SIG/Professional Development Session - Saturday, March 21

SIG/Professional Development Sessions with CE/CME

SIG/Professional Development Sessions without CE/CME


SIG/Professional Development Sessions with CE/CME

  • 8:00-9:30 a.m.
From Violence to Wellness: Helping Adolescents Transition to a Life Free from Victimization and Perpetration
Nicholas J. Westers, PhD1; Alison Culyba, MD, MPH2
1Children's Medical Center Dallas, 2The Children's Hospital of Philadelphia

Description: As adolescents move toward forming unique identities, they must navigate unpredictable circumstances that may affect their physical and mental health both now and into adulthood. Such circumstances often include exposure to violence, whether as victims or perpetrators, or sometimes both. When these circumstances are a regular occurrence, adolescents may become accustomed to a lifestyle where violence is the norm and becomes tied to their identities. For instance, adolescents may be exposed to a culture of sexual violence in which sexual harassment or homophobic name-calling are normalized as “just joking” and accepted as part of everyday culture. They may be immersed in a world where even minor interpersonal conflicts often escalate to life-threatening altercations. When violence is aimed toward the self, such as in nonsuicidal self-injury (NSSI), adolescents may find solace in identifying with the behavior as a “cutter” or “self-injurer.” Most violence research to date has focused on identifying factors that pose risks for violence perpetration and victimization. Less research has focused on finding protective mechanisms through which adolescents thrive despite the adversity that surrounds them. Assisting young people with adjusting to a new way of life, or a new identity, in the absence of violence, often proves challenging. Wellness models provide insight into strengthening health and wellbeing from a holistic perspective. Their emphasis on prevention, autonomy, and optimal living may provide useful methods of conceptualizing how youth might navigate into adulthood and form identities outside the context of violence.   

This SIG session will first provide an overview of different forms of violence perpetration and victimization, including sexual violence, physical violence, and violence toward the self (i.e., NSSI) using data from the 2013 Youth Risk Behavior Surveillance, the CDC National Center for Injury Prevention and Control, and peer-reviewed research publications. Models of wellness will then be outlined and critiqued. Particular emphasis will be placed on using wellness models to create non-violent conceptions of identity. Participants will then apply this research and wellness models in small groups to generate ideas about how providers might help youth transition to wellness according to each type of violence outlined, with particular emphasis on adolescents who may have formed identities and received peer support within a culture of violence. To generate relevant applications of the concepts learned during the session, participants will reflect and share thoughts regarding how the ideas generated and exchanged during the SIG session may potentially influence their current work.

Educational Objectives:
  1. Discuss the long-term consequences of violence exposure with regard to interpersonal violence, sexual violence, and nonsuicidal violence toward the self (i.e., nonsuicidal self-injury).
  2. Apply wellness models to assist violence-exposed youth in transitioning to overall health and well-being.
  3. Identify opportunities to incorporate wellness models into clinical care, advocacy, research, and program development.

Spirituality SIG
Richard Wahl, MD, FSAHM1; Sarah Stender, MD, FAAP, CDE2; Velya Leybas Nuno, PhD3
1Arizona Health Center, 2LSU Health Sciences Center/Childrens Hospital, 3University of Arizona

Description: Our SIG discussions this year will continue our ongoing discussion of the role that spirituality plays in the lives of our adolescent patients, as well as in our lives as providers of adolescent health care. We will bring together two major themes of the past few SIG meetings: 1. Dr. Sarah Stender will continue our discussion of "Nature Deficit Disorder" as presented by Richard Louv in his two books: Last Child in the Woods and The Nature Principle, which both focus on the crucial role that unstructured time in nature plays in the development of children and adolescents. 2. Dr. Velya Leybas Nuño will update the results from our "Global Study of Spirituality and Adolescent Health", with the results of our survey of SAHM members on the role that spirituality plays on their provision of care to our patients and in our own lives.

Bone Health SIG: Hot Topics in Adolescent/Young Adult Bone Health
Sarah Pitts, MD
Boston Children's Hospital

Description: Bone health is an essential clinical concern in adolescence and young adulthood, and a great deal of research is published each year that could inform our clinical practice. In order to prevent the significant morbidity and mortality associated with adult osteoporosis, adolescent medicine providers must make bone health care a routine part of their daily practice. Through an interactive, case-based presentation, an evidence based approach to adolescent and young adult bone health care will be discussed. Emphasized points will include: 1) the changes in the 2013 International Society for Clinical Densitometry Positions regarding the use of DXA and its interpretation in adolescents and young adults; 2) a review of the latest vitamin D research and how, if at all, it may influence change in the current SAHM position statement regaring vitamin D; and 3) the current evidence guiding the bone health care of adolescents and youngs adults with nutritional deficiency, female athlete triad, and immoblity, among other common clinical presentations. Attendees new to the notion of adolescent bone health will also benefit from the interactive discussion and input from other experts in the field who are likely to be in attendance, including Drs Neville Golden, Amy Divasta, Keith Loud and Catherine Gordon.

Educational Objectives:
  1. Translate the 2013 International Society for Clinical Densitometry recommendations for bone densitometry of adolescents and young adults into practical clinical approaches.
  2. Analyze updated research regarding vitamin D testing and supplementation to inform any necessary changes in the SAHM vitamin D position paper.
  3. Identify the most current evidence to direct the bone health care of adolescents and young adults with nutritional deficiencies and/or hormonal imbalances.

Runaway and Homeless Youth SIG
Meera S. Beharry, MD1; Seth David Ammerman, MD, FSAHM2; April S. Elliott, MD, FSAHM3;  Scott B. Harpin, PhD, RN4
1McLane Childrens Hospital Baylor, Scott & White; Texas A & M Health Science Center, 2Stanford University Medical Center & Lucile Salter Packard Children's Hospital, 3Alberta Children’s Hospital, 4University of Colorado, Anschutz Medical Center

Description: We will follow the format of last year's successful SIG.  We will begin with a review of the literature in the past year that involved homeless youth.  When available, authors will be invited to briefly present their own work.  This portion of the meeting will be limited to 20 minutes. Participants will then be asked to make a list of areas of concern for their work with homeless youth.  We will divide into small groups of 10 participants each who will discuss strategies for dealing with these issues.  This will provide an opportunity for networking.  Participants will be encouraged to share their own work as well as information gleaned from other sources (other conferences, publications).  We will then reconvene as a larger group to share solutions and ideas. This will segue into the final component of our SIG, identifying activities that will help all participants.  Among the ideas to be discussed will be how the SIG and its list serve can be used to address concerns identified.

Educational Objectives:
  1. Review new literature involving homeless youth.
  2. Discuss issues in providing care to homeless youth.
  3. Develop strategies and partnerships for addressing issues identified.

Exploring the Health Provider Toolkit for Adolescent and Young Adult Males
David J. Breland, MD, MPH1; Stanley R. Vance, Jr., MD2; David L. Bell, MD, MPH3;  Dennis J. Barbour, JD4
1University of Washington, Seattle Children's Hospital, 2University of California, San Francisco, 3Columbia University, 4The Partnership for Male Youth

Description: Pre-adolescent and early adolescent boys and girls have approximately equal utilization rates of healthcare; yet by mid-adolescence, females continue to seek out and access health care services through their gynecologic provider because of their reproductive health care needs, while males, having no parallel need or interface with the health care system, neither seek out nor are engaged in their health care.  As a result, their unique health care needs are overlooked and unaddressed not only by the health care system but by providers in settings where male adolescents could be provided care, such as in school health clinics. While changes brought about by the Affordable Care act, through extended coverage through parents’ health insurance plans or the insurance mandate will provide incentives for young adult males to access health care, few providers are trained in their unique health care needs. Consequently, a rare opportunity to engage young males in their health care could be mismanaged or lost. Societal norms regarding traditional masculine beliefs may also play some role in the fact that males are not engaged in their own health care.   

In addition to reproductive health care needs, adolescent males have higher morbidity and mortality from preventable causes such as accidental trauma, substance use/abuse, suicide, and violence compared to adolescent females.  In response to these troubling disparities, in 2012 The Partnership for Male Youth began researching the state of health care for adolescent and young adult (AYA) males with an eye toward developing and encouraging clinical interventions to improve their health.  After an extensive literature search and discussions with over 100 individuals from a range of medical disciplines, and under the guidance of a multidisciplinary medical advisory board, the Initiative developed a groundbreaking resource for health care providers that the Partnership released in January 2014: the Health Provider Toolkit for Adolescent and Young Adult Males. 

The educational format goal of the SIG is to provide a forum of interactive exchange of experiences, perspectives and ideas amongst colleagues with regards to providing healthcare for AYA males; hence, it is an appropriate sponsor for initiating a dialogue among SAHM members on this important subject. In addition to a presentation about the rationale for and content of the Toolkit, the session will explore how it can be used as a foundation for bringing other resources to bear on the improvement of adolescent male health within clinical practice.

Educational Objectives:
  1. Describe the 9 main areas in which the health care needs of AYA males are unique.
  2. Understand how the provider toolkit can be used as a reference by those who clinically serve adolescent and young adult males and how other clinical tools emanating from the toolkit can be applied in clinical practice.
  3. Describe clinical strategies and tools that can be used to improve the health care needs of AYA males in the attendee’s clinical practice.

Creating a Youth Research Advisory Board
Marina Catallozzi, MD, MSCE1; Kym  Ahrens, MD, MPH2; Nicola J. Gray, PhD, FSAHM3
1Columbia University, 2Seattle Children’s Hospital & Research Institute, 3Green Line Consulting Limited

Description: Through case studies and discussion, this joint meeting of the Qualitative Research and Research SIGs will give attendees information about the issues associated with creating a Youth Research Advisory Board (YRAB). The session will start with a short didactic presentation to orientate attendees to the topic, and will then allow small discussion groups for attendees to reflect on the challenges in their own situation. The session will end with some action planning activities. This topic is associated with the SAHM strategic plan and will enable members to consider some of the ideas of the SAHM leadership and how to translate them for their own communities.

Educational Objectives:
  1. Consider the benefits and challenges of creating a Youth Research Advisory Board (YRAB) in their community.
  2. Discuss case studies of existing YRABs in the US and internationally.
  3. Create a strategy for proposing the formation of a YRAB in their community.

The Power of One: Adolescent Health Leaders in Divisions of One
Paul A. S. Benson, MD, MPH1; May C. Lau, MD, MPH2
1University of Oklahoma-Tulsa School of Community Medicine, 2UT Southwestern Medical Center

Description: Many adolescent medicine physicians and other adolescent health providers enjoy the support – and the challenges – associated with practice in multi-faculty divisions.  A growing number, however, thrive in academic or private practice environments where our unique expertise and leadership are valued as solo adolescent subspecialists.  With the advent of newer ACGME-mandated pediatric residency requirements, Adolescent Medicine-boarded physicians in particular may find themselves in greater demand and practicing in "divisions of one".  Following a lively and successful discussion last year at the inaugural Power of One Professional Development Session where many of the challenges and successes working as sole adolescent health faculty were identified, this year we turn to three specific objectives in greater depth.  In keeping with this meeting's theme of "embracing transitions," this session will first examine the existing literature and evidence base which support healthy professional transitions from fellowship to a "division of one" faculty position and from a position in a multi-faculty division to a "division of one."  Participants will then share their experiences, discuss advantages, and generate practical solutions for challenges faced during such transitions. 

Next, small group format followed by larger group information sharing will be used to examine each of the two remaining educational objectives in turn: self-advocacy strategies for negotiating effective time allocation among one's academic pursuits and methods of demonstrating value and leadership to one's institution as a solo adolescent medicine physician or other health provider.  This session, while open to all SAHM conference participants, is particularly aimed at faculty and trainees of all adolescent health disciplines who practice or may soon practice in a solo setting at their respective institutions.  This session will serve as an opportunity to network, build resources, and communicate questions, concerns, and advice among solo providers.

Educational Objectives:
  1. Analyze the strengths and challenges of transitioning from fellowship training or a multi-adolescent faculty program to a "division of one".
  2. Identify and verbalize at least three self-advocacy strategies for negotiating effective time allocation among clinical, research, teaching, and other academic pursuits as a sole adolescent health leader.
  3. State at least five methods of demonstrating value and leadership to one's institution with respect to clinical care, teaching, community service, advocacy, research, and administrative activity, as a "division of one".

Adolescents with HIV/AIDS SIG
Tanya Kowalczyk Mullins, MD1; Daniel Reirden, MD2; Errol Fields, MD, MPH, PhD3;  Lana Lee, MD3
1Cincinnati Children’s Hospital Medical Center, 2University of Colorado School of Medicine; Children’s Hospital Colorado, 3Johns Hopkins School of Medicine

Description: This Special Interest Group provides an opportunity for healthcare providers working with HIV-infected and at-risk adolescents and young adults to network and share experiences. Information regarding regional, national, and international endeavors will be discussed, as well as issues related to collaborative research, health policy, prevention, and funding. The format of the session will be primarily interactive, with some didactic presentation. There will be an effort to tie the session to the “Embracing Transitions” theme of the 2015 SAHM conference. The session organizers will prepare an outline for the session, as well as introductory didactic information in order to lay the groundwork for group discussion. Engagement from group participants about the presented topics will be actively encouraged in order to maintain an interactive format.

Educational Objectives:
  1. Summarize current adolescent HIV/AIDS research studies and findings from national research coalitions (such as IMPAACT, ATN, etc.).
  2. Describe possible changes to the provision of HIV healthcare related to the Affordable Care Act (ACA). Discuss the potential impact of the ACA on Ryan White programming. Understand the possible impact of such changes for youth transitioning to adult care.
  3. Identify strategies for and barriers to establishing clinics to i) deliver healthcare to high risk youth and/or ii) deliver oral HIV pre-exposure prophylaxis.

SIG/Professional Development Sessions without CE/CME

  • 8:00-9:30 a.m.

Advocacy SIG
Mychelle Y. Farmer, MD1; Lisa Barkley, MD2
1Jhpiego, 2University of Central Florida, College of Medicine

Description: The Advocacy SIG is an opportunity for SAHM members to participate in a critical review of recent legislation and health policies affecting adolescents and young adults. This year, we will focus on SAHM’s recently released position papers relating to reproductive health, as a way to support adolescent access to care and to promote positive health transitions.  Over the past year, access to contraceptives, as part of the preventive health benefit mandated in the Affordable Care Act (ACA) has been challenged. This Advocacy SIG will be an opportunity to 1) learn about the recent Supreme Court ruling of June 30, 2014; 2) review congressional legislative actions; and, 3) determine how these recent events may affect future access to contraceptives services. It will also offer the opportunity to consider ways to use SAHM’s new position papers as advocacy tools at our institutions and during future interactions with policy makers and legislators at all levels of government – federal, state, and local. The outcomes of this discussion will be shared with the SAHM Advocacy Committee, as important feedback concerning access to contraceptives for adolescents and young adults.

Educational Objectives:

  1. Describe the current policy related to adolescents and  young adults accessing contraceptive services, as defined by and included in the Affordable Care Act.
  2. Describe how the recent policies and decisions can affect adolescent's future access to reproductive health care.
  3. Develop a plan to use SAHMs position papers as advocacy tools for SAHM members, with particular attention to advocacy's significance to promoting healthy transitions for adolescents and young adults.


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