LEAH interdisciplinary training program

This article describes the Leadership Education in Adolescent Health (LEAH) interdisciplinary training program in the United States. The Maternal and Child Health Bureau authorized by legislation provides monies to train leaders in adolescent health through a competitive grant process. Currently, seven academic medical centers have funding to provide leadership in adolescent health (LEAH) training in five core disciplines: medicine, nursing, psychology, social work and nutrition. LEAH training programs both ensure high clinical competence in core disciplines serving adolescents and prepare trainees for leadership positions in adolescent health and public health care realms. Together, these programs trained almost 1000 long-term trainees across these five disciplines, and graduates from these programs are working in 45 of the 50 states within the United States. About 90% of these graduates are working with maternal and child/adolescent health populations, and almost all have held leadership positions in the areas of public health, advocacy, public policy, academic medical centers and/or clinical care settings

FUN WITH FACEBOOK: THE IMPACT OF FOCUS GROUPS ON THE DEVELOPMENT OF AWARENESS CAMPAIGNS FOR ADOLESCENT HEALTH

poster abstractAbstract Efforts at improving adolescent health through mass communication are frequently undertaken by corporate design firms using traditional design development methods. While such methods may create work that is aesthetically significant, their effect on their intended audience is often overlooked in the process. Left unaddressed are youth media consumption, existing knowledge of health issues, and youth social patterns. By conducting focus groups with local youth, we wanted to learn about 1) attitudes and prior knowledge about the areas identified in Indiana’s Adolescent Health Plan, and 2) consumption of media and preferences in programming Results Knowledge of adolescent health issues Designers learned first-hand youth attitudes toward adolescent health issues and relied on their findings to develop storylines, dialog, and casting decisions. Media consumption While television remains the most popular method of media consumption, social networking sites play a large role in determining what media youth consume. The connection to peers and information sharing enabled by Facebook presented the most potential for effective media development. Design deliverables These data resulted in development of public service announcements (PSAs) and a health survival booklet. PSAs resembled instant communication or ‘chats’ on Facebook and addressed topics of obesity, stress, vehicular safety, and substance abuse. The PSAs provide a familiar visual reference for youth while leveraging its social networking function for emotional impact. The booklets balance practical information with content intended to entertain as well as inform the reader

Fun with Facebook: The Impact of Focus Groups on the Development of Awareness Campaigns for Adolescent Health (Poster)

Poster presentation regarding adolescent health and media consumption for the 2011 Society for Adolescent Health and Medicine Conference

Partners and Peers: Sexual and Dating Violence Among NYC Youth

Partners and Peers found that youth tell other youth -- if they tell anyone at all -- about their experiences. This makes it essential that information is available to teens in a format they can utilize. The Teen Health Map, with a subway map on one side and youth-friendly referral guide to health and sexual violence resources on the other, was developed by the Alliance to support those who participated in the study. This has become an important resource on its own as a confidential source of information that youth can share with each other. In its second printing, the map has been purchased by the NYC Department of Education and Department of Youth and Community Development for those they serve. The Teen Health Map was tested extensively and developed to young people's specifications for use and confidentiality

Adolescent relationship violence and acculturation among NYC Latinos

Acculturation has been shown to positively and negatively affect Latino health. Little research investigates the overlap between acculturation and the different types of relationship violence among Latino youth and most research in this area predominantly involves Mexican-American samples. The current study examined associations between indices of acculturation (language use at home, chosen survey language, and nativity) and relationship physical violence and sexual coercion, both received and delivered, among predominantly Dominican and Puerto Rican adolescents from New York City. From 2006 to 2007, 1,454 adolescents aged 13-21 years in New York City completed an anonymous survey that included the Conflict in Adolescent Relationships Inventory which estimates experiences of physical violence and sexual coercion, both received and delivered, in the previous year. This analysis includes bivariate and multivariate methods to test the associations between language use at home, chosen survey language, and nativity with the different types of relationship violence. Among females, there is a significant association between language use at home and overall level of acculturation with delivering and receiving relationship physical violence; however, we did not find this association in delivering and receiving relationship sexual coercion. We found no association between acculturation and any type of relationship violence among males. Among Latina females, language spoken at home is an indicator of other protective factors of physical relationship violence. Future research in this area should explore the potential protective factors surrounding relationship violence among Latina females of various subgroups using comprehensive measures of acculturation, household composition and family engagement

Perspectives of family medicine physicians on the importance of adolescent preventive care: a multivariate analysis

BACKGROUND: The study objective was to identify commonalities amongst family medicine physicians who endorse annual adolescent visits. METHODS: A nationally weighted representative on-line survey was used to explore pediatrician (N = 204) and family medicine physicians (N = 221) beliefs and behaviors surrounding adolescent wellness. Our primary outcome was endorsement that adolescents should receive annual preventive care visits. RESULTS: Pediatricians were significantly more likely (p < .01) to endorse annual well visits. Among family medicine physicians, bivariate comparisons were conducted between those who endorsed an annual visit (N = 164) compared to those who did not (N = 57) with significant predictors combined into two multivariate logistic regression models. Model 1 controlled for: patient race, proportion of 13-17 year olds in provider's practice, discussion beliefs scale and discussion behaviors with parents scale. Model 2 controlled for the same first three variables as well as discussion behaviors with adolescents scale. Model 1 showed for each discussion beliefs scale topic selected, family medicine physicians had 1.14 increased odds of endorsing annual visits (p < .001) and had 1.11 greater odds of endorsing annual visits with each one-point increase in discussion behaviors with parents scale (p = .51). Model 2 showed for each discussion beliefs scale topic selected, family medicine physicians had 1.15 increased odds of also endorsing the importance of annual visits (p < .001). CONCLUSIONS: Family medicine physicians that endorse annual visits are significantly more likely to affirm they hold strong beliefs about topics that should be discussed during the annual exam. They also act on these beliefs by talking to parents of teens about these topics. This group appears to focus on quality of care in thought and deed

Adolescent Relationship Violence: Help-Seeking and Help-Giving Behaviors among Peers

Young people tend to disclose relationship violence experiences to their peers, if they disclose at all, yet little is known about the nature and frequency of adolescent help-seeking and help-giving behaviors. Conducted within a sample of 1,312 young people from four New York City high schools, this is the first paper to ask adolescent help-givers about the various forms of help they provide and among the first to examine how ethnicity and nativity impact help-seeking behaviors. Relationship violence victims who had ever disclosed (61 %) were more likely to choose their friends for informal support. Ethnicity was predictive of adolescent disclosure outlets, whereas gender and nativity were not. Latinos were significantly less likely than non-Latinos to ever disclose to only friends, as compared to disclosing to at least one adult. The likelihood of a young person giving help to their friend in a violent relationship is associated with gender, ethnicity, and nativity, with males being significantly less likely than females to give all forms of help to their friends (talking to their friends about the violence, suggesting options, and taking action). Foreign-born adolescents are less likely to talk or suggest options to friends in violent relationships. This study also found that Latinos were significantly more likely than non-Latinos to report taking action with or on behalf of a friend in a violent relationship. This research shows that adolescents often rely on each other to address relationship violence, underlining the importance of adolescents’ receipt of training and education on how to support their friends, including when to seek help from more formal services. To further understand the valuable role played by adolescent peers of victims, future research should explore both which forms of help are perceived by the victim to be most helpful and which are associated with more positive outcomes

Adding 6 months of androgen deprivation therapy to postoperative radiotherapy for prostate cancer: a comparison of short-course versus no androgen deprivation therapy in the RADICALS-HD randomised controlled trial

Background Previous evidence indicates that adjuvant, short-course androgen deprivation therapy (ADT) improves metastasis-free survival when given with primary radiotherapy for intermediate-risk and high-risk localised prostate cancer. However, the value of ADT with postoperative radiotherapy after radical prostatectomy is unclear. Methods RADICALS-HD was an international randomised controlled trial to test the efficacy of ADT used in combination with postoperative radiotherapy for prostate cancer. Key eligibility criteria were indication for radiotherapy after radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to radiotherapy alone (no ADT) or radiotherapy with 6 months of ADT (short-course ADT), using monthly subcutaneous gonadotropin-releasing hormone analogue injections, daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as distant metastasis arising from prostate cancer or death from any cause. Standard survival analysis methods were used, accounting for randomisation stratification factors. The trial had 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 80% to 86% (hazard ratio [HR] 0·67). Analyses followed the intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov, NCT00541047. Findings Between Nov 22, 2007, and June 29, 2015, 1480 patients (median age 66 years [IQR 61–69]) were randomly assigned to receive no ADT (n=737) or short-course ADT (n=743) in addition to postoperative radiotherapy at 121 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 9·0 years (IQR 7·1–10·1), metastasis-free survival events were reported for 268 participants (142 in the no ADT group and 126 in the short-course ADT group; HR 0·886 [95% CI 0·688–1·140], p=0·35). 10-year metastasis-free survival was 79·2% (95% CI 75·4–82·5) in the no ADT group and 80·4% (76·6–83·6) in the short-course ADT group. Toxicity of grade 3 or higher was reported for 121 (17%) of 737 participants in the no ADT group and 100 (14%) of 743 in the short-course ADT group (p=0·15), with no treatment-related deaths. Interpretation Metastatic disease is uncommon following postoperative bed radiotherapy after radical prostatectomy. Adding 6 months of ADT to this radiotherapy did not improve metastasis-free survival compared with no ADT. These findings do not support the use of short-course ADT with postoperative radiotherapy in this patient population