Workshop Session: Saturday, March 11, 2017

Click here for session handouts.

8:00 - 9:30 a.m.

Connecting and Empowering Youth Post-Detention

Rebecca Monk. Beyda, MD1, Michael Fu, BS2, Patricia Jaber, LMSW3, Ariel Test, JD4, Arash Anoshiravani, MD, MPH2, Ann Sattler, MD, MAT, FSAHM5
1University of Texas McGovern Medical School at Houston; 2Stanford School of Medicine; 3UT Physicians; 4Louisiana Center for Children's Rights; 5University of Massachusetts Medical School    
Track: Public Health/Advocacy

Description: Annually, nearly one million youth are arrested in the United States.  On any given day, 54,000 youth are held in approximately 2000 residential facilities nationwide.  Youth in the juvenile justice system are faced with a new set of challenges upon re-entry into the community after release from juvenile justice facilities.  In the process of re-integrating themselves into their communities, youth may encounter barriers when seeking needed medical or psychiatric care, accessing work opportunities or legal assistance, putting them at risk for recidivism.   Individuals and community organizations can assist in easing this transition, promoting healthy re-engagement in the larger community.  During our workshop, we will provide examples through interactive case presentations involving three areas of youths’ lives including medical care follow-up, vocational opportunities and legal involvement after release from juvenile justice facilities.  Physicians will discuss connecting youth with medical homes upon release.  Vocational opportunities will be presented by the founder of “My Homie’s Couch,” a youth-led social entrepreneurship program that is working to create an online platform that allows justice-involved and marginalized youth to showcase their voices and create a peer-led community to spark action.    Legal challenges will be discussed by a supervising attorney for Louisiana Center for Children’s Rights.  After the presentations, experts will conduct fishbowl style question and answer with the group, discussing challenges and successes in connecting youth with services upon release.  Finally, we will divide into three small groups and discuss strategies with each presenter in more detail regarding the medical, vocational and legal aspects of care.

Educational Objectives
  1. Review the various needs of youth upon release from juvenile justice facilities
  2. Discuss strategies used to connect and engage youth with medical services, vocational opportunities and legal assistance upon release from juvenile justice facilities
  3. Analyze challenges and successes of programs involving youth post-detention
Faculty Expertise:The three physician members of the workshop all have prior teaching, speaking and publishing on the topic of detained youth.  Drs. Beyda and Sattler were involved in a SAHM Institute presentation 3 years ago and have co-led the Juvenile Justice Special Interest group for the past 3 years.  They both currently work on connecting youth with care upon release from juvenile justice facilities.  Dr. Anoshiravani has dedicated his career to the health of detained youth, publishing over 10 peer-reviewed articles, and serving as the medical director of the Santa Clara Juvenile Justice Custody Institutions.  Michael Fu founded "My Homie's Couch" which provides justice involved youth with vocational opportunities. Ariel Test works with the Louisiana Center for Children's Rights assisting with legal matters for youth in the justice system.  Finally, Patricia Jaber is a social worker who works closely with a teen clinic following youth post-detention.

Tanya L. Kowalczyk Mullins, MD, MS, FSAHM1, Daniel H.Reirden, MD2
1Cincinnati Children's Hospital Medical Center; 2Children's Hospital Colorado

Track: Clinical Advances 

Description: New HIV infections continue to heavily impact adolescents and young adults both in the U.S. and internationally. Pre-exposure prophylaxis (PrEP) is a new strategy that may play an important role in HIV prevention. Growing evidence demonstrates that the use of PrEP can significantly decrease the risk of HIV infection, which led to the U.S. Food and Drug Administration (FDA) approving the first medication for PrEP for use in adults in 2012. The overall intent of this workshop is to educate participants about PrEP for HIV prevention, including a review of existing literature supporting the efficacy and effectiveness of PrEP and reviewing published reports describing PrEP implementation. We also will discuss domestic (U.S.) and international recommendations (such as WHO, UNICEF, etc.) about the use of PrEP, with a focus on use of PrEP in youth. We will examine at least one successful model of PrEP delivery, including discussion of the challenges faced by this program and how this program developed linkages to other critical resources (such as housing, substance abuse and mental health services, etc.) Time will be allocated to allow interaction between participants and faculty to discuss the experiences of participants in providing PrEP. The session faculty hold expertise in both the research and clinical aspects of PrEP provision to youth thus allowing for a unique interaction and discussion between faculty and participants.

Educational Objectives
  1. Describe research supporting the efficacy and effectiveness of pre-exposure prophylaxis (PrEP) for HIV prevention , and discuss the current U.S. Public Health Service recommendations about use of PrEP and relevant international recommendations (such as gu
  2. Determine risk factors that may indicate an adolescent could be a potential candidate for PrEP, and describe how to initiate, monitor, and discontinue use of PrEP
  3. Identify potential challenges in providing PrEP to youth and formulate possible strategies to address these challenges
Faculty Expertise: Dr. Mullins has expertise in the field of HIV prevention in youth, having completed studies of clinicians and the use of pre-exposure prophylaxis (PrEP) that were supported by the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN). She holds NIH funding to study the potential use of PrEP and microbicides for HIV prevention in youth by primary care physicians, and she was an invited participant in a UNICEF-sponsored consultation on PrEP and adolescents. Dr. Reirden is the medical director of the Children’s Colorado’s Adolescent and Young Adult HIV program. He is grant-funded by the Colorado Department of Public Health to provide PrEP to clients aged 15 to 25 years old. As the Co-Principal Investigator of the ATN at the University of Colorado, he participated in research trials of PrEP in 15 to 22 year-olds. Drs. Mullins and Reirden co-led the SAHM Adolescents with HIV/AIDS Special Interest Group for 6 years.

Genderqueer, non-binary youth and how they fit into the transgender paradigm
David J. Breland, MD, MPH1, Shauna Lawlis, MD2, Sarha Painer, LISW2, Julia Crouch, MPH3
1Seattle Children's Hospital, University of Washington; 2Cincinnati Children's Hospital Medical Center; 3Seattle Children's Research Institute

Track: Clinical Foundations

Description: Gender has historically been considered to come in two forms- male (masculine) or female (feminine), yet we are now familiar with individuals who are transgender (people who identify as the opposite of their assigned birth sex). Transgender people still follow the binary of gender. Some people have a gender which is neither male nor female and may identify with both male and female or of different genders. These individuals are considered under the umbrella term of genderqueer or non-binary gender identity. Although the numbers of individuals who may identify as non-binary, based on population based studies are a small percentage, they are still at risk for victimization and minority marginalization stress as a result of discrimination. We currently have medical protocols for patients who halt puberty or transition with hormones to their desired binary genders but what about those whose gender doesn’t fall into a binary category? It is important for clinicians to understand these youth in order to counsel them and provide optimal treatment options.

Educational Objectives
  1. Define the various terms used by youth in regards to gender
  2. Synthesize the evidence around non-binary or genderqueer youth
  3. Explore treatment considerations for non-binary youth
Faculty Expertise: I am currently the Medical Director of the Seattle Children's Gender Clinic. I have worked with trans* youth for the last 4 years and have was the senior author of a recent paper in JAH on Youth and Caregiver perspectives on barriers to transgender health care. I recently attended the WPATH Research Symposium and present my research on the subject. I have complete part of the Certificate training from the WPATH.

Nicholas Chadi, MD1, Trisha Tulloch, MD2, Karen Leslie, MD1
1Hospital for Sick Children; 2Centre for Addiction and Mental Health

Track: Clinical Foundations

Description: This session will offer a comprehensive perspective on youth smoking in North America. Behind the steady decrease in traditional cigarette smoking rates in adolescents from developed countries hides a new pattern of tobacco and nicotine addiction. E-cigarettes, hookahs, ‘poppers’ (the conjunction of tobacco and marijuana), and chewable forms of tobacco have become favorites among today’s teens. Less studied and unequally regulated when compared with traditional cigarettes, these alternate tobacco forms present a challenge and an opportunity for both clinicians and policymakers. This workshop will aim to uncover and explore some of tobacco’s newer formats while highlighting some of their connections with eating disorders, comorbid substance use and long term health risks. Building on the presenters’ experience with in-patient and outpatient, and primary/secondary/tertiary care populations, the interactive nature of this workshop will allow participants to share challenges and examples from their own practice. It will also allow attendees to develop new skills and approaches to tobacco prevention in a rapidly evolving context.

Educational Objectives
  1. Describe recent trends in tobacco and alternate tobacco product use in youth
  2. Summarize current evidence on the adverse health effects of adolescent tobacco use
  3. Compare and contrast current approaches and treatment of young tobacco users
Faculty Expertise: Nicholas Chadi is the co-author of two recent policy statements on youth tobacco prevention and cessation for the Canadian Pediatric Society. He also sits on a provincial steering committee on adolescent LGBT smoking prevention. Trisha Tulloch is a staff pediatrician with the youth concurrent disorders program at the Center for Addiction and Mental Health (CAMH) in Toronto. She is a coauthor and faculty instructor for the Youth and Young Adult Tobacco Cessation course through CAMH and the University of Toronto Faculty of Medicine Continuing Education and Professional Development program.  Karen Leslie is the head of the substance abuse program at the Hospital for Sick Children. She is the author of a Canadian Pediatric Society position paper on Harm Reduction, and a Canadian Medical Association Journal article on Adolescent Substance Abuse. Current research includes a study exploring the prevalence of substance use and mental health disorders in adolescents with chronic conditions.

Richard J. Chung, MD, FSAHM, Gary Maslow, MD, MPH, Amanda Rozycki, MSW, Samuel Brotkin, BA
Duke University School of Medicine

Track: Clinical Advances

Description: The transition from being an adolescent with a chronic condition to adult with a chronic condition is fraught with challenges. Youth must learn to take on self-management responsibilities from their parents and also learn how to navigate an increasingly complex healthcare system. This time of healthcare transition is a period in which youth are at increased risk of negative medical and psychosocial outcomes.  The goal of this workshop is to describe an approach to healthcare transition that focuses on promoting thriving among youth with chronic conditions by leveraging interpersonal connections in their families, communities, and healthcare settings. Through this workshop, participants will learn about the 5Cs approach to Positive Youth Development (PYD) and how this PYD approach can be specifically implemented to support the development of youth with chronic conditions. The 5Cs PYD model focuses on the ecological resources available to youth, their own internal assets, and the ways in which youth can both shape and be shaped by their environments and relationships with important people and institutions. Through this workshop, participants will learn about programmatic interpersonal approaches to promoting PYD for youth with chronic conditions including peer mentoring, technology-supported coaching interventions, and group programs designed to more deeply connect youth with chronic conditions to broad networks of support.

Educational Objectives
  1. Describe the 5Cs model of Positive Youth Development (PYD) and the role of PYD in driving successful healthcare transition for youth with chronic conditions.
  2. Delineate practical strategies for operationalizing core PYD components through incorporation of peer, parent, health coach, and technology-based transition interventions.
  3. Formulate a personal action plan for implementing PYD-based supports for youth with chronic conditions as they transition to adulthood.
Faculty Expertise: Richard Chung is a Med-Peds adolescent medicine specialist who co-directs the ATLAS Transition Clinic for adolescents and young adults (AYA) with chronic conditions. Gary Maslow is a pediatrician and child psychiatrist who has created programs promoting positive youth development (PYD) for AYA with chronic conditions in New Hampshire, Rhode Island, North Carolina, Indiana, and California. He co-founded the Duke Adolescents Transitioning to Leadership and Success (ATLAS) group mentoring program. Amanda Rozycki is a social worker who coordinates the Duke ATLAS programs, including a monthly leadership group, annual camp, narrative writing program, and the ATLAS Transition Clinic. Samuel Brotkin helps disseminate and evaluate the ATLAS Transition Programs. He serves as a lead coach for the Coaching Program, which pairs AYA with transition coaches to target the development and practice of self-management and healthcare navigation skills. All faculty partner closely in developing, implementing, and evaluating ATLAS transitions programming at Duke.

Margret W. Chang, MD1, Eric Chow, MD, MPH2, Jackie Hsieh, MD2, Karen Barbosa, MEd3
1University of Massachusetts Medical School - Family Health Center; 2Alpert School of Medicine at Brown Univ - Rhode Island Hospital; 3Woonsocket High School / Riverzedge Arts

Track: Public Health/Advocacy

Description: Teens can be powerful advocates in their communities, given their energy, enthusiasm, and ability to provide novel perspectives on pre-existing issues. However, their collective efforts have sometimes been difficult to engage. Breaking this inertia is important, especially with regard to mobilizing youth participation in issues around adolescent health and development.   It is in response to this issue that Teens Empowered to Advocate for Community Health or “TEACH” was formed. TEACH is an organization that empowers youth with basic health knowledge and inspires them to enact change in their communities. We have partnered with Expanded Learning Opportunities (ELO), an organization that provides support to after school classes that students can take for credit. Along with Brown University’s Warren Alpert Medical School and School of Public Health, groups of medical students and resident physicians lead teaching sessions to build a fund of basic health knowledge. With this background, youth go on to identify health topics in their local community that they would like to see changed and think of ways to change them.   As the focus of SAHM 2017 is “Cultivating Connections,” this workshop is well-suited for the conference theme. Participants in the workshop will get a sense of how partnerships between healthcare professionals and school systems work to improve community health. Moreover, we will be focusing specifically on teamwork between clinical health professionals, public health, and education, and how modeling these connections and interdisciplinary collaborations lead to more effective and powerful advocacy around adolescent health issues in a given community.

Educational Objectives
  1. Realize the benefits of partnership with a public school system to engage in health advocacy with adolescents
  2. Describe the structure of “Expanded Learning Opportunities” (ELO) –an innovative organization offering for-credit opportunities for students engaged in real-life learning opportunities
  3. Recognize the strengths of an interdisciplinary health curriculum with a focus on research skills as a means to empower adolescents to advocate for community health
Faculty Expertise: Drs. Chang and Chow are the Co-Executive Directors of TEACH and are present to give perspective on the process and challenges of developing an adolescent peer to peer education program while partnering with a local public school system. Dr. Hsieh is the Director of Curriculum Development and will be giving an overview of how the program’s curriculum challenges its students to critically think about healthcare. She will also give workshop learners an idea of how providing high school students training in public health thinking can make them more effective advocates for health issues in their communities. Finally, Ms. Barbosa, our ELO representative, will be giving insights into how best for healthcare professionals to collaborate with school systems to engage teens in the community, as well as describe the specific model that TEACH has adapted to meet the needs of the community of Woonsocket, RI.

Jason R. Rafferty, MD, MPH1, Jodie Neukirck, LCSW2, Diane DerMarderosian, MD1, Daniel Spencer, MD2, Christina Pastorello, MD1, Heather A. Chapman, MD1
1Rhode Island Hospital; Warren Alpert School of Medicine of Brown University; 2Hasbro Children's Hospital

Track: Clinical Advances

Description: Just as adolescence is characterized by dramatic physical, emotional and social change, “illness” during this stage is also uniquely dependent upon physiology, behavior, and relationships.  The Medical Psychiatric Program (MPP) at Hasbro Children’s Hospital (Providence, RI) provides integrative, family-centered treatment for children and adolescents who struggle with medical and psychiatric issues.  The model emphasizes a developmentally informed, biopsychosocial approach through collaboration within multidisciplinary teams of pediatricians, adolescent specialists, psychiatrists, psychologists, teachers, social workers, dietitians, and nurses.  Since the launch of the Hasbro Children’s Partial Hospital Program in 1998 to the opening of the 16-bed Inpatient Medical Psychiatric Unit in 2012, the model has proven particularly effective in addressing the complicated nature of adolescent morbidity. Both of these programs specialize in treating the multifaceted needs of adolescent patients challenged by complex medical and psychiatric illnesses, such as eating disorders, pain syndromes, complex seizure disorders, and chronic conditions including diabetes and inflammatory bowel disease. The tremendous demand for multidisciplinary services has led to regional referrals and expansions of both programs.  Finally, the MPP provides a valuable training environment for students, residents, and fellows in promoting collaboration and illustrating the complex nature of adolescent development.  It has contributed to the success of interdisciplinary “triple board” residency combining pediatrics, general psychiatry, and child psychiatry.  This workshop will examine the clinical potential of the MPP, particularly as it relates to adolescent health and shortcomings of traditional approaches.  Discussion will explore how the MPP model may be translated to specific adolescent populations and diverse clinical settings.

Educational Objectives
  1. Describe the multidisciplinary approach and principles that makes the Medical Psychiatric Program effective in addressing adolescent morbidity through the perspectives of different providers
  2. Appreciate how the Medical Psychiatric Model as been applied to both inpatient and partial (day) hospitalization settings, as well as in creating valuable training opportunities in adolescent medicine
  3. Engage in discussion comparing the Medical Psychiatric Model to traditional clinical approaches, and on means of translating the model to other settings and practices
Faculty Expertise: Diane DerMarderosian is the Pediatric Director of the Hasbro Partial Hospital Program (HPHP) and Interim Director of the Division of Adolescent Medicine.  She has published and spoken nationally on patient and family centered care, integrated care, and eating disorders.  Heather Chapman is a pediatrician in the integrated medical psychiatric partial program.  Daniel Spencer graduated from the Brown Triple Board Residency and is now the Director of the Medical/Psychiatric Inpatient Program.  Jason Rafferty and Christina Pastorello are current Triple Board residents.  Dr. Rafferty focuses on working with high risk adolescent populations, including LGBTQ and substance abusing youth.  Dr. Pastorello has broad experience working with adolescent girls around body image and coping with complex trauma.  Jodie Neukirch is a social worker who focuses on supporting adolescents through coping with chronic illnesses, overcoming eating disorders, and transitions to adult care.  

10:00 - 11:30 a.m.

Honoring their roots: creating and cultivating positive connections with Latino adolescents and young adults.
Maria Veronica Svetaz, MD, MPH, FSAHM1, Claire Brindis, DrPH2, Javiera Monardez, MD, MPH1, Diego Garcia-Huidobro, MD, PhD3, Marissa Raymond-Flesch, MD, MPH4, Jennifer O'Brien, MPH1, Michele Allen, MD5
1Hennepin County Medical Center; 2University of California, San Francisco; 3Department of Pediatrics, University of MN; 4University of California; 5University of Minnesota Track:  Clinical Advances

Description: The Latino population is the fastest growing group in the United States. By 2025, Latinos could account for 25% of teens aged 11-19. Thus, it is imperative that adolescent health practitioners be knowledgeable on how to effectively cultivate and nurture long-lasting relationships with Latino youth. Adolescents of Latino backgrounds often face challenges that differ from other cultural and minority communities. In addition, they have specific cultural assets that can help them thrive in the US. Learning about Latino adolescents and young adults, their opportunities for growth, their cultural backgrounds and values, and the challenges they face can be very useful for effective clinical practice and research. This workshop will examine the shift in cultural experiences and values experienced by Latino youth across the different generations of immigration, and cover strategies to create, nurture and cultivate strong and positive connections with Latino youth. Having presenters from different Latino settlement areas, such as California and Minnesota, gives a broader point of view of the Latino communities and provides a more accurate description of the issues providers will have to deal with working with them.

Educational Objectives
  1. Gain skills in identifying the cultural characteristics that impact health in a wide variety of Latino communities.
  2. Discuss challenges faced by Latino youth, and how providers can work to support them.
  3. Acquire skills to interact effectively with Latino communities in clinical and research settings
Faculty Expertise: Dr Svetaz, MD, MPH is a Faculty at HCMC Department of Family and Community Medicine and have created a multi awarded program to serve the Latino youth and their families. With Jennifer O’Brien, they developed a Population Based intervention,  out of this clinical program, where Dr Monardez is a parent coach. Drs. Allen, Svetaz and Garcia-Huidobro have been leading different CBPR projects with the Latino Community in MN. Dr. Brindis, one of the most renowned leader in Latino Youth Health,  is a Professor of Pediatrics and Health Policy in two  Departments  at the University of California, San Francisco.Dr. Brindis has extensive experience doing research in reproductive health and public health policy in undeserved communities. Dr. Raymond-Flesch is an assistant professor at UCSF. Her research focuses on using community based research to study the health and health care access of California’s Latino youth with a particular focus on immigrant health.

Jason R. Rafferty, MD, MPH, Agnieszka Janicka, MD
Rhode Island Hospital; Warren Alpert School of Medicine of Brown University

Track: Education/Training

Description: Our understanding of gender identity and the medical services available to transgender and gender questioning youth are rapidly evolving, which can make it difficult for providers to keep up.  In addition, many gender nonconforming youth will present with complex medical and psychiatric needs.  This session will go beyond defining terms and basic approaches, to address more complicated issues that arise in serving gender nonconforming adolescents and young adult populations.  A particular focus will be on models of collaboration between mental health and pediatric specialists to best foster resiliency, understanding, and positive youth development.  There will also be an emphasis on using a social ecological model to examine relevant interactions between the patient’s internal sense of self and the environment in which they live.  Interactive cases will be used to foster discussion, particularly on issues of adolescent and family expectations, ambivalence, access to and transitions in care, gender dysphoria, and managing mental health comorbidities.  Often sessions on gender nonconforming youth focus on providing a basic understanding of terms and initiation of hormones.  This session will be a much needed extension on the subject looking at issues that continue to arise throughout one’s gender transition within the patient’s bio-psycho-social context.  Ultimately, the goal will be to provide audience members with a framework for understanding the complex nature of gender identity and expression, and strategies for supporting and affirming patients through challenging situations.

Educational Objectives
  1. Summarize the unique barriers to care and comorbidities that are prevalence within the gender nonconforming community
  2. Describe essential roles of pediatric and psychiatric providers working collaboratively to meet the needs of gender nonconforming youth
  3. Implement a social ecological model to understand and address the complex, unmet needs of many gender nonconforming youth and their families
Faculty Expertise: Agnieszka Janicka is a Child Psychiatrist and the Director of Transgender Care at Rhode Island Hospital, which is also where she trained and established a unique Transgender and Gender Variant Child, Adolescent, and Adult Training Track.  She has conducted trainings for medical and psychiatric providers locally and internationally.  Jason Rafferty is a Triple Board Resident training in Pediatrics, General Psychiatry and Child/Adolescent Psychiatry.  He has had a continuity clinic in adolescent medicine focusing on transgender and gender questioning populations for the past five years.  He has additional degrees in public health concentrating on Maternal and Child Health, and education focused on adolescent development and psychology.  He has been invited to many institutions to lecture on transgender medicine and also advocates for transgender youth with the American Academy of Pediatrics, where he is currently working on a related policy statement.

Terez Yonan, DO, Bridgid Conn, PhD, Sophie de Figueiredo, Psy.D
Children's Hospital Los Angeles

Track:  Clinical Foundations

Description: Parenting teens are a vulnerable population with limited resources due to their age, level of education, ability to work and provide for their families. One of the most important protective factors that enables parenting teens to succeed is receiving assistance and support from grandparents. This allows parenting teens to care for their child, learn effective parenting techniques, complete their education and support their family’s growth. The unfortunate reality is that many parenting youth do not have a positive support network to facilitate their success. Further, teen pregnancy and parenting can place great strain on a family unit leading to poor outcomes for each respective generation. Research has shown that families with poor cohesion and higher levels of family discord have higher rates of depression and lower health status for the grandparents, higher rates of school failure and poverty for parenting teens, and poor cognitive and social skills for children of teen parents. Strengthening the connections between teen couples and their parents and family supports can have a significant positive impact on their psychosocial and health outcomes; strong bonds and positive relationships have also been shown to be factors that increase treatment engagement and adherence to provider recommendations. This workshop will focus on the challenges related to multigenerational child rearing and the unique complications faced by teen parents. This workshop will utilize motivational interviewing to highlight the importance of integrating developmental and family systems approaches to increase engagement and outcomes.

Educational Objectives
  1. Summarize key foundational theories related to family systems, intergenerational dynamics, and young parenthood.
  2. Identify and apply critical Motivational Interviewing techniques to improve treatment, engagement, and adherence to positively impact intergenerational family connections.
  3. Develop action plans for improving outcomes for adolescent parents through augmenting connections between families and providers and supporting advocacy efforts in the community.
Faculty Expertise: Dr. Conn and I have worked closely with parenting teens within the division of adolescent and young adult medicine at Children's Hospital Los Angeles over the last two years. My clinical experience includes caring for teen parents in addition to general adolescent medicine. I have presented on teen pregnancy and biopsychosocial outcomes for teen parents in a grand rounds presentation at Children's Hospital Los Angeles. Dr. Conn has led group sessions that engage teen mother and teen fathers and aim to improve several psychosocial domains including interparental relationships, intergenerational relationships, parenting approach and education and job skills. Dr. Conn and I have led several workshops for teen parents on general health and contraception. Dr. Conn is well versed in motivational interviewing and I have completed a year long motivational interviewing curriculum.

Sonia Lee, PhD1, Bill G. Kapogiannis, MD1, J. Dennis Fortenberry, MD2, Rachel C. Vreeman, MD
1Eunice Kennedy Shriver National Institute of Child Health and Human Development; 2Indiana University School of Medicine

Track: Research

Description: Adolescents and young adults 10-24 years represent over 25% of the world population. In 2013, over 75,000 adolescents aged 10-19 died from HIV/AIDS, making it the 2nd most common cause of death among adolescents in resource limited settings. Every hour, 26 adolescents (15-19 years) were newly infected with HIV in 2014 (220,000 total). In order to prevent HIV infections among young people, more targeted research on combination interventions (interventions combining biomedical interventions such as PrEP with social and behavioral youth-friendly approaches) are needed. Furthermore, interventions which take into account the multiplicity of factors from different levels (individual, partner, family, community) need to be developed and implemented. In tandem with efforts to enhance HIV prevention research with adolescents are efforts to improve health outcomes among those with HIV infection focusing on the HIV care continuum. Disability-Adjusted Life Year (DALY) rates due to HIV/AIDS have increased by over 2,600% among adolescents over the past two decades, with a ranking of 101 in 1990 that has risen to represent the world’s sixth most common cause of DALY in 2013 in resource limited settings. In order to turn the tide of HIV/AIDS among adolescents and young people, greater connections and synergistic efforts among researchers, clinicians, communities, youth, and public health agencies need to be fostered. Only by working together in a coordinated and concentrated manner will we accelerate reductions in new HIV infections and in AIDs-related deaths among adolescents.

Educational Objectives
  1. To gain up to date information on recent high-impact HIV research targeting adolescents in the US and in international settings, and to engage in a discussion on the highest priorities for adolescent HIV research
  2. To better facilitate ways to effectively garner relationships among researchers, clinicians, communities, youth and public health agencies
  3. To better navigate the legal and regulatory issues regarding adolescent enrollment into HIV research and the provision of adolescent HIV services
Faculty Expertise: Both Workshop presenters, Drs. Fortenberry and Vreeman, have extensive expertise in the field of adolescent HIV research with NIH grants, as well as relevant clinical experience. Furthermore, as evidenced by their respective CVs, both presenters have prior teaching, speaking, and publishing engagements on this Workshop topic. For example, Dr. Fortenberry is a Professor of Pediatrics and has guided a research program focused on adolescents over the past 17 years. He has also served as a research mentor to 17 adolescent medicine fellows, as well as other students and junior faculty members. Dr. Vreeman is an assistant professor of pediatrics, as well as a pediatrician. Furthermore, she is co-director of pediatric research for an academic collaboration between Indiana University School of Medicine and the Moi University School of Medicine in Kenya. Her research focuses on the development of instruments to improve children’s health care within resource-limited settings.

Elizabeth Miller, MD, PhD, FSAHM1, Alison Culyba, MD, MPH2
1Children's Hospital of Pittsburgh of UPMC; 2The Children's Hospital of Philadelphia
Track: Clinical Advances

Description: One in four female college students report experiencing sexual violence after matriculating at a college; prevalence is even higher among sexual minority students and students with disability.  The risk for sexual violence during the college years (especially in the first year) is significantly higher for those who have been exposed to sexual or partner violence prior to college.  This workshop examines the current research on college campus sexual assault, what modifiable factors contribute to sexual violence victimization and perpetration, as well as the overlap with other forms of violence exposure including intimate partner violence and childhood sexual abuse.  We will review the evidence base on clinic and community-based interventions which may help reduce sexual violence with an emphasis on integrated, collaborative models for prevention and intervention. We will synthesize best practice models for teaching youth about healthy relationships. Case-based scenarios will provide opportunity for participants to understand the pathways by which previous exposure to violence may increase risk for sexual violence, to explore the role of clinicians in sexual violence and relationship abuse prevention, to propose strategies for targeting prevention efforts towards high school students preparing to go to college, and to identify key stakeholders in school and community-based settings to participate in collaborative approaches to prevention and intervention.

Educational Objectives
  1. Describe the intersections of exposure to childhood abuse, adolescent relationship abuse, and sexual violence and the mechanisms by which such violence exposure may increase risk for sexual violence victimization during college years
  2. Practice strategies for providing trauma-informed universal education and brief counseling interventions for adolescents preparing to start college, including encouraging positive bystander behaviors
  3. Identify opportunities for collaboration with schools, faith-based organizations, and youth-serving agencies to promote healthy relationships and comprehensive sexuality education as preparation for college
Faculty Expertise: Faculty facilitating this workshop are members of the SAHM Violence Prevention Sub-committee. Miller has over a decade of experience developing and evaluating clinic and community-based prevention programs and intervention efforts to address sexual and partner violence. She is the lead investigator of a randomized controlled trial of a sexual violence prevention intervention across 28 college student health centers in Pennsylvania and West Virginia.  Culyba has expertise in strength-based approaches to prevent violence perpetration and victimization, with particular focus on the role of family and community in safeguarding youth.

Starting an Adolescent Addiction Program: the nuts and bolts of successful program development

Julia Potter, MD, Brittney Carney, MS, Ellen Kreida
Boston University Medical Center

Track: Clinical Advances

Description: Most adults with substance use disorders begin using substances during adolescence, making adolescence an opportune time to initiate substance use prevention and treatment efforts. In addition, an increasing number of opioid overdose deaths in the U.S. make opioid addiction an increasingly significant public health problem. Medication-assisted treatment is an evidence-based strategy that has shown efficacy in reducing morbidity and mortality from opioid use disorders, yet treatment options for adolescents are limited. Few adolescent-focused addiction treatment programs exist in the U.S. There is a need for shared experience with regard to best practices in adolescent addiction treatment. Addiction treatment is multidisciplinary at its core; collaboration between physicians, nurses, behavioral health providers, and community outreach workers is essential. This workshop proposal is particularly relevant to this year’s conference theme, as adolescent addiction and addiction treatment involves the family and social network. There is a need for shared strategies and research supporting how to best engage adolescents and their families in addiction treatment, as part of a treatment plan but also as a harm reduction strategy if the adolescent is not yet ready to engage in treatment.

Educational Objectives
1. Describe and compare multidisciplinary models of adolescent substance use treatment within various practice settings
2. Identify facilitators and barriers to adolescent addiction treatment program development and implantation
3. Engage in a dialogue about the real world experience of adolescent addiction treatment program development, including team building, identifying referral sources, addressing program adherence, engaging families, establishing funding, licensing, and maintaining confidentiality
Faculty Expertise: In my role as adolescent medicine attending at Boston University Medical Center, I have partnered with collaborators in addiction medicine and behavioral health to build a multidisciplinary adolescent addiction program. This experience is the jumping off point for the workshop. In this role, I have developed and delivered educational presentations for community health centers and other learners at our institution and become a waivered buprenorphine provider. As an adolescent fellow, I did an elective rotation with a pediatric addiction medicine specialist to inform my interest and to build a skill set in the area of adolescent addiction.
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