Workshops

Each workshop is roughly one hour in length and offers CME/CE credit unless otherwise noted. Sessions are organized by the following educational tracks: 

Workshops by Track

Clinical Advances 

From Telehealth to LARC Doulas: Improving LARC counseling and insertion ‎experiences for adolescents in the era of COVID

Session Leaders: Lisa Mihaly, RN, MS, University of California, San Francisco; Arin Kramer, RN, MS, La Clinica de la Raza; Naomi Schapiro, PhD, RN, CPNP, University of California, San Francisco/La Clinica; Arlett Hernandez Chavez, Medical assistant, La Clinica de la Raza 

Description: LARC methods have been recommended as first line contraception for adolescents by ‎the AAP and ACOG, and studies have shown high adolescent satisfaction rates for ‎adolescents who use them. However, a barrier to LARC uptake is that adolescents ‎report negative recollections of LARC insertions. Nearly half of IUD users reported in ‎one study that dislike of the insertion procedure might or would probably prevent them ‎from getting another IUD in the future. As the number of adolescents with a uterus who ‎choose IUDs rise, this data should further impel our efforts to improve the IUD insertion ‎experience so that an increasingly common procedure does not cause distress to a ‎vulnerable population. COVID 19 has moved contraceptive counseling for many ‎adolescents to remote platforms. This change has worsened health inequities, and has ‎particularly impacted lower-resource youth who lack privacy, high-speed internet ‎connections, and computer equipment required to take full advantage of remote health ‎care. Limited access to in-person care has impaired adolescents’ access to ‎contraceptive care, and has increased the importance of thorough and supportive ‎counseling. We will present multimodal approaches to improve the IUD insertion ‎experience for adolescents, including trauma-informed strategies, pharmacologic and ‎non-pharmacologic approaches to pain management, and coping strategies for pre- ‎and intra-procedure anxiety. These procedures training support staff as doulas. We will ‎include a LARC doula, who is a young adult, in the development and presentation of ‎the workshop. We will explicitly address issues of health equity in the context of LARC ‎counseling and provision. 

Learning Objectives: 

  1. Identify key components of telehealth counseling with adolescents for IUDs and ‎subdermal implants in the era of COVID 
  2. Integrate a reproductive justice framework into LARC counseling, acknowledging the ‎history of coercive use of LARC to BIPOC, and the imperative to provide more ‎compassionate, autonomous gynecological care to all adolescents. 
  3. Demonstrate practical techniques to improve the IUD insertion experience that directly ‎target anxiety and pain control, including trauma-informed language, and ‎nonpharmacologic support via staff trained as LARC doulas

The Onus on Adolescent Medicine to Train the Next Generation of Health ‎Professionals to Integrate Behavioral Health into Primary Care

Session Leaders: Ana Radovic, MD, MSc, UPMC Children’s Hospital of Pittsburgh, University of Pittsburgh; Brian Pitts, MD, Children’s Hospital Colorado; Matthew C. Aalsma, PhD, HSPP, Indiana University School of Medicine; Robert McKinney, MSW, LCSW, ACSW, PhD,University of Alabama; Preeti M. Galagali, MD, PGDAP, FIAP, Bengaluru Adolescent Care and Counselling Centre; Merrian Brooks, MD, University of Pennsylvania Perelman Medical School; Laura P. Richardson, MD, MPH, University of Washington, Seattle Children’s 

Description: Adolescent depression is globally recognized as a major cause of disability, and is the ‎strongest risk factor for adolescent suicide, a rising cause of death in adolescents ‎across the world. Prevention and early diagnosis and treatment can improve outcomes, ‎thereby transforming risk into wellness. Unfortunately, ten years pass on average ‎before most children and adolescents access mental health services. As a ‎multidisciplinary organization, SAHM members are uniquely positioned to understand ‎benefits of different disciplines working as a team for the benefit of a depressed ‎adolescent and be able to apply team-based approaches. The integrated behavioral ‎health (IBH) model is one that has been shown to be effective for reducing symptoms ‎of depression in multiple adult studies, and more recently by Dr. Richardson in a large ‎trial in adolescent primary care.

The SAHM Mental Health Committee has developed a ‎position paper to propose training competencies, programs, and funding and ‎reimbursement priorities needed to develop robust behavioral health training systems ‎which will optimize mental health treatment outcomes.

Session content will include:

  1. A ‎brief overview of current evidence-based recommendations for IBH. 
  2. Published quality improvement intervention which benefited from social work trainees
  3. Decision support systems in primary care.
  4. Current primary care ‎mental health competencies. 
  5. International perspectives on ‎mental health services. 
  6. Case-based discussion ‎on funding and reimbursement concerns.

Quotes from AYA regarding ‎perceptions of benefits of receiving treatment in primary care will be featured ‎throughout. 

‎ Learning Objectives:  

  1. Describe current evidence-based recommendations for integrated behavioral health in ‎primary care and how they may be applied in practice. 
  2. Review examples of real world applications of integrated behavioral health in ‎adolescent medicine and how they have been iteratively evaluated through quality ‎improvement methods and implementation research. 
  3. Describe current primary care competencies in mental health diagnosis and treatment ‎‎(pediatrics, family, internal medicine, nursing), as well as in specific integrated ‎behavioral health training programs and further needs to strengthen the workforce.‎

Rapid, Point of Care Diagnosis of STIs, Harnessing Technology to Transform Risk of ‎STI to Sexual Health

Session Leaders: Lea E. Widdice, MD, Cincinnati Children’s Hospital and Medical Center; Charlotte Gaydos, M.S., M.P.H., Dr.P.H., Johns Hopkins University; Anne Rompalo, M.D., Sc.M., Johns Hopkins University; ‎Yukari C. Manabe, M.D., Johns Hopkins University 

Description: Recent developments in STI diagnostic tests combined with novel implementation ‎strategies for STI testing have the potential to transform STI testing from a tool to ‎mitigate adolescents’ risk of STI to a tool to promote adolescents’ sexual wellness. ‎Session content includes updates on performance and implementation studies of ‎laboratory-based and point-of-care diagnostic tests for chlamydia, gonorrhea, ‎trichomoniasis, syphilis, M. genitalium and HIV. Session content will serve as a ‎foundation to change and challenge medical providers’ STI testing practices and ‎prompt further research in implementation of STI testing, including pharmacy-based, ‎over-the-counter, and internet-based STI testing.

The session content supports the ‎goal to be inclusive of diverse populations by using sex-positive approaches towards ‎STI testing and engaging attendees’ from multiple disciplines in discussions informed ‎by research, clinical experience, and program outcomes from around the world, diverse ‎populations and nontraditional healthcare settings. International voices are ‎encouraged through inclusion of research findings, clinical experience, and program ‎management experience from the US, Uganda, South Africa, Australia, and other ‎countries represented by participants. Session content will be of interest to ‎multidisciplinary audience and members because point-of-care testing programs are ‎well suited to providing testing in clinical and nonclinical settings. Adolescent and ‎young adult voices will be included through presentation of qualitative and quantitative ‎research findings from adolescent participants, including research with adolescent ‎participants enrolled with waiver of parental consent. Presenters will share quotes from ‎adolescents. 

Learning Objectives:  

  1. Identify and consider the performance characteristics of diagnostic tests STIs available ‎in the US and worldwide, including tests newly cleared for clinical use, currently in ‎clinical trials, and promising tests under development. 
  2. Critique and propose implementation strategies of diagnostic tests and testing ‎programs with the highest potential to transform STI testing and reduce disparities in ‎STIs worldwide. 
  3. ​Discuss how point-of-care STI diagnostic testing technology, using self-collected-‎vaginal, -penile, -pharyngeal, and –rectal sampling, can promote sexual wellness and ‎autonomy among adolescents by increasing access to STI testing. 

All Together Now: Mapping a Multidisciplinary Agenda to TRANSform the Future Care ‎of Transgender and Gender Diverse Youth

Session Leaders: Rachel D. Snedecor, MD, MS, Cincinnati Children’s Medical Center; Lee Ann Conard, RPh, DO, MPH, Cincinnati Children’s Hospital Medical Center; Sarah Corathers, MD, Cincinnati Children’s Hospital Medical Center; Armand Antommaria, MD, PhD, Cincinnati Children’s Hospital Medical Center; Bridget Hagood, Psy.D., Cincinnati Children’s Hospital Medical Center; Evelyn Heflin, LISW-S, Cincinnati Children’s Hospital Medical Center; Sue Jelinek, M.Divv, BCC, Cincninnati Children’s Hospital Medical Center 

Description: Our Transgender Health Clinic was established in 2013 with the cooperation of a ‎multidisciplinary team. Over time, the clinic and patient population have grown ‎exponentially, with nearly two thousand patients seen in the clinic and drawing from a ‎six state area. During this workshop, members of the team from varying disciplines will ‎discuss current challenges that are faced in the field, along with plans to innovate and ‎evolve the future of gender health in a region and political climate that may provide ‎their own challenges.

The voices of patients and their families will be represented ‎throughout to discuss their journeys with the team and visions for the future of gender ‎affirming care. A patient and family will share their story and team interactions via ‎multimedia. Featured teams and their associated topics will include:

  1. Medicine ‎‎(Adolescent Medicine, Endocrinology): Cementing the bonds of a multidisciplinary ‎team, the future of coproduction, and patient education in the age of the Internet (when ‎patients have researched treatments online and have preconceived expectations).
  2. ‎Ethics: Ethical considerations in clinical operation, recommendations in response to ‎negative messages, and working against harmful legislation (such as a proposed bill in ‎‎2019 making it a felony to treat gender diverse youth)
  3. Mental Health Professionals ‎‎(Psychology/Social Work): A discussion on trauma based approaches and patient ‎support in a time charged with uncertainty, a global pandemic, and racial tension
  4. ‎Pastoral Care: The incorporation of pastoral care, addressing spiritual needs/struggles, ‎and building bridges to understanding in patients and families 

‎Learning Objectives:  

  1. Explore the current challenges faced by a multidisciplinary team caring for transgender ‎and gender diverse youth, with a focus on acknowledging the diverse perspectives ‎and skill sets offered by team members of various backgrounds. 
  2. Examine the creation, functionality, and maintenance of a multidisciplinary team when ‎it comes to gender affirming care. 
  3. Apply the skills from various fields presented in this session towards their own clinical ‎practices when addressing concerns associated with spiritual needs, mental health, ‎ethical conundrums, patient education, and anticipating future needs.‎

Transforming Adolescent Healthcare: Navigating a Medicaid Accountable Care Organization (ACO) with Implementation of a Care Coordination Team in an Adolescent/Young Adult (AYA) Practice

Session Leaders: Cailin Ryrie, MSW, Boston Children’s Hospital; Nerry Francois, BS, Boston Children’s Hospital; Sara Forman, MD, Boston Children’s Hospital; Kathleen Waddicor, BSN, RN, CPN, Boston Children’s Hospital; Allison Pelletier, BS, Boston Children’s Hospital; Hannah English, BS, Boston Children’s Hospital; Joshua Borus, MD, MPH, Boston Children’s Hospital; Angela Vu, BSN, RN, Boston Children’s Hospital; Tamara Prudent, BSN, RN, Boston Children’s Hospital
 
Description: Our ACO practice serves a racially diverse AYA population who are enrolled in public insurance. The initiation of our ACO contract 2.5 years ago gave us the opportunity to transform our practice, incorporating the overarching principle of how to offer best services to these patients with greatest needs. We translated the three hospital wide ACO priorities – complex care, health related social needs (HRSN), and behavioral health care – into integrated medical and behavioral health services, and screening/assistance with HRSN for our AYA patients. We set up measures to evaluate the success of our strategies.

In this workshop, we will share our experiences considering the question “How do we best care for a vulnerable AYA population in a way that maximizes health on a limited budget?” and reflect on how best to allocate resources within your own practice. Presenters consist of members of the Adolescent ACO team – a variety of clinical/ administrative roles – all of whom bring different areas of expertise and perspective to the process.

By combining insights from our care team along with feedback from actual patients, we will review how we have used population management techniques, alternative modes of patient/clinic interaction and principles of a medical home model to support our patients in the three priority areas noted above. Our patient navigator/resource specialists and population managers, who are young adults themselves, will reflect the real-world voices of the patients we serve.

Learning Objectives:

  1. Demonstrate comprehension of the critical issues in care coordination and logistical issues which lead to gaps in care.
  2. Apply ideas to develop the learner’s own strategy for building a care coordination team.
  3. Utilize material presented for application to home institution.​

Transforming the Adolescent Health Visit for Youth in Foster Care: How the Los Angeles Reproductive Health Equity Project (LARHEP) partnered with Physicians and Foster Youth to Address Barriers to delivering sexual and reproductive health care

Session Leaders: Stacy Barron, MD, Olive View-UCLA Medical Center; Rebecca Gudeman, JD, MPA, National Center for Youth Law

Description: Standard adolescent clinical practice and practice environments may unintentionally construct or enable barriers that limit certain populations from fully benefiting from a health visit. These barriers contribute to inequitable health outcomes. In this workshop, we will describe how, in response to the disproportionately high STI and unintended pregnancy rates youth in foster care face, a multidisciplinary team worked in partnership with youth in foster care to identify the unique barriers and facilitators they face in successfully obtaining sexual and reproductive health care during an adolescent health visit.

Our multidisciplinary panel, including youth from the LA RHEP advisory board, will discuss the findings of our study and how the key themes that emerged when we included youth and practitioner voice in the process. These discussions have led to transformations in the Olive View-UCLA Hub clinic, a clinic specifically designed to serve foster youth in Los Angeles County. We will describe some of these changes, including development of an innovative reproductive health patient navigator project. 

Learning Objectives:

  1. Explain the impact of the adolescent environment to the success of the visit
  2. Recognize the unique barriers and facilitators to sexual and reproductive health care for youth in foster care.
  3. Discuss an innovative program strategy, a reproductive health navigator, as a pilot program to facilitate sexual and reproductive health education as well as linkage to desired services for youth in foster care.

Breaking Barriers and Improving Access to Trauma-Informed Health Services for Trafficked and Exploited Youth

Session Leaders: Jordan Greenbaum, MD, International Centre for Missing and Exploited Children

Description: Survivors of sex and labor trafficking around the world have experienced substantial barriers to accessing medical and mental health care and when able to obtain services, these are often provided in a way that is experienced by the patient as insensitive and re-traumatizing. Trafficked youth and young adults have voiced their needs for healthcare and described their negative (and positive) experiences with the healthcare sector. We will review this rich source of information. Additional guidance is provided by health professionals and victim service providers in low-, medium- and high-resource countries. Taken together, this information points to an urgent need to examine and modify existing practices to increase healthcare access for trafficked youth, and to provide medical and mental health care that is based on human rights, cultural sensitivity, and a knowledge of the impact of trauma on a youth’s beliefs, emotions and behaviors.

In this workshop, we will begin with a brief overview of human trafficking and its related health consequences. Participants will learn about the global research regarding barriers and facilitators to healthcare for trafficked persons, complete a written assessment of their own facility’s services for labor and/or sex-trafficked youth, and identify ways they can improve accessibility, acceptability and availability of healthcare for this very vulnerable population.

Learning Objectives:

  1. Explain common barriers faced by trafficked youth in accessing trauma-informed, rights-based, culturally appropriate healthcare.
  2. Assess the strengths and gaps in services for trafficked youth characterizing your practice.
  3. Identify three action steps to improve healthcare for trafficked youth at your facility.

Puberty Suppression in the Care of Transgender and Gender-Diverse Adolescents: What Clinicians Need to Know

Session Leaders: David A. Klein, MD, MPH, Uniformed Services University; Jason R. Rafferty, MD, MPH, EdM, Warren Alpert Medical School of Brown University

Description: In the United States, approximately 0.7% of adolescents identify as transgender or gender-diverse (TGD). TGD persons are at risk for poor health outcomes and discrimination based on their identity. However, affirming care — including Gonadotropin releasing hormone agonists (GnRH-a) when indicated — may mitigate gender dysphoria and adverse health outcomes, and reduce health disparities. The Endocrine Society recommends that clinicians offer TGD adolescents the option of GnRH-a for puberty suppression after the physical changes of puberty begin, and describes potential utility of GnRH-a beyond the pubertal period. The American Academy of Pediatrics also details the importance of GnRH-a for pubertal suppression. GnRH-a are exceptionally effective in suppressing effects of endogenous hormones. Although use of GnRH-a exclusively for TGD care is considered off-label, the safety and effectiveness of these medications has been studied in many populations for over 40 years, including adolescents with precocious puberty. Despite this, many clinicians receive little training on the use of GnRH-a and refer TGD adolescents to other subspecialty services.

The purpose of this workshop is to familiarize clinicians who care for adolescents on the nuances of puberty suppression when providing services to TGD adolescents, and to introduce the procedures for administration, including reviewing and demonstrating procedures for the injectable and implantable forms of GnRH-a. This workshop is relevant to international attendees who care for TGD persons as well. From the perspective of the conference theme of Transforming the Future of Adolescent Health, a clinician’s comfort with this topic can benefit a patient’s long-term health outcomes.

Learning Objectives:

  1. Discuss the biology and rationale justifying use of puberty suppression the care of transgender and gender-diverse adolescents
  2. Prescribe and monitor gonadotropin releasing hormone agonists (GnRH-a) and alternative medications in clinical practice. This will include familiarity with indications, risks/benefits, dosing, and ethical/legal considerations of relevant medications
  3. Explain the procedure for implanting subdermal GnRH-a through demonstration and discussion. After completion participants may consider provision or facilitation of these services.

Strategies For The Future: Minding The Gap In Sexual Health Through Lessons Learned In a System Wide Program in The Safety Net

Session Leaders: ​Javiera Paz Monardez Popelka, MD, MPH, Hennepin Healthcare; Rachel Claire Sixberry, RN, PHN, Hennepin Healthcare; Maria Veronica Svetaz, MD, MPH, FSAHM, FAAFP, Hennepin Healthcare; Diego Garcia-Huidobro, MD, PhD, University of Minnesota

Description: Confidentiality is essential in order for adolescents to access comprehensive health care, particularly reproductive and mental health services. The advent of Electronic Health Records (EHR) posed extra challenges in this regard for most healthcare organizations and providers caring for them. For years, most adolescents have been referred out of Primary Care to Family Planning Clinics for their confidential care. However, those most vulnerable, with a pile up of social conditions on their shoulders, do not have the luxury to get a second chance for optimal care. This workshop will include various strategies used in large safety net primary care settings to reach our predominantly minority patient population, and provide the confidential care they need when they need it.

The workshop will have 2 parts. First we will present the strategies to reach our minority youth before COVID-19. With the pandemic, systemic inequities became more evident. Therefore, we refocused our efforts. In the second part of the workshop we will share the advocacy efforts done with leadership that addressed and identified barriers to minorities accessing telehealth in our systems. It is 2020 and we are still wrestling with disparities in reproductive health. That will need to be the core of our next Agenda: how to solve this difference once and for all. We will provide clear feedback of what worked in a large system in a safety net, and that hopefully participants will be able to replicate in their systems.

Learning Objectives:

  1. Identify specific strategies designed to support providers in serving patients to improve health outcomes and reach diverse patient populations.
  2. Implement strategies to improve and expand reproductive health services in a large safety net primary care system.
  3. Address racial inequities and their impact on patients and care delivery.

Using Text Messaging as a Health Intervention Tool to Reach, Teach, and Improve the Health of Underserved Adolescents

Session Leaders: Seth Ammerman, MD, Alliance Medical Center; Lisa Lestishock, DNP, RN, CPNP-PC, CNS, Lucile Packard Children’s Hospital

Description: Text-Messaging Interventions (TMI) can have significant potential for educating patients and supporting positive changes in health-related behaviors. Typically TMI has been used successfully in clinical settings for administrative or logistic purposes (e.g., appointment confirmation) or reminders for health maintenance tasks (such as taking scheduled medications or checking blood glucose levels). Instead, our goal was to see if TMI could help underserved adolescents improve knowledge and behavior change for health issues of importance to them. We closely collaborated with the underserved adolescent patients who were receiving comprehensive primary health care services in our mobile clinic program. The adolescents chose a variety of topics of most relevance to them, with 14 total: Abdominal Pain, Asthma, Birth Control, Depression/Anxiety, Fitness, Headaches, Nutrition, Relationships, Self-Esteem, STIs, Stress, Substance Use, Tobacco Cessation, and Weight Management. We will discuss the development, implementation, and evaluation of the TMI utilized in our mobile clinic and present data that demonstrate their utility for supporting positive health-related behavior change.

Learning Objectives:

  1. Describe the clinical utility of Text-Messaging Interventions (TMIs)
  2. Employ the skills and insights needed to collaborate with adolescent patients to create a patient-centric TMI
  3. Discuss the possibilities for, barriers to, and strategies to support utilization of TMI in various clinical settings.

Technology mapping the future of health care: Apps for the Treatment of Non-adherence in Teens

Session Leaders: Sinem Akgul, Md-PhD, Hacettepe University; Nuray Kanbur, MD, Hacettepe ‎University; Zeynep Tuzun, PhD, Hacettepe University; ‎

Description: Insufficient adherence to medical treatment is a major global health-threatening problem, and treatment ‎adherence is often a larger challenge to adolescents. Adolescents that stop taking their medication often ‎make this decision on their own. Not understanding the medical condition or need for the medication, ‎feeling the negative effects outweigh the benefits, simply forgetting or the stigma of taking medication ‎can all play a part. Exploring barriers to medication adherence among adolescents is important for ‎several reasons. Most importantly, missing medical treatment can have serious health consequences ‎resulting in increased morbidity and mortality, increased hospitalization, emergency department use and ‎doctor visits. Knowledge of barriers to medical treatment may improve the planning of interventions as ‎well as an individual approach to young patients. Globally, technology has transformed the future of ‎health care especially amid the COVID-19 pandemic. Adolescents are the most devoted users of ‎technology but more often than not the negative aspects are associated with adolescence such as ‎screen addiction, cyberbullying or isolation but in reality, there are many positive effects too. A growing ‎number of mobile phone apps are available to support people taking their medications and improve ‎medication adherence. However, little is known about how these apps differ in terms of features, quality, ‎and effectiveness. The coupling of different approaches to adherence problems especially incorporating ‎technology holds promise not only for modifying end behavior but also for helping teens to develop ‎strengths to promote general well-being as digital technology interventions show promise as the future of ‎medicine.‎

Learning Objectives:

  1. Describe the factors that account for the high prevalence of low adherence to ‎treatment during adolescence
  2. Discuss how to evaluate adherence to different treatment modalities with an ‎adolescent
  3. Discuss the effective approaches to tackle this problem, including motivational ‎interviewing, resilience building and use of technology.
  4. Describe the use of popular smartphone medical ‎applications (apps) to help with teen adherence problems.‎

Core Clinical Topics 

Employing a Trauma-Informed Approach to Transform Adolescent Health and Promote Wellness

Session Leaders: Binny Chokshi, MD, Children’s National Hospital; Leandra Godoy, PhD
Children’s Nation Hospital; Arin Swerlick, MD, MPH, Emory University

Description: Research has shown that traumatic exposures, such as adverse childhood experiences (ACEs), can have lasting negative effects on health. In adolescence, the health impact of childhood adversity can start to manifest clinically through diagnoses such as ADHD, obesity, and poorly controlled asthma. Mediated by direct effects on brain development, a history of traumatic exposures can also manifest as adolescent risky behaviors. As such, it is imperative for adolescent medicine specialists to understand the link between traumatic exposures and health and to know how to respond appropriately. The global pandemic is another critical traumatic exposure for our patients. It is imperative to recognize that the public health measures necessary to contain the pandemic have effectively removed access to the precise protective factors that buffer traumatic experiences: school, support systems, and community resources. Mitigation of the acute psychosocial and long term mental and physical health consequences associated with COVID-19 through the use of a trauma informed approach is a tool for clinicians and advocates to transform the future of adolescent health.

This workshop will review the connection between trauma, adversity, and health outcomes. It will focus on a trauma-informed framework, CARES, rooted in the Substance Abuse and Mental Health Services Administration’s (SAMHSAs) trauma-informed approach, which strives to understand the context within which a patient’s health develops and to empower patients by collaborating with them. The facilitators will also review the components of adolescent resiliency building, and participants will be able to utilize these tools through practical application to patient cases.

Learning Objectives:

  1. Recognize how childhood traumatic exposures can affect adolescent health outcomes, with a focus on how COVID-19 represents a community trauma.
  2. Review and apply CARES, a trauma-informed framework, to relevant clinical patient scenarios.
  3. Describe the components of adolescent resiliency building and identify opportunities to employ these during routine clinical patient scenarios.

Developing Adolescent-Centered Contraception Decision Making Tools for Use in Clinical Practice

Session Leaders: Christy Jones, FNP, The Tim & Carolynn Rice for Child and Adolescent Health; Martha F. Perry, MD, University of North Carolina Medical School; Bianca Allison, MD, MPH, University of North Carolina Medical School; Anna Jones, MPH, University of North Carolina Medical School

Description: Contraceptive use is a central component of adolescent pregnancy prevention. Unplanned pregnancies are often the result of suboptimal contraceptive behavior including nonuse, choosing lower efficacy methods, incorrect/inconsistent use of methods, or switching between methods. Adolescents need accurate and accessible information about contraceptive methods in order to choose an option they like and that they understand how to use effectively. This empowerment and choice can promote continuation and effective use of their chosen method over time. Decision-making tools, like decision aids, can guide a discussion between providers and adolescents, and enable their selection of effective contraception methods. A well-designed contraceptive decision aid can facilitate shared decision-making in choosing contraception and help an individual choose a method that aligns with their goals and preferences.

This workshop will present results of a systematic review of contraceptive decision-making tools evaluated in adolescents and young adults (AYA), highlighting key findings based on the populations studied, a thorough analysis of six studies related to contraceptive decision aids including the limitations of these studies and implications for future studies. The workshop will then pivot to opportunities for future research in the development of contraceptive decision aids that meet the needs of the specific adolescent population served. 

Learning Objectives:

  1. Describe findings from a systematic review of contraceptive decision-making tools tested/studied in adolescents.
  2. Identify contraceptive decision-making tools appropriate for specific populations based on evidence regarding contraceptive knowledge, patient experience, and contraception selection.
  3. Utilize existing evidence regarding contraceptive decision-making tools to design an adolescent-focused contraceptive decision-making tool for care delivery and evaluation.

Transforming the Future of Adolescent Health: A safe and efficacious role for dietary supplement use in Adolescent / Young adult health and well being

Session Leaders: Cora Collette Breuner, MD MPH, University of WA Seattle Childrens Hospital; Bryn Austin, ScD, Harvard University; Jillian Hagerman, DO, University of Washington Seattle Childrens Hospital; Kritika Tiwari, MBBS DNB, Matushree Gomati Hospital

Session Description: Use of dietary supplements including vitamins, minerals, herbs or other botanicals and amino acids are used by between 12-30% of the pediatric and AYA population, with higher prevalence in those with complex medical and behavioral health conditions. Estimated to generate nearly $57 billion in annual revenue in the US by 2024, dietary supplements have transformed the healthcare industry and sales have only continued to increase during the COVID-19 pandemic. Nearly one in five individuals taking prescription medicines is also taking dietary supplements, thus increasing the potential for interactions. Proprietary blends of supplements with undisclosed ingredients and sometimes toxic ingredients, those sold with claims to improve weight loss or boost sports performance, energy, or immune function, raising USFDA concerns. As a health care provider, one must approach supplement use with an open mind and consider usage through multiple lenses including both health benefits and morbidity, safety and efficacy standards, affordability and equity of access vs. potential disproportionate risk in underserved communities. Participants will learn how supplements can impact health outcomes and will gain an understanding of usage patterns in all races and ethnicities, efficacy and safety for commonly used dietary supplements including Elderberry, Melatonin, Creatine, St. Johns Wort, Coenzyme Q10, N-Acetyl Cysteine, Omega 3 fatty acids, Magnesium, Zinc and Butterbur. Emphasis will also be placed on use especially during COVID pandemic.

Learning Objectives:

  1. Review top dietary supplements including vitamins, minerals, herbs or other botanicals and amino acids used in the Adolescent/Young Adult population and how they may be transforming health care.
  2. Recognize efficacy and safety of drug/ dietary supplement interactions and complications of dietary supplement use including vitamins, minerals, herbs or other botanicals and amino acids.
  3. Discuss cases from interdisciplinary participants on the use of dietary supplements including vitamins, minerals, herbs or other botanicals and amino acids in their AYA patient population especially during the COVID 19 pandemic.​

Histrelin Acetate Subcutaneous Implant for Gender Affirming Care: hands-on training for outpatient procedure

Session Leaders: Megan Jacobs, MD, Oregon Health & Science University; Kara Jeanne Connelly, MD, MCR, Oregon Health & Science University; Araceli Trejo-Rosas, BS, RN
Oregon Health & Science University, Julie Park, MBBS, Oregon Health & Science University

Description: Gender affirming care practice guidelines for medical management of gender diverse youth strongly support the use of gonadotropin releasing hormone agonists (GnRHas). Multiple forms of GnRHas are available including variable length intra-muscular (IM) injectables, as well as 1-2+ year histrelin acetate subcutaneous arm implants (Vantas®, Supprelin® LA). These implants are intended for placement with local injectable lidocaine in the outpatient setting. By training more primary care, adolescent and pediatric endocrine clinicians to offer these implants we can improve access, diminish costs and anesthesia risks associated with outpatient procedures being performed in operating rooms. Most importantly, we can provide a timely response to affirming gender identity presenting in early puberty. There is no FDA-mandated training for this procedure, however it has similarities to contraceptive arm implants, indicating that SAHM attendees may already have a set of easily transferable procedure skills. The workshop will first review implant indications of use, off-label use in gender care, safety and efficacy data. It will then guide the participant through clinical workflows for counseling patients and families, obtaining prior authorizations, and obtaining & storing the implant kit in clinic. 

Learning Objectives:

  1. Review and discuss indications for use, pharmacology, and safety data for histrelin acetate implants.
  2. Outline workflow to obtain insurance approval, and medication kit in the clinical setting.
  3. Practice outpatient implant insertion, removal, and reinsertion procedures with pre-obtained training kit.

If You Don’t Understand the Media, You’re Not Going to Completely Understand Adolescents in the Future

Session Leaders: Victor C. Strasburger, MD, University of New Mexico School of Medicine;  Ed Donnerstin, Ph.D., University of Arizona; Katya Bess Strasburger, Southern New Hampshire University

Description: In the future, it is highly likely that adolescents will be even more affected and influenced by media than they even are now. Understanding media effects and who is susceptible will be crucial for clinicians. Media research is voluminous and often difficult to assess. Nevertheless, this workshop will help of summarize current studies and show how understanding the research will make clinicians more astute in the future. Research comes from around the world – – as important findings have recently come from both Europe and Australia. Social networking, cyberbullying, and sexting have risen to great prominence, and these will be discussed in detail. At the same time, clinicians can use media to their advantage, promoting important positive public health messages, not to mention communicating with their patients in unique ways. We will address the issue of social networking with patients such as texting, Facebook friending. Also, the future need for the entertainment industry to make changes, schools to institute media education, and governments to adopt appropriate regulations regarding media.

Learning Objectives:

  1. Summarize the existing research on media effects on adolescents including media violence, sex, substance use, cyberbullying, sexting, and social networking.    
  2. Compare and to contrast various solutions to negative media effects and to maximize positive media effects in the future such as government regulation, rating systems, media literacy, and to discuss if internet addiction is a valid diagnosis.     
  3. Identify clinicians’ role in (1) addressing media effects on adolescents, including social media and traditional media (2) eliciting an appropriate media history (3) using that history to intervene when necessary and (4) using media in their own practices to promote adolescent health.

Professional Development/Training/Education 

Racism 101 And More: Mapping the Intersection of Racial Identity, Medicine, and ‎Education through the Lens of Youth and Educators

Session Leaders: Fareeda Haamid, DO, Nationwide Children’s Hospital; Deena Chisolm, Ph.D., Nationwide Children’s Hospital; Valencia Walker, MD, MPH, Nationwide Children’s Hospital; Jennifer Walton, MD, MPH, Nationwide Children’s Hospital; Aurelia C. H. Wood, MD, Nationwide Children’s Hospital 

Description: This workshop aims to empower attendees grappling with the realities of racial discord ‎in medical, educational, and other therapeutic settings. The session builds from the ‎premise that meaningful efforts to transform the future of adolescent health begin with ‎equipping healthcare professionals with the historical context of race, racism, and ‎inequities in health literacy. The workshop guides participants towards thoughtful ‎considerations for the lived experiences of youth and those tasked with ensuring their ‎education and well-being. The session creatively and seamlessly weaves recently ‎obtained interviews from youth and educators to facilitate solution-based dialogue ‎among attendees. This innovative and compelling workshop seeks to target ‎participants interested in actionable steps for dismantling current health inequities ‎originally shaped by historical injustices.

This workshop prioritizes the creation of respectful ‎environments to foster crucial conversations. As experienced facilitators, the session ‎leaders engage with this challenging topic in a welcoming manner for attendees. ‎Participants completing the workshop should leave emboldened to affect positive ‎change against racism and health inequities through their career endeavors. 
‎ 
Learning Objectives:

  1. Describe the historical roles of science and medicine in creating race as a biological ‎construct. 
  2. Compare and contrast theories examining the formation of racial awareness across ‎developmental stages. 
  3. Amplify the lived racial experiences of diverse youth and educators through personal ‎storytelling to promote positive racial identity formation and health literacy among ‎adolescents‎

Identifying and Supporting Trafficked Youth in Health Care Settings: A Whole-Clinic Approach

Session Leaders: Jenni Lane, MA, University of Michigan; Cornelius Jamison, MD, MSPH, 
University of Michigan; Azzia A. Roberts, MPH, CHES, University of Michigan

Description: Human trafficking and commercial sexual exploitation of adolescents and young adults are significant public health concerns, and adolescents are particularly vulnerable to exploitation. Among survivors of sex trafficking, 87% report having contact with medical providers while they were trafficked. However, survivors report not disclosing their status to providers due to obstacles including fear, shame, other psychosocial factors, language barriers, and limited time with providers. Concurrently, professional development opportunities on identifying trafficked youth remain limited for providers. There are fewer opportunities still for staff, despite the fact that there are specific, unique ways that people in any role in a health center can identify and support trafficked youth. To address this gap, the Adolescent Health Initiative developed an innovative mini-training using a whole-health center approach, recognizing that everyone can play a part in identifying and supporting victims of trafficking at their clinical setting. This ready-to-use training is designed for use in primary care, specialty clinics, or school-based health centers. In this workshop, participants will take part in the mini-training, address challenges to its delivery, and receive the materials needed to replicate it in their own setting. The session will also include helpful strategies to identify and support victims of both labor and sex trafficking. AHI’s engaging new training video highlights the voices of survivors and other experts to shed light on what human trafficking victims want and need from providers and staff.

Learning Objectives:

  1. Identify signs of trafficking and sexual exploitation among adolescent and young adult patients.
  2. Describe strategies for providers and staff to support trafficked and sexually exploited adolescent and young adult patients.
  3. Conduct a mini-training module on human trafficking and receive materials to replicate it.   

Preventing Provider Burnout to Enhance Outcomes for High-Risk Adolescent Patients: Introduction and Demonstration of the Ekstasis Peer Consultation Model via Remote Videoconferencing

Session Leaders: Lauren Haack, PhD, University of California, San Franciso; Ashley Maliken, PhD, University of California, San Franciso; Allison Libby, PsyD, University of California, San Franciso; Gabriela Moreno, LMFT, University of California, San Franciso; Shailey Prasad, MBBS, MPH, University of Minnesota; Natalie Todd, PsyD, University of California, San Franciso

Description: First, we will present the background and significance for reducing “Occupational Burnout,” which is characterized by emotional exhaustion, depersonalization/cynicism, and reduced personal accomplishment/efficacy. Burnout is understandable in providers of at-risk adolescents given the potential exposure to intense emotional suffering, suicidal ideation, and traumatic life events from our patients. Burnout is associated with increased mental and physical health problems amongst providers, greater absenteeism and turnover, and poorer patient treatment response.

Next, we will describe predictors of burnout, including increased workload, amplified time pressures, reduced resources, role ambiguity, and lack of supervision and/or consultation. We will explain that burnout interventions appear more successful when they are delivered to groups with high baseline burnout, are person-directed rather than organization-directed, and are offered in a non-judgmental environment.

Finally, we will propose a specific model of peer consultation useful for providers of high-risk adolescents: the Ekstasis model. We will present previous literature suggesting that peer consultation can reduce burnout by improving providers’ negative feelings towards their patients, communication and consultation skills, perceived support and job satisfaction, as well as isolation and stress. We will also share first-hand reflections about how Ekstasis teams have enhanced joy in our own workplaces by facilitating coworker bonding and a shared sense of meaning and purpose. We will propose that peer consultation may actually enhance perceived patient outcomes by providers (directly) and actual patient outcomes (directly and indirectly). We also plan to present preliminary data from a pilot of Ekstasis with adolescent mental health providers demonstrating impact on provider burnout.

Learning Objectives:

  1. Recognize the association between occupational burnout -with- negative provider and patient outcomes.
  2. Discuss potential solutions to prevent occupational burnout when working with high-risk adolescents (e.g., structured peer consultation) and predictors for success.
  3. Facilitate a specific structured peer-consultation strategy (i.e., Ekstasis model) via remote videoconferencing.

The Increasingly Electronic Healthcare Environment: Teaching Healthcare Teams Strategies to Protect Adolescent Confidentiality

Session Leaders: Ariel Reinish, MD, University of Rochester School of Medicine and Dentistry; Marybeth Jones, MD, MS, University of Rochester School of Medicine and Dentistry; Ryan H. Pasternak, MD, MPH, LSU Heath Sciences Center School of Medicine; Margie Hodges Shaw, JD, MA, PhD, HEC-C, University of Rochester School of Medicine and Dentistry; Katherine Blumoff Greenberg, MD, University of Rochester School of Medicine and Dentistry

Description: Adolescent autonomy may be enhanced by supporting access to health information using online health portals; adolescent users can send confidential messages and have independent communication with their health care providers. Adolescent users of online health portals show enthusiasm for this means of patient-provider communication. However, balancing autonomy and confidentiality is complicated by open access medical records, including patient portal messaging and shared notes, and highly variable institutional policies protecting adolescent confidentiality. Adolescent healthcare professionals often find themselves responding to patient, family, and system pressures to increase transparency and access to the electronic health record (EHR), especially with the legal mandates put forward by the 21st Century Cures Act rules.

In this workshop, we will review the foundational learning objectives, learning assessments, and activities addressing this tension, using materials developed through the University of Rochester’s General Academic Pediatrics educational scholarship and quality improvement work. We will share our unique and overlapping curricula in adolescent outpatient medicine, for first-year medical students, pediatric residents, and pediatric faculty and staff around this content, including interactive case-based discussions, self-reflection surveys, simulated patient portal responses, and quality improvement methods. Furthermore, we will present self-reflection survey data and process outcomes from our quality improvement initiatives and their effects on portal engagement. Finally, we will discuss how our methods can be adapted on an institutional level, with special consideration to the unique local and legal barriers that can inhibit access to confidential care.

Learning Objectives:

  1. Review and identify key educational strategies for foundational learning objectives for adolescent healthcare providers to protect adolescent confidentiality in electronic health record and patient portal use.
  2. Discuss learning activities for medical trainees, faculty, and staff to improve adolescent confidentiality protections within the electronic healthcare environment, with a focus on open access medical records within patient portals.
  3. Describe how educational and quality improvement methods can be used to address adolescent confidentiality within the electronic healthcare environment and consider strategies to adapt to your own institutional needs.

The Mindful Adolescent Health Provider: Hands on Skills for Integrating Mindfulness to Build Health Professional Resilience, and a Culture of Wellness

Session Leaders: Dzung X. Vo, MD, BC Children’s Hospital and University of British Columbia; Anju Sawni, MD, Hurley Children’s Hospital/Hurley Medical Center; Nicholas Chadi, MD MPH, Sainte-Justine University Hospital Centre, University of Montreal

Description: Burnout, mental health disorders, and suicide among health professionals and trainees is reaching a crisis point, and represents an increasing threat to the sustainability of the health care workforce and the ability of adolescent health professionals to serve youth, adolescents, and families with effectiveness and compassion. The medical landscape has changed with the introduction of technology and pressures of productivity, thus adding to increased challenges and stressors for clinicians. Health professionals who serve adolescents with emotional or physical pain, crisis, and/or trauma, are even more at risk of secondary trauma and compassion fatigue. When health professionals are unable to handle the suffering of their patients and families in an effective and healthy way, it can limit their capacity to serve adolescents by impairing one of their most vital qualities: Their capacity to “stay present” with adolescents and families, with unconditional compassion and loving kindness. In recent years, mindfulness meditation practice for health professionals has been increasingly researched and recognized as powerful tools to improve health professionals’ own wellness, and the quality of care that providers can offer. Mindfulness practice improves health professionals’ emotional intelligence, attention and performance. This can help professionals learn to stay present, and practice compassion for both themselves and patients. In this institute, we will discuss the science behind the power of mindfulness and meditation in promoting compassion and loving kindness, leading to better self-care and a greater capacity to care for adolescents/young adults by cultivating a culture of wellness.

Learning Objectives:

  1. Describe how burnout and compassion fatigue is affecting healthcare providers and learn the research behind how mindfulness can be a valuable modality to address this and enhance clinician well-being.
  2. Describe how the practice of mindfulness, and meditation can increase self-awareness and the quality of “presence” in order to improve health provider resilience, wellbeing, and effectiveness.
  3. Demonstrate simple, practical mindfulness practices that can be integrated in the setting of clinical practice to nurture patient and provider well being.

Public Health/Advocacy 

“Push-Outs not Drop-Outs”: Transforming health by dismantling systemic ‎racism in education 

Session Leaders: Michele Kelley, ScD, MSW, MA, ACSW, University of Illinois at Chicago; Marissa Raymond-Flesch, MD, MPH, University of California San Francisco; Wanda Thurston, DNP, PNP, RN, Indiana University School of Nursing; Romina Loreley Barral, MD, University of Missouri Kansas City and University of Kansas Medical Center; José E. López, MA, University of Illinois at Chicago and Chicago Puerto Rican Cultural Center; Maria Veronica Svetaz, MD, MPH, FSAHM, FAAFP 
University of Minnesota 

Description: Years of completed education is an internationally recognized determinant of health, ‎and has a strong association with health over the life-course and longevity. Recently, ‎the National Academy of Medicine called for a deeper understanding of this ‎relationship, furthering knowledge of how education is a vital predictor of health. ‎Structural racism in educational quality and opportunity has been recognized by ‎federal law, and yet the literature is replete with examples of how inequities in ‎education are currently manifested. As schools are adapting to a global pandemic, ‎education and health inequities are exacerbated. This institute will review the ‎mechanisms by which structural racism directly impacts youth development, their ‎school trajectory (as the “school to prison pipeline”), and lifelong health inequities. ‎Innovative policies and practices in and with schools will be presented by a ‎multidisciplinary panel of scholars and practitioners from the health equity educational ‎and medical fields.

The session will address proximal and distal determinants of ‎adolescents’ health as related to school systems and explore the interconnectedness ‎of whole child- whole community development. Community case examples of culturally ‎responsive education that promote adolescent health and well-being will be presented ‎and contrasted with normative, hegemonic models of “subtractive education” (that ‎deny non-dominant racial/ethnic youth their identity, cultural assets in the community, ‎and critical hope for a future). International examples of health promoting school-based ‎strategies are provided. Practical strategies will be given for health professionals to ‎utilize with youth themselves, and tools to dismantle structural racism by enhancing ‎organizational responsiveness and policy strategies. 
‎ 
Learning Objectives:  

  1. Describe the association between education and health; specifically how systemic ‎racism in education impacts youth development, the prison pipeline, and lifelong ‎health inequities. 
  2. Analyze the historical trajectory of systemic racism in education and its ‎manifestations today. 
  3. Identify action steps we can take as health professionals to address systemic racism ‎and educational inequities, both at the system and individual level.‎‎

Transforming adolescent health through knowledge of and action on the pandemic behind the pandemic: Femicide and gender-based violence

Session Leaders: Nuray Kanbur, MD, Hacettepe University Faculty of Medicine; Veronica Svetaz, MD, MPH, University of Minnesota, School of Medicine; Michele Kelley, ScD, MSW, MA, ACSW, University of Illinois at Chicago Health Sciences; Liz Miller, MD, PhD, University of Pittsburgh; Swati Bhave, M.D, DCH, FCPS, FIAP FAA, Dr. DY Patil Medical College, Pimpri & Dr D.Y.Patil Vidyapeeth; Yvette Efevbera, ScD, MSc, Harvard University; Marissa  Raymond-Flesch, MD, MPH, University of California San Francisco; Romina Barral, MD, MsCR, University of Kansas

Description: According to WHO, “femicide” is the term used for the multitude of women who are abused or killed (including “honor killings”) at the hands of their kin network or partners primarily because they are women. Global data regarding femicides is limited due to the differences in reporting and data aggregation. While gender-based violence is a global public health concern, some countries including parts of Latin America, Turkey, and India, are recognized as areas with high prevalence of femicides and gender-based violence. Adolescence and young adulthood are critical developmental stages that can increase young women’s vulnerability towards gender based violence. The COVID-19 pandemic and related social isolation have created an increase in domestic violence as more women are isolated with their potential abusers and less able to access support at school or work. The absence of social engagement and economic distress in families may contribute to increases in violence. Simultaneously, the impact of the pandemic on health care, social services, and victim advocacy services has made providing services and support to survivors more challenging. This workshop will cover both national and global epidemiologic profiles of gender-based violence and femicide, the national and international laws protecting women, and evidence-based screening tools and resources that workshop participants can use in their clinical, educational, and programming activities. Historical oppression/ colonialism as social determinants of gender-based violence will also be considered. We will particularly highlight the variations between regional laws and cultural influences that can be leveraged or changed to protect young women.

Learning Objectives:

  1. Recognize the impact of the pandemic in rising femicide and gender-based violence as a global public health emergency by identifying its epidemiology and risk factors (both at a global and interpersonal levels).
  2. Identify national and international laws protecting against femicide and gender-based violence.
  3. Implement evidence-based screening tools to identify patients at risk for gender-based violence.
  4. Utilize current laws and evidence-based approaches to propose organizational policies that promote gender equity and safety for all adolescents and young adults where workshop participants work and practice.

​Positive, Problematic and Productive Social Media Use: Breaking down barriers and focusing on potential for how young people engage online

Session Leaders: Kaleigh Cornelison, BA, MSW, Adolescent Health Initiative; Cornelius D. Jamison, MD, MSPH, MS, Adolescent Health Initiative

Description: Technology and social media shape the identities, worldviews and relationships of today’s teens. Unfortunately, many professionals fall short when they solely focus on what is problematic about social media use and ignore its positive aspects. This workshop will start from the ground up, beginning with definitions and a roadmap of technology commonly used by young people. From there, we will examine how technology influences teen sexuality and relationships and the ways relationships and identity can be strengthened by technology. This will include how young people have utilized social media during current event including the 2020 elections, COVID-19, and the Black Lives Matter Movement. Finally, the workshop will focus on how to work with and relate to teens through the lens of technology. Members of AHI’s Teen Advisory Council will participate as youth presenters if the event is virtual. 

Learning Objectives:

  1. List 10 or more social media platforms that are commonly used among adolescents.
  2. Describe the difference between a tech-negative and tech-positive approach to adolescent social media use and site 2 or more examples of positive adolescent social media use.
  3. Identify at least 3-5 strategies for positively engaging with youth through a tech-positive framework.

​Community Engagement Models for Increasing Access to Quality Adolescent Reproductive Health Services

Session Leaders: Anna Willingham Brittain, Master of Health Science, Centers for Disease Control and Prevention; Kia Thacker, Master of Public Health, Sexual Health Initiative for Teens- North Carolina (SHIFT NC); Hope Crenshaw, PhD, EdS, MA, Teen Health Mississippi

Description: Despite decades of significant declines in U.S. teen birth rates, racial/ethnic and other disparities persist. This workshop will address strategies for implementing community-focused, locally driven adolescent reproductive health (ARH) efforts. Presenters will describe two Federal initiatives. The first is the 2010-2015 Community-Wide Initiatives (CWI), which demonstrated evidence of a significant reduction in the average teen birth rate across intervention as compared to control communities. Five components were implemented by community-based organizations (CBOs) in each CWI: (1) mobilizing the community through leadership teams and partnerships; (2) educating stakeholders to build support for teen pregnancy prevention; (3) promoting health equity through strategies to work with diverse communities; (4) implementing evidence-based teen pregnancy prevention interventions; and (5) enhancing ARH services. This presentation will be followed by a description of the 2015-2020 Teen Access and Quality Initiative, in which CBOs are supporting ARH quality improvement initiatives in publicly funded health centers while engaging local youth-serving organizations in the referral of youth for services. Following this, implementation partners will discuss strategies and tools they developed to implement these initiatives, such as stakeholder education on local teen pregnancy data and social determinants of teen childbearing, and collaborations with nontraditional sectors like workforce development to implement evidence-based teen pregnancy prevention programs. Via video, local voices will describe a frontline perspective on community and youth action teams that guided implementation. 

Learning Objectives:

  1. Describe two federally funded programs (Community-Wide Initiatives [CWI] and Teens Access and Quality [TAQ] Initiative) that prioritized community engagement to strengthen access to quality adolescent reproductive health services.
  2. Describe the strategies used in each program’s model for community engagement and identify at least two lessons learned from each approach.
  3. Identify at least three resources from these programs that can be utilized by clinical and public health professionals to improve access to quality adolescent reproductive healthcare. 

Research 

Be Nimble, be Quick: Adapting Multi-site, Multi-disciplinary, Community-based ‎Interventional Studies with Vulnerable Adolescents and Young Adults with HIV in the ‎COVID Era

Session Leaders: Allison Agwu, MD, ScM, FAAP, FIDSA, Johns Hopkins University School of Medicine; Maria Trent, MD, MPH, Johns Hopkns University School of Medicine; Mobeen Rathore, MD, FIDSA, FAAP, University of Florida 

Description: Adolescents and young adults (AYA) ages 12-25 years with HIV have the lowest rates ‎of engagement, retention, and viral suppression compared to other HIV-positive ‎groups. The reasons for these poor outcomes, including social determinants of health ‎and individual and systemic barriers, necessitate innovative and dynamic approaches ‎to clinical care and research. TECH2CHECK is a randomized-controlled trial of a ‎technology-enhanced community health nursing intervention addressing self-care ‎behavior, adherence, and viral suppression among AYA with non-adherence to ‎antiretroviral treatment. Launched in July 2018, to date, the multi-site protocol is ≈50% ‎accrued (target=120) across 3 cities (Baltimore, MD; Washington, DC; Jacksonville, FL). ‎‎95% of participants are African-American with significant challenges (e.g., unstable ‎housing, mental health). Only 1 participant, to date, has been lost to follow-up, ‎demonstrating how well-designed clinical trials and research protocols using novel ‎strategies can result in completion of study procedures along with potential ‎improvements in health for the participants. The TECH2CHECK team has adapted the ‎study protocol across sites, addressing differential regulatory approaches, including ‎interpretation of minor consent laws, comfort with use of technology in research, and ‎relationships between clinical and research entities. We have also managed ‎differences in local COVID-19 infection rates and mitigation strategies at the ‎participating sites and their impact on study enrollment and retention. The workshop ‎uses TECH2CHECK as a case-study, demonstrating how research with AYA has to be ‎multi-disciplinary, including youth, intrinsically intertwined with their clinical care team, ‎forward-thinking, innovative, and dynamically nimble and flexible to be able to adapt to ‎challenges for implementation. 
‎ 
Learning Objectives:

  1. Identify the key questions and planning behaviors necessary in adapting a research ‎protocol to a new locale, including differences in regulatory approaches without ‎disrupting study integrity. 
  2. Explain mechanisms to adapt field-level engagement in times of unprecedented ‎disruption of pre-determined outreach and engagement approaches, and capitalizing ‎on opportunities to capture new and relevant information to improve outcomes for AYA. 
  3. Discuss necessary team dynamics for effective recruitment, study design, and ‎retention of vulnerable AYA populations in longitudinal research and using research ‎to promote retention in care for AYA whose care has been disrupted by the COVID ‎pandemic.‎‎

Journal of Adolescent Health: A Case Study for Understanding the Publication Process

Session Leaders: Tor D. Berg, B.A., Journal of Adolescent Health; Teresa Dal Santo, Ph.D., Journal of Adolescent Health; Carol A. Ford, M.D., Children’s Hospital of Philadelphia

Description: Publishing an article in a scientific journal can be a complicated and frustrating process. Many aspects of publishing are mysterious and poorly understood by scientific authors. The Journal of Adolescent Health (JAH) is a top-ranked, peer-reviewed health science journal with a 40-year history of publishing high-quality scientific results aimed at improving the health and well-being of adolescents and young adults. The editors of JAH will present a case study of the journal’s operations in order to clarify the publication process. Attendees will gain an understanding of the work of journal editors, will learn which aspects of a scientific paper can increase its likelihood of being accepted, and will discover resources available to assist them in every aspect of the publication process. Current topics will include Open Access and Plan S, opportunities to publish creative work in peer-reviewed journals, and strategies for promoting a published article on social media.

Learning Objectives:

  1. Examine the operations of an academic journal and the day-to-day activities of journal editors.
  2. Identify the characteristics of a scientific article that maximizes its chances of being accepted by a scientific journal.
  3. Compile a list of resources available for maximizing one’s success in the publication process, from submission to promotion.

Youth Engagement and Empowerment 

Youth Perspectives and Provider Messaging within the Changing Landscape of ‎Legalized Recreational Marijuana

Session Leaders: Jenni Lane, MA, University of Michigan; Catherine Miller, MD, University of Michigan Mott Children’s Hospital

Description: Data concerning the impact of increased recreational marijuana legalization on ‎adolescent attitudes and marijuana use is scant, but emerging. Medical and mental ‎health providers and other youth-serving professionals – along with adolescents and ‎parents – are navigating this new landscape without a roadmap. This workshop will ‎address the biases, uncertainties, and best practices for communicating with youth ‎around the topic. Youth will co-facilitate the workshop, sharing their perspectives about ‎current forms of marijuana use, social norms, and what health messaging they find ‎effective. Using a strengths-based approach to risk, the session will both acknowledge ‎the developmental appropriateness of adolescent novelty-seeking and ‎experimentation, and draw upon the most recent literature to help adolescents reduce ‎negative health outcomes of marijuana use. Participants will leave with strategies to ‎help providers and adolescents navigate the changing landscape of marijuana use ‎together. 
‎ 
Learning Objectives:  

  1. Recognize legalization status changes across the country and recent youth trends in ‎marijuana use. 
  2. Utilize commentary from adolescents about their attitudes and beliefs related to marijuana use, its ‎impact, and what health messaging they find effective. 
  3. Discuss strategies for discussing marijuana use and approaches to assist youth with ‎positive behavior change.

A Social Network Agenda to Engage and transform the health of Black and Latinx Sexual and Gender Minority Youth (BLSGMY)

Session Leaders: Renata Sanders, MD, MPH, ScM, Johns Hopkins University; Kimberly Hailey-Fair, MPH, Johns Hopkins School of Medicine; Marne Castillo, PhD, Children’s Hospital of Philadelphia; Nadia Dowshen, MD, MSHP, Children’s Hospital of Philadelphia; Andrea Wirtz, PhD, Johns Hopkins Bloomberg School of Public Health

Description: Social network strategies (web-based mobile applications, respondent driven sampling, coach support) have been identified as techniques to engage vulnerable populations by transforming one’s risk into wellness. Black and Latino Sexual and Gender Minority Youth (BLSGMY) are particularly at risk. Partnerships in clinical, research, and wellness programs have the potential to change risk paradigms and improve outcomes of such youth. This workshop will present specific strategies to engage in such settings through social network approaches. Case scenarios (youth qualitative feedback and quotes) will facilitate discussion of possible ways providers can partner with youth. this workshop will highlight practical experiences and evidence-based approaches used to engage youth via (web-based mobile applications, respondent driven sampling, coach support). The Promoting Unique Support for Health (PUSH) and LITE Studies are prospective and intervention studies that support BLSGMY. The studies have successfully engaged SGMY across the country into substance use, mental health and reproductive services through social network strategies. Experts will present youth voices and feedback to demonstrate successful techniques, while also engaging participants to share their own experiences and ideas. This session will offer concrete social network strategies to effectively transform risk into wellness, present lessons learned from implementing a developmentally and culturally approaches, and how to influence one’s social network from risk into wellness.

Learning Objectives:

  1. Review social-network strategies and an agenda to effectively engage Black and Latinx Sexual and Gender Minority Youth (BLSGMY) into clinical, research, and wellness programs.
  2. Describe practical challenges to engage BLSGMY.
  3. Illustrate successful technical approaches (web-based mobile applications, respondent driven sampling, video support, etc.) to engage BLSGMY and transform risk into wellness.

Engaging Adolescents and Young Adults to Improve Health Literacy and Transition to Adult Care

Session Leaders: Jeannie S. Huang, MD, MPH, University of California San Diego; Maya Kumar, MD, University of California San Diego; Eve Nguyen, PhD, Rady Children’s Hospital; 
Robin Kruth, RN, Rady Children’s Hospital; Jacob Parker, BS, Rady Children’s Hospital

Description: We will present our multidisciplinary experience related to system-wide deployment of a transition program to improve adolescent and young adult (AYA) health literacy at a pediatric tertiary care institution serving a diverse youth population in a large metropolitan area. In particular, the body of work was deployed within the electronic health record (EHR) and thus could be incorporated within clinical workflows. To deploy this program system-wide, our approach had to account for and integrate viewpoints of multiple stakeholders (primary care providers, subspecialty providers, AYA patients, and their families) in addition to disease-specific factors. Intervention delivery modalities were selected to meet patient comprehension needs and the message formats preferred by targeted audiences. Further, youth volunteers were recruited to deliver health literacy tips/messages to peer-aged patients to improve message uptake and comprehension. Lessons learned and outcomes from the work will be reviewed and application of such a program to other settings will be explored. As the work was deployed through a common EHR system, dissemination and uptake of the work at other sites will be facilitated and hopefully permit more systematic deployment of services that improve AYA health literacy and necessary transition preparation. We will showcase the experiences of both the health professionals and youth who were involved in the project.

Learning Objectives:

  1. Identify system-based methods to improve adolescent and young adult (AYA) health literacy.
  2. Discuss a successful example of a multidisciplinary intervention to improve transitional care for AYA patients, deployed through an electronic health record.
  3. Integrate youth into health literacy campaigns geared towards AYA.

From Teens to Teens: Winning Strategies for Adolescent Vaccination

Session Leaders: Patti Wukovits, BSN, RN, Meningitis B Action Project and Kimberly Coffey Foundation; Alicia Stillman, MBA, Emily Stillman Foundation, Meningitis B Action Project; Kelly Danielpour, VaxTeen

Description: This workshop will explore unique considerations for improving adolescent vaccination through personal stories and experiences from a range of perspectives – a teen vaccination advocate (VaxTeen), mothers (and advocates) who lost their adolescent daughters to a vaccine-preventable disease (Meningitis B Action Project), and a healthcare provider in a college setting (e.g., San Diego State University). Each will share best practices for increasing awareness and uptake of vaccination among parents and adolescents. 

Learning Objectives:

  1. Recognize recommended vaccination schedules for adolescents.
  2. Define key factors affecting adolescent vaccination rates in the United States.
  3. Identify strategies to improve awareness and uptake of vaccinations among adolescents.
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