possible responses and resources for AYA considering/using SSMA, and the professionals who serve them.

Learning Objectives:

  1. Define self-sourced/self-managed medication abortion and identify reasons why adolescents and young adults might end a pregnancy on their own, without help from a medical provider.
  2. Describe, based on data from a new medication abortion hotline, the kinds of medical questions that adolescents and young adults have for medical providers when self-sourcing/self-managing a medication abortion
  3. Develop and practice possible responses, including providing available resources, to adolescents and young adults who are considering, or are in the process of self-sourcing/self-managing a medication abortion.

The Relegated (and Suddenly Vital) Importance of Caring for Positive Racial-Ethnic Identities for Youth and Community Health: A Guide for Action
Maria Veronica Svetaz, MD, MPH, FAAP, FSAHM, Hennepin Healthcare, University of Minnesota; 

Description: Research shows that parental racial-ethnic socialization (RES) actions (e.g., positive ethnic identity development and preparation for bias that youth may experience) contribute to strong self-esteem and well-being, and protect against poor mental health substance use. RES bias-reduction intervention studies have also been found to reduce racial prejudice and promote positive attitudes about other racial-ethnic groups among white youth. -Yet, the translation of RES research to interventions has not occurred at a scale needed, particularly in the current sociopolitical context. 

Translation interventions and materials will be discussed. -RES can be applied to counteract the substantial shift from globalism to nationalism that started with the 2008 economic recession that propelled the largest international migration ever.

A rampant increase of hate crimes has been perpetrated by far-right extremists globally and in the US in recent years, particularly in high schools, targeting youth of color. Extremists have increasingly leveraged online spaces to promote violent radicalization as white supremacist tendencies, targeting youth to join them.

This Hot Topic will share how to recognize early signs of radicalization and to provide talking points to counter hateful far-right propaganda, using a Southern Law Poverty Center guide.

This Hot Topic will:

  1. Address sentinel concepts for RES development.
  2. Share tools to support RES to be used with youth and parents.
  3. Discuss signs of radicalization and how to counter hateful far-right propaganda.

The “Resilience prepared this Hot Topic in Immigration” Lab from the MN LEAH Program  prepared this hot topic.

Learning Objectives:

  1. Identify the components of Racial-Ethnic identity (RES), its development, what fosters it, and the health outcomes of a positive RES.
  2.  Understand how to support RES development for youth and how to pass the importance of doing that to parents.
  3. Learn the importance of coaching parents to spot radicalization signs, and what to do about this.

Police-Free Schools: How Adolescent Providers can Support Youth-Led Advocacy
Rebekah Fenton, MD, Lurie Children’s Hospital; Meredithe McNamara, MD, University of Illinois Chicago

Description: In the summer of 2020, a global movement for racial justice was sparked by various events, including the murder of George Floyd. This highlighted the long-standing efforts of Black and Brown youth to remove police officers from American public schools. The presence of police in schools is independently associated with school drop-out, lower college enrollment and youth incarceration, particularly among Black and Brown students. It also leads to criminalization of age-appropriate behavior, the use of excessive force, sexual assault, and adverse mental health outcomes. An extreme amount of public funding is absorbed by school-based police programs, which is desperately needed in restorative justice initiatives. Health professionals have a unique platform to advocate for police-free schools and elevate the voices of youth-led efforts. The speakers will share their experience in advocating for the removal of police in Chicago Public Schools, thereby offering guidance to adolescent health providers who seek to promote safety for all youth.

Learning Objectives:

  1. Describe the history of school-based policing and its associated harms, with an evidence-driven approach
  2. Define the School to Prison Pipeline and specific ways in which police in schools disproportionately harm students of color
  3. Learn how adolescent health professionals can advocate for police-free schools and support youth-led efforts

Hot Topics III

Understanding the Impact of Long-Haul COVID-19 on Adolescents: Fatigue, Brain Fog, and Near-Fainting
Peter C. Rowe, MD, John Hopkins School of Medicine

Description: * Emerging data confirm that adolescents are developing prolonged fatigue, cognitive fogginess (brain fog), and lightheadedness after Covid-19 infection, even when their initial infections were relatively mild and did not require hospitalization. *

These long-haul Covid patients often meet criteria for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) as well as for postural tachycardia syndrome (POTS) and other forms of orthostatic intolerance. Like those with POTS and ME/CFS, affected post-Covid long haul patients are likely to experience academic struggles due to both a reduced ability to get to school and difficulty with short-term memory and concentration.

*Because of the high global prevalence of Covid-19 infection, especially in disadvantaged communities and underdeveloped countries, there is a strong potential for chronic symptoms to develop in a large proportion of the world’s adolescents and young adults.

As we begin to map an agenda to transform the future of adolescent health following this global pandemic, it will be important for Adolescent Medicine providers to know where to find resources on treating both ME/CFS and orthostatic intolerance symptoms. As has been shown in adolescent ME/CFS and orthostatic intolerance syndromes, effective treatment directed at these overlapping conditions is likely to improve post-Covid-19 adolescent health outcomes.

Learning Objectives:

  1. Recognize treatable contributors to “long-haul” Covid-19 symptoms, including orthostatic intolerance syndromes.
  2. Recognize the post-Covid-19 development of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) in adolescents and emerging adults.
  3. Identify resources for non-pharmacological and pharmacological treatments of post-Covid-19 orthostatic intolerance and ME/CFS in adolescents and emerging adults.

Suicidal Behaviors among Adolescent Girls of Color: The Impact of COVID-19
Lauren Gulbas, PhD, UT Austin School of Social Work

Description: COVID-19 presents several mental health challenges for adolescents. Recent research highlights the effects of physical distancing on social isolation and disruption in mental health services. Each of these factors has important implications for youth at risk of suicide. Given that adolescent girls of color have the highest rates of attempted suicide compared to non-Hispanic white adolescents, and that populations of color have been disproportionately affected by COVID-19, this presentation describes the impacts of COVID-19 on youth of color as it pertains to suicide risk.

Based on systematic assessments of the current research and in-depth, qualitative interviews conducted with 18 girls of color and their maternal caregivers, this presentation will:

  1. Describe risk and protective factors for suicide among youth of color. Results indicate disproportionate experiences of trauma, alongside racial discrimination as shaping risk. Protective factors include cultural socialization, alongside the development of positive racial/ethnic identity.
  2. Compare and contrast differences in risk before and during COVID. Youth reported increased social isolation, reduced sense of purpose in life as school activities transitioned to online, more time to ruminate on suicidal thoughts, and a decrease in informal mechanisms of support.
  3. Delineate practice considerations when working with youth of color at risk of suicide.

The presentation will end with a discussion of ways to support youth during COVID, including working with youth to develop and implement activities that promote engagement, meaningfulness, and a sense of purpose.

Learning Objectives:

  1.  Describe risk and protective factors for suicide among youth of color.
  2. Analyze the impact of COVID-19 on suicide risk among adolescent girls of color.
  3. Delineate practice considerations when working with youth of color at risk of suicide.

COVID-19 and Adolescent Mental Health: Responding to the “hidden epidemic”
Nicholas Chadi, MD, MPH, Sainte-Justine University Hospital Centre/University of Montreal

Description: Several experts have spoken about a hidden epidemic to describe the global mental health crisis among youth since the beginning of the COVID-19 pandemic. International data shows unprecedented increases in rates of adolescent and young adult eating disorders, depression, anxiety, and suicidal ideation since the beginning of the pandemic.

This first section of the presentation will summarize current evidence on adolescent mental health in the context of COVID-19 while highlighting key resiliency factors and promising mitigating strategies to support youth in these times of extraordinary challenge. Social distancing and lockdown measures have led to important increases in problematic social media use and gaming and in turn, to higher rates of media addiction, physical inactivity, and impaired sleep. Similarly, evidence shows patterns of increased intensity of alcohol and psychoactive substance use as well as increased solitary use among several youth, which are both associated with adverse mental health outcomes.

This second section of the presentation will focus on trends and patterns of media and substance use among youth and discuss the use of brief validated tools to screen for problematic media and substance use. With an important proportion of schools worldwide shifting from in-person to online learning, sharply climbing rates of school drop-out and increasing inequalities among students, are posing new challenges to educators around the globe.

This final section of the presentation will feature youth voices collected from focus group interviews to summarize key challenges encountered by youth and strategies available to health providers to promote school success during COVID-19.

Learning Objectives:

  1. Describe the effects of the COVID-19 pandemic and associated public health preventive measures on adolescent mental health.
  2. Discuss changes in addictive behaviors and the use of validated screening tools to screen for problematic substance and media use among youth in the context of COVID-19.
  3. Analyze the impacts of the COVID-19 pandemic on school attendance, success and achievement among adolescents and young adults.

Extended Hot Topics Workshop

COVID, Schools, and Public Health:  Aligning Science, Education, Economics, and Politics
Moderator: Gregg Montalto, MD, MPH, Lurie Children’s Hospital
Presenters: Allison Malloy, MD, MSc, Uniformed Services University; Sabrina Kitaka, MD, Makerere University

Reopening schools is not a one-size-fits-all endeavor.  Virology, epidemiology, public health, mental health, structural inequities, economics, and politics are on a Venn diagram, and their overlap and relative importance – which is community-dependent – will inevitably influence our ability to get adolescents back into schools safely.  During this session, two experts from two different countries will discuss how they might apply the current science while developing evidence-based strategies to support teachers and their students.  Questions, answers, experience, and ideas are encouraged by our presenters and audience alike.

Special Sessions

International Roundtable Discussion – The Impact of COVID-19 on Adolescents and Young Adults: reflections and lessons learned across the globe

Description: This session will provide a forum for members across the globe to share their country’s experiences with COVID-19, discuss lessons learned and reformulate ideas on how to support adolescents and young adults (AYA) globally. 

Session Objectives:  

  • Describe the impact of the COVID-19 pandemic on the health and wellbeing of AYA globally. 
  • Explore the similarities and differences in the impact of the pandemic on AYA. 
  • Share telehealth or telemedicine experiences with AYA, as a stepping stone to the creation of best practices.  
  • Discuss emerging research involving AYA and COVID-19 in different countries.  
  • Describe the changing needs of AYA during COVID-19 globally. 

Healthysexual: Health & Sex Belong Together
Facilitator: George Bouldin Gates; Sr. Community Liaison – Manhattan

Description: Healthysexual highlights the importance of incorporating sexual health into overall health care. The presentation brings together sex and health and discussions on STIs, HIV, prevention options, testing and retesting, and tools and tips for communicating with healthcare providers and sexual partners about sexual health.

This session was supported by Gilead.

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