Hot Topics & Special Sessions

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.