Investing in adolescent healthcare: reducing risk for global impact

Pitts, Sarah; Forman, Sara F.

doi: 10.1097/MOP.0000000000000373
ADOLESCENT MEDICINE: Edited by Sara F. Forman and Sarah Pitts

aDivision of Adolescent/Young Adult Medicine

bDivision of Endocrinology, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA

Correspondence to Sarah Pitts, MD, Division of Adolescent/Young Adult Medicine, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA. Tel: +1 617 355 3732; fax: +1 617 730 0184; e-mail: sarah.pitts@childrens.harvard.edu

Article Outline

Suicide, homicide, substance abuse, unprotected sex, homelessness … These are a few of the harrowing words that may come to mind when thinking about Adolescent Medicine, but providing optimal healthcare for adolescents is a meaningful endeavor with significant opportunity for prevention, education, and collaboration. In addition to experimentation, adolescence is a time for identity formation, psychological maturation, exploration, uncertainty, and realization. Being a part of this essential developmental process for adolescents, through parenting, teaching, clinical care, advocacy, or research, is an extremely rewarding and worthwhile pursuit. Worldwide, the adolescent population is larger than ever with health concerns best addressed by those who view them not as large children or as unmyelinated adults, but as a unique group with specific health needs and perspectives.

Despite the struggles we encounter when caring for teen patients, there is much to celebrate. At the annual Society for Adolescent Health and Medicine conference in March 2016, clinicians, researchers, and policy makers from around the world convened to highlight the latest advances in adolescent healthcare. For example, with increasing use of the human papilloma virus vaccine, successful herd immunity has been demonstrated, and rates of human papilloma virus are decreasing [1]. Telehealth is successfully being utilized to educate those adolescents in remote underserved areas [2]. A crisis text message hotline offers a novel 24/7 text message service for individuals in mental health crisis, to support them in their time of need (www.crisistextline.org). US alcohol policies are associated with reduced teen motor vehicle deaths [3]. Finally, with readily available long-acting reversible contraceptives, teen pregnancies are being reduced in the USA [4]. This has significant implications in the USA and globally. Of the 74 million unintended pregnancies in the developing world, 30% are related to contraceptive failure, and most are in women under the age of 25 years [5]. With improved access to long-acting reversible contraceptives worldwide, life trajectories for teen and young adult women could be drastically altered. These and other exciting efforts are improving adolescent care with large public health implications.

In this year's section, authors highlight important issues across the spectrum of Adolescent Medicine. Drs Tsappis, Freizinger, and Forman (pp. 415–420) provide an in-depth review of the binge-eating disorder diagnosis and recent trials supporting management options specific to adolescents. Drs Quinn and Louis-Jacques (pp. 421–427) provide a useful algorithm for the menstrual management of adolescent and young adult women with hematologic and oncologic disease. Drs Adams and Woods (pp. 428–433) address the need for, and the implementation, of a chronic care model of healthcare delivery for adolescents with chronic illness and its possible applications for the medical home model. Drs D'Souza-Li and Harris (pp. 434–440) shed light on substance use screening and brief intervention, providing several easy-to-access tools for use across healthcare settings. They underscore the need for further research and advocacy for adolescent and young adult substance use disorder treatment resources. Dr Dodson (pp. 441–446) passionately argues that gun violence is an adolescent health concern, and that clinicians are well positioned to prevent gun-related injuries and to advocate for reform to save lives. Finally, Drs Golub and Hassan (pp. 447–453) illustrate how the call for adolescent-specific healthcare training is, happily, resonating worldwide with increasing numbers of certifying programs and accessible adolescent health course options for clinicians.

The risks associated with adolescence are considerable. Focused efforts by clinicians, parents, teachers, researchers, and policy makers to better understand and to advocate for this population are essential if rates of suicide, homicide, unintentional injury, unintended pregnancy, and sexually transmitted infections are to be reduced. As expertise in Adolescent Medicine permeates throughout the world, we should see significant positive health, economic, and social impacts.

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Acknowledgements

None.

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Financial support and sponsorship

The study was supported in part by the Leadership Education in Adolescent Health Training grant #T71MC00009 from the Maternal and Child Health Bureau, Health Resources and Services Administration.

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Conflicts of interest

There are no conflicts of interest.

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REFERENCES

1. Widdice LE, Ding L, Bernstein DI, et al. Epidemiologic impact of HPV vaccination and evidence for heard immunity over the first 8 years after vaccine introduction in a community [abstract]. J Adolesc Health 2016; 58 (2S):S9.
2. Yoost JL, Hensley C, Woodall B. Use of telehealth to teach healthy life skills to rural adolescent females. J Adolesc Health 2016; 58 (2S):S31–S32.
3. Hadland SE, Xuan Z, Blachette J, et al. Alcohol policies and motor vehicle injury fatalities among underage youth in the United States. J Adolesc Health 2016; 58 (2S):S13–S14.
4. Colorado Department of Public Health and Environment. Fact sheet: unintended pregnancies and reducing abortion. https://www.colorado.gov/pacific/cdphe/reducing-unintended-pregnancy. [Accessed 4 January 2016].
5. 2016; Polis C, Bradley SEK, Bankole A, et al. Contraceptive failure rates in the developing world: an analysis of demographic and health survey data in 43 countries. https://www.guttmacher.org/report/contraceptive-failure-rates-in-developing-world#full-articlehttps://www.guttmacher.org/report/contraceptive-failure-rates-in-developing-world#full-article. [Accessed 4 January 2016].
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