Workshops: Thursday, March 15

11:00 a.m. - 12:30 p.m. Sessions 

Tackling the Global Problem of Adolescent Opioid Use Disorder
Steven C. Matson, MD1, Margret W. Chang, MD2, Eva M. Moore, MD, MSPH3, Cara C. Young, PhD, RN, FNP-C4, Alyssa Richard-Figueroa, MSW, LCSW5
1Nationwide Children’s Hospital; 2Family Health Center of Worcester / UMass Memorial Health Care; 3British Columbia Children's Hospital; 4University of Texas at Austin; 5Community Healthlink, Inc.

Track: Clinical Advances

Description: Opioid use represents a significant threat to adolescent health. Drugs are now the leading cause of death for people under 50 and opioids are responsible for 40% of overdose deaths. Opioid misuse is associated with a significant increased risk of heroin use with four out of five new heroin users reporting they started with misusing opioid analgesics (Jones, 2013; Martins et al., 2017). Effective treatments are available but underused, particularly for adolescents and young adults. The purpose of this workshop is to provide attendees with the basic information & tools needed to treat adolescents and young adults in an outpatient setting with a focus medication assisted treatment (MAT). Multiple learning strategies will be used to learn about medication approaches as well as best practices regarding care coordination and counseling for MAT patients. Attendees will leave inspired to complete a buprenorphine training course. Through a ‘lessons learned’ approach, the expert panel of presenters, representing a range of disciplines, will utilize patient cases to facilitate discussion regarding the nuances of serving the complex needs of substance using youth. All disciplines are encouraged to attend as best practices for curbing morbidity and mortality associated with the opioid epidemic requires involvement of the full spectrum of adolescent health professionals. At the conclusion of this workshop, attendees will be equipped with practical knowledge that can be disseminated within their respective organizations to increase knowledge of, and ultimately access to, MAT strategies to improve the health of adolescents who suffer from opioid addiction.

Educational Objectives:
  1. Recognize the growing worldwide crisis related to opioid use
  2. Explore treatment strategies for opioid use disorder and overdose prevention, with particular attention to medication assisted treatment in the office setting.
  3. Analyze common issues that arise in identifying and treating adolescents with opioid use disorder.
Faculty Expertise: The interdisciplinary team is comprised primarily of members from the SAHM Subcommittee for Alcohol and Other Drugs. Dr. Matson has served as the Director of the MAT for Addiction Clinic at Nationwide Children’s Hospital since 2009. He is also a member of Ohio’s Opioid Medical Support Clinical Advisory Panel. Dr. Chang is a Medicine-Pediatrics physician who provides MAT for adults and teens. She also leads a med-school elective in adolescent substance use. Dr. Moore, committee chair, has worked to support youth affected by substance use in British Columbia for the last 5 years including training youth in overdose prevention and distributing naloxone kits. Dr. Young’s research is focused on development of novel integrative behavioral interventions for adolescents with comorbid substance use and psychiatric disorders. Alyssa Richard-Figueroa (LCSW) works in direct care and community outreach as a SUD Recovery Clinician for youth and as an ED Crisis Intervention Specialist.

2:30 - 4:00 p.m. Sessions

“I Don’t Think Doctors Think About Vaginas”: Strategies to reduce disparities and promote sexual and reproductive health for young women with pediatric-onset chronic disease
Susan Gray, MD, Traci Kazmerski, MD, MS
Boston Children's Hospital

Track: Clinical Advances

Description: Adolescent and young adult women with many pediatric-onset chronic diseases (POCD) have seen major improvements in their life expectancy and health outcomes over the past several decades. As these women live longer and healthier lives, they increasingly face a variety of concerns around their sexual and reproductive health (SRH). Many young adults with chronic medical conditions and disabilities receive some reproductive health education from schools, parents, media, or peers about topics such as birth control, pregnancy and sexually transmitted infections, but only a small percentage receives specific information about disability and sexuality. This lack of information puts them at risk for poor health outcomes. For example, women with sickle cell disease or rheumatologic conditions are often prescribed teratogenic medications and those with pulmonary hypertension face seriously increased morbidity and mortality if they become pregnant. The presenters will share both quantitative data delineating disparities in SRH education and outcomes of women with chronic medical conditions, and also new qualitative data on young women with cystic fibrosis and cerebral palsy to provide context about the lived experience of patients with POCD.

Educational Objectives:
  1. Attest to the need for improved education about sexual health for young women with chronic medical conditions.
  2. List the highest priority areas for sexual and reproductive health care discussion for young women with chronic medical conditions
  3. Identify resources for both patients and providers that expand upon sexual health topics broached at a health visit.
Faculty Expertise: I have been site co-PI for the multisite Transforming Healthcare for Women with Disabilities study funded by the Cerebral Palsy Foundation for the past two years. Our work has included both quantitative and qualitative studies of disparities in SRH education and care. I have spoken on this topic nationally, including at the AACPDM and the AAPM&R. My co-presenter Dr. Kazmerski is an accomplished researcher and brings the perspective of a practicing pediatric pulmonologist. Her publications include: Kazmerski, T.M., et al. “Attitudes and decision making related to pregnancy in young women with cystic fibrosis.” (2016). Maternal and Child Health Journal. Kazmerski, T.M., et al. “Patient and provider attitudes regarding sexual health in young women with cystic fibrosis.” (2016). Pediatrics. 137(6). pii: e20154452. Kazmerski, T.M., et al. “Cystic fibrosis program directors’ attitudes toward sexual and reproductive health in young women with CF.” (2016). Pediatric Pulmonology. 51: 22-27.

Transyouth Care – Self-reflection On Personal Biases and Their Impact On Care
Mandy Coles, MD, MPH1, Johanna Olson-Kennedy, MS, MD2, Aydin Olson-Kennedy, MSW, ACSW3
1Boston University Medical Center; 2Children’s Hospital Los Angeles; 3Los Angeles Gender Center

Track: Clinical Foundation

Description: As medical providers, we are expected to be objective when providing patient care. Despite the expectations of objectivity, we all hold personal values that can influence how we respond to patients. Some of these values are very clear to us and are easily articulated. Others exist at a deeper level and may influence how we treat patients without our awareness. Our values also change as we gain life and professional experience. As humans, we are judgmental people. Professionalism involves separating the judgments that we make as humans from the care that we provide for patients as professionals. In this session, we aim to use the above framework of values clarification to become more aware of the unconscious biases and challenges that we, as providers across different disciplines, all have in regards to caring for transgender and gender diverse youth and adolescents. We also hope to explore considerations of underlying rationale for treatment decisions and limitations and programmatic choices within a cis-normative environment. We will use a number of interactive exercises (about 30 minutes each) to reach session aims. We will end this session with a presentation by a gender diverse patient and/or parent sharing their perspective on how provider values can impact medical care.

Educational Objectives:
  1. To reflect on one's own feelings and values about transgender and gender diverse individuals
  2. To become self-aware of one's own feelings and biases around caring for transgender and gender diverse individuals
  3. To discuss clinical interactions around gender care that may make us feel uncomfortable
Faculty Expertise: As medical directors of leading centers for gender care, Drs. Coles and Olson-Kennedy have been providing care for gender non-conforming and transgender children, youth, and young adults for more than two decades combined. Dr. Coles is the chair of the SAHM education committee chair and has presented at numerous national workshop and institute presentations. In her role as co-director of an Adolescent Medicine rotation, she leads a values clarification program for pediatric residents. Dr. Olson-Kennedy speaks across the United States and internationally about the needs of transgender youth, and the existing barriers to appropriate and timely intervention. Mr. Olson-Kennedy is the Executive Director of the Los Angeles Gender Center. In addition to mentoring gender-diverse you and providing therapeutic support for families, he also presents nationally and internationally through educational seminars and invited presentations on topics of gender care, youth, and mental health.

Enhancing the Management of Adolescent Nutritional Disorders: The Role of Credentialed Nutrition Professionals (CNP)
Alicia Dixon Docter, MS, RDN, CD1, Maya Michelle Kumar, BMSc, MD, FAAP, FRCPC2, Yolanda Evans, MD, MPH1, Preeti Manmohan Galagali, MBBS, MD, PGD AP3, Lauren Mozer, BA4
1Seattle Children's Hospital; 2University of California San Diego; 3Bangalore Adolescent Care & Counselling Centre; 4University of Washington

Track: Clinical Foundation

Description: Adolescence is a unique window of opportunity to prevent the onset of chronic nutritional disorders, address specific nutritional behaviors, and support youth while they are nutritionally vulnerable due to high energy requirements for growth, increased risk-taking behavior, and increased peer and environmental influence. Credentialed Nutrition Professionals (CNP), which include, Registered Dietitian Nutritionists (RDs or RDNs) in the United States, Canada, and Israel, are optimally qualified and experienced in providing individualized medical nutrition therapy to at-risk adolescent patients of all races, cultures, religions, sexual orientations, gender-identifications, and health statuses using biopsychosocial and developmental approaches. Unfortunately, CNP services are often not accessible to adolescents due to variability in health insurance reimbursement, poor access to health care, lack of knowledge among medical providers about the benefits of CNP referral, and/or lack of qualified CNPs in many regions of the world. The lack of CNP services in low- and middle-income countries (LMICs), where adolescents increasingly experience overweight and/or undernutrition, is particularly concerning. This session aims to educate providers on how the involvement of a CNP enhances the management of adolescent nutritional disorders, discuss ways that providers can improve equitable access to CNP services among their adolescent patients, and explore public health strategies to improve CNP access for adolescents in LMICs. Our multidisciplinary, multinational panel will facilitate audience discussion about integrating CNPs into their clinical practice and advocating for equitable access to CNP services. The session will also include narratives from adolescent patients on how CNP services have helped them overcome nutritional challenges.

Educational Objectives:
  1. Discuss ways that providers can improve equitable access to Credentialed Nutrition Professional services among their adolescent patients
  2. Describe how the involvement of a Credentialed Nutrition Professionals enhances the management of adolescent nutritional disorders
  3. Assess public health strategies to improve access to Credentialed Nutrition Professionals services for adolescents in low- and middle-income countries
Faculty Expertise: Our multinational expert panel and presenters have over 117 years of combined experience in managing challenging adolescent nutritional disorders in healthcare systems across the globe. Our collaborative and multidisciplinary team of physicians, dietitians, PA-C, and managers are actively involved in advancing adolescent medicine through clinical research and publications, advocacy, policy, and education of both health professionals and community members. We are experienced in providing care for nutritional complications such as restrictive eating disorders, overweight/obesity, nutrient deficiencies, and malnutrition in the inpatient, outpatient, and community settings. Audience members will benefit from the expertise of our experiences, and will leave with a clear understanding of the tangible successes health professionals and adolescent patients experience when working with a Credentialed Nutrition Professional.

Amplification of Youth Voices in Partnerships for Change

Renee Kinman, MD, PhD, MAEd1, Sarah Stender, MD1, Kelly  Colwell-Walker, MA Special Education2, Jeffrey W. Hutchinson, MD COL, US Army3
1University of California, San Francisco-Fresno; 2Fresno Unified School District; 3F. Edward Hébert School of Medicine Uniformed Services University

Track: Public Health/Advocacy

Description: Pediatricians have a unique ability to operate at the intersection of adolescent health, education, and mentorship by training pediatric residents to step out of the practice setting and partner with school systems and others in the community to effectively impact child health on a larger scale in their community and beyond. In a large urban inner city high school of the San Joaquin Valley, a constructivist (Piaget: experiential) approach is being used to link pediatricians in training with extremely high risk minority youth. Through cultivation of meaningful personal relationships and the use of social media, including Kahoot surveys created and implemented by the youth themselves, both young physicians on their Adolescent medicine rotation and minority high school students work together on topics of their concern ranging from sugar sweetened drinks and obesity to gender/ethnicity stereotyping. By utilizing the combination of a “Youth as Partner” approach and community partnerships, and by leveraging the power of social media to amplify youth voices to reach a greater audience, pediatric residency programs thus have the opportunity to advocate for improvements in the social determinants of health that adversely affect the health of many children and families in both the United States and abroad. This workshop promises to blend the “Youth as Partner” approach to community and adolescent health with the evolving digital world in an effort to achieve the best of sustainable outcomes for both personal as well as community health.

Educational Objectives:
  1. Describe the development of a “Participatory Action Project Toolkit” for community health, including the use of various educational technology and social media approaches pertinent to improving adolescent health
  2. Identify how to create innovative collaborative partnerships between pediatricians and adolescents that result in the amplification of youth voices to help overcome the challenges of the social determinants of health
  3. Describe the benefits of collaborative "youth as partner" approaches to improve adolescent health within the local community for both physician and adolescents
Faculty Expertise: Renee Kinman holds a master’s degree in education, with an emphasis on social justice and the use of technology in education. As a pediatric endocrinologist and member of the UCSF Academy of Medical Educators, she is passionate about education and utilizes both a constructivist approach and motivational interviewing to create a “youth as partner” approach to adolescent health. She has received grants from the Community Pediatrics Training Initiative and the Institute on Medicine as a Profession to develop educational curriculum in community pediatrics and advocacy. Renee is a member of the Fresno Unified School District Medical Advisory Committee, the Fresno Unified Career Technical Education Advisory Committee, and the Fresno Unified School District Health Careers Advisory Committee, and is currently serving as a Champion Provider Fellow in a program sponsored jointly by UCSF and the California Department of Public Health to improve the health of communities beyond the clinic setting.

Going Global: Building Adolescent Health Partnerships
Areej Hassan, MD, MPH1, Erwin Calgua, MD, MSCE2, Juan Carlos Reyes Maza, MD3, Hayley Teich, MD1, Sarah Golub, MD1
1Boston Children's Hospital; 2Universidad San Carlos de Guatemala; 3Hospital San Juan de Dios

Track: Training/Education

Description: The inclusion of adolescent health in the UN Secretary General’s Global Strategy as well as the creation of targets directly linked to adolescent health in the post-2015 Sustainable Development Goals framework speak to a growing global health focus. However despite remarkable advances, access to youth friendly health services, the distribution of essential resources, and opportunities for additional training are variable, with vast health disparities noted in low and middle income countries (LMICs) which house the majority of the global adolescent population. In the last decade, there have been increasing numbers of partnerships between academic institutions in high income countries (HICs) with formal adolescent medicine programs and LMICs to build sustainable professional capacity in their partner countries as well as create opportunities for trainee exchanges, medical education, and collaborative research. This workshop aims to describe a successful model of academic collaboration in adolescent health, introduce a blueprint to guide development of international partnerships, and provide knowledge, resources, and practical strategies in fostering sustainable collaborations with measurable and defined impacts. Speakers will discuss their experiences in working together on a national adolescent health program in Guatemala.

Educational Objectives:
  1. Describe key elements in developing and structuring partnerships
  2. Discuss practical strategies to address challenges including cultural barriers, limited resources, financing, and lack of governmental recognition and/or support
  3. Share perspectives and lessons learned from personal experience in establishing, fostering, and sustaining partnerships
Faculty Expertise: Dr. Hassan directs global health programming for the Division of Adolescent Medicine at Boston Children’s Hospital. She currently is involved in adolescent health curricula and training program development at multiple sites in Central America and Asia. Dr. Calgua is a Professor of Research in the School of Medicine and the Director of the International Cooperation Office at Universidad de San Carlos de Guatemala. He has led partnerships with numerous institutions in a diverse number of specialties including adolescent health. Dr. Maza is the Chief of Pediatrics at San Juan De Dios Hospital. He established the first interdisciplinary adolescent clinic, Atención Integral del Adolescent, which has since become a model for the provision of adolescent health care throughout the country. Dr. Teich is part of the Department of Global Health at BCH and the former Director of EMAS Indonesia partnership. Dr. Golub is a third year adolescent medicine fellow in the Global Health Pathway tract.

2:30-4:00 p.m. Sessions

Utilizing a Developmental Science Lens to Inform AYA Practice & Policy
Ron Dahl, MD1; Nick Allen, PhD2
1Center for the Developing Adolescent, Institute of Human Development, University of California, Berkeley; 2Department of Psychology University of Oregon; Director, Center for Digital Mental Health; Director of Clinical Training

Track: Research
Description: Recent developmental science research offers the potential to identify windows of opportunity to inform AYA health policies and practice. This workshop will begin with an overview of a transdisciplinary developmental science of adolescence. Presenters will then illustrate a transdisciplinary approach to AYA health through brief presentations with exemplars of clinical examples.  Workshop participants will actively engage in discussion of strategies to leverage developmental science to advance AYA health. 

Educational Objectives:
  1. Participants will understand key findings from adolescent developmental science research.
  2. Participants will understand how a transdisciplinary approach to AYA health can inform practice through clinical examples. 
  3. Participants will be aware of how developmental science research may offer the potential to identify windows of opportunity to inform AYA health policies and practice.
Faculty Expertise: Drs. Dahl and Allen are leaders of the Center for the Developing Adolescent, a core partner of the Adolescent and Young Adult Health Research Network AYAH-RN ( Dr. Dahl presented the Gallagher lecture at the SAHM 2016 meeting and is senior author of the AYAH-RN’s review article on Leveraging Neuroscience to Inform Adolescent Health (org/10.1016/j.jadohealth.2016.12.010). Dr. Dahl’s current work focuses on emotional regulation, brain development, and adolescence as a developmental period with unique opportunities for early intervention and prevention. Dr. Allen is a leading researcher in the area of clinical depression, known especially for his work on the relationship between biological and interpersonal aspects of adolescent development and risk for the onset of depression. His recent work focuses on identifying potent, modifiable risk factors for poor mental health during adolescence, and developing and testing preventative interventions that target these risk factors.  Dr. Allen directs the Center for Digital Mental Health at the University of Oregon, conducting research and building digital tools to enhance mental health –especially among underserved groups and young people.

SAHM Violence Prevention Special Interest Group: Bystander-based Interventions to Reduce Violence
Erin Alexandria Jones, MD1, Alison Journey Culyba, MD, Phd, MPH2, Nicholas J. Westers, Psy.D.3, Eric J. Sigel, MD4, Elizabeth Miller, MD, PhD, FSAHM5
1University of California, San Francisco; 2University of Pittsburgh School of Medicine; 3Children’s Medical Center Dallas; 4University of Colorado Children’s Hospital of Colorado; 5Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center

Track: Clinical Foundation

Description: While most research focuses on risk and protective factors for adolescent violence perpetration and victimization, less emphasis has historically been placed on the role of bystanders in multiple forms of violence including peer violence, sexual violence, and bullying. Violence during adolescence often occurs in the context of peer conflicts, and can result in violence unfolding in the presence of peer bystanders. More recently, violence broadcast over social media, such as Facebook Live, has raised new questions about the potential for online peer bystanders. This SIG will provide a brief overview of the role of bystanders as passive observers, instigators, and de-escalators of violence using psychological theory and informed by adolescent neurocognitive development. We will review the epidemiology of bystander involvement in peer violence, sexual violence, and bullying using peer-reviewed research and national surveillance data as well as provide an overview of innovative research to study bystander involvement in violence depicted on social media. We will critically appraise interventions that leverage bystanders to reduce violence and brainstorm how existing evidence-based interventions can be applied to prevent other forms of violence. We will discuss innovative approaches to help shift social norms around bystander involvement and promote advocacy efforts that empower bystanders to intervene to prevent violence. This workshop will serve as the Violence Prevention Special Interest Group meeting, and will include time to address SIG business at the end of the session.

Educational Objectives:
  1. Recognize the role of bystanders in multiple forms of adolescent and young adult violence
  2. Synthesize psychological and developmental theories that inform adolescent bystander behavior
  3. Critically appraise existing evidence-based bystander-focused violence prevention models and identify opportunities to adapt these strategies to new trends in violence amongst adolescents and young adults
Faculty Expertise: Faculty facilitating this workshop are members of the SAHM Violence Prevention Special Interest Group. Erin Jones, MD is a clinical fellow in adolescent medicine with a background in family and community medicine in urban settings. Alison Culyba, MD PhD MPH is a researcher and clinician with expertise in strengths-based approaches to peer violence prevention. Her research focuses on fostering social connections to reduce violence exposure. Nicholas Westers, Psy.D. is a clinical psychologist with expertise in violence toward the self, including suicide and nonsuicidal self-injury. He frequently teaches and presents on nonsuicidal self-injury. Eric Sigel MD’s research focuses on violence prevention and intervention through the primary care setting; currently he has an NIJ funded project focusing on training health care providers how to counsel families on firearm risk. Elizabeth Miller, MD PhD’s community-partnered, stakeholder-engaged research focuses on interpersonal violence prevention among adolescents, with particular emphasis on dating violence and reproductive coercion.

Collaboration or Coercion: Challenges in prioritizing vulnerable youths’ agency and autonomy in contraceptive counseling interactions with health care providers
Brandi Shah, MD, MPH1, Aletha Akers, MD, MPH2
1Pacific Medical Centers; 2Children's Hospital of Philadelphia

Track: Clinical Foundation

Description: Recent commentaries describe how features of reproductive coercion are extrapolated from romantic relationships to other relationships that involve power dynamics, including the patient-provider relationship. Reproductive coercion is traditionally defined as behaviors intended to maintain power and control over someone’s reproductive health. As gatekeepers of services at the crux of female autonomy, reproductive health care providers must acknowledge developmental capacity of adolescents and young adults (AYA), as well as power asymmetries in the patient-provider relationship that undoubtedly influence patients’ reproductive decisions. This session will highlight how principles of reproductive rights and justice inform family planning services when providing care to AYA, particularly those who are marginalized. Successful utilization of reproductive health services requires awareness and skills for articulating one’s reproductive goals, and for thinking abstractly about how reproductive choices help or hinder achievement of goals. These are advanced skills, developed through self-determined interactions with the healthcare system; thus, they are frequently underdeveloped among AYA seeking contraceptive services. Negotiating these interactions is often worse for youth marginalized by identity, place, economics, trauma and other social determinants of health, rendering them further disenfranchised from the healthcare system. This session will orient participants to the context and impact of this disenfranchisement, including the potential for real or perceived coercion in healthcare interactions. Attendees will critically compare contraceptive counseling approaches through a rights-based lens that centers youth, their personal agency, and their lived experience in order to maintain a balance of influence and achievement of reproductive health goals.

Educational Objectives:
  1. Apply principles of a reproductive justice framework and knowledge of historical legacies when developing contraceptive counseling approaches that affect whether, when and how youth present for contraceptive services
  2. Differentiate nuances of reproductive coercion or oppression on youth when exercised by intimate partners, parents/caregivers, institutions and/or health care providers
  3. Translate knowledge gained in session to identify youth engagement and counseling skills they can practice to maximize patient autonomy and to activate youth to minimize discrepancies between their reproductive goals and actions
Faculty Expertise: Dr. Shah practices family and adolescent medicine. She works at the intersections of rights-based sexual and reproductive health service delivery, community engagement and positive youth development. Her clinical work and research has focused on many settings domestically and internationally, focusing on service and system improvements for underserved youth. She works closely with public health, legal and community partners to center voices and agendas of marginalized youth and women in healthcare innovation. Dr. Akers is an expert in pediatric and adolescent gynecology. She has experience developing and evaluating public health programs and health services interventions to improve adolescent and young adult health in both academic and community settings. Her research focuses on improving reproductive health outcomes among adolescent women by reducing unintended sexual health outcomes by increasing adolescents’ access to high quality reproductive health services. Dr. Akers is widely published in the fields of medicine, public health, and the social sciences.

Chronic Cannabis Use Disorder in Adolescents: Helping Young People in a Changing Global Landscape
Julie Potter, MD1, Pam Matson, PhD, MPH2, Eva Moore, MD, MSPH3
1Boston Medical Center; 2Johns Hopkins School of Medicine; 3University of British Columbia

Track: Clinical Advances

Description: Increased legalization of marijuana in jurisdictions across the world has made counseling adolescents about marijuana use increasingly difficult. While literature shows that there are significant negative neurocognitive and other health effects of chronic marijuana use in adolescence, including decline in IQ and increased risk of psychosis, increasingly permissive attitudes about marijuana use make it challenging to engage teens and their families in treatment. There are a handful of evidenced-based interventions which address cannabis use disorders, including group and individual cognitive behavioral therapy, motivational enhancement therapy, community reinforcement approach counseling, family therapy, and contingency management. In addition, there are promising data regarding medications for cannabis use disorders among adults. However, a small minority of individuals with cannabis use disorders accesses these interventions and there is little data on the adolescent specific experience. Moreover, there is a need for shared experience with regard to best practices in adolescent cannabis use treatment. This workshop will mobilize shared strategies from across international jurisdictions to explore how to address problematic adolescent marijuana use, identify limitations of available evidence, and strategize how to uphold health equity when it comes to substance using adolescence. Presented by the SAHM Subcommittee for Alcohol and Drugs, this diverse, interdisciplinary team working across multiple US and international jurisdictions will lead an interactive, globally-focused workshop designed to build clinical care, research and advocacy dialogues around this timely topic.

Educational Objectives:
  1. Address the changing perception of risk with regard to adolescent marijuana use in the context of increasing global decriminalization of marijuana and legalization of marijuana for medical and recreational use
  2. Examine evidence-based strategies for treatment of adolescent cannabis use disorder, with a focus on contingency management
  3. Address the role of parents/family members in treatment of adolescents with cannabis use disorders
Faculty Expertise: Presented by members of SAHM’s Subcommittee of Alcohol & Drug Abuse, this interdisciplinary North American team brings research, education, training, and clinical experience. Dr. Potter in an Adolescent Medicine Specialist instrumental in starting the Center for Addiction Treatment for Adolescents/Young Adults (CATALYST) at Boston Medical Center which was presented at SAHM 2017. Dr. Matson is an epidemiologist and Director of Research for Johns Hopkin’s Leadership Education in Adolescent Health program, and studies the role of adolescent relationship context on drug use. She has numerous publications on substance use in adolescents and is funded by NIDA and the National Institutes of Justice. Dr. Moore is an Adolescent Medicine Specialist in British Columbia working with substance using youth in the hospital, outpatient and community settings. She is the SAHM Subcommittee lead and developed innovative strategies to reach vulnerable adolescent as part of the Social Pediatrics Program in Vancouver, BC.


Recent Advances in Caring for Transgender Youth
May Lau, MD, MPH1, Jason Jarin, MD2, Meredith Chapman, MD1
1University of Texas Southwestern; 2University of Texas Southwestern, Children's Health

Track: Clinical Advances

Description: Transgender care is an evolving area within adolescent health and medicine. A multidisciplinary focus is needed to provide optimum care to transgender youth. Given that transgender youth can be found around the world, their providers need to remain up to date in the care and management of transgender youth. The Endocrine Society will be releasing their updated guidelines for caring for transgender individuals in 2017. These guidelines will be compared with the standards of care guidelines from the World Professional Association for Transgender Health, an international interdisciplinary professional organization whose focus is to further the understanding and treatment of gender dysphoria. The most recent medical, psychiatric, and psychological research will be reviewed, along with their applications to the care of transgender youth. Finally, the care and management of transgender youth with special considerations such as medical, psychiatric, or psychological needs will be explored.

Educational Objectives:
  1. State the changes in the most recent Endocrine Society guidelines regarding care of transgender youth and compare these changes with the World Professional Association for Transgender Health Standards of Care guidelines.
  2. Explore the latest research in the care and management of transgender youth.
  3. Discuss the management of transgender youth with special considerations.
Faculty Expertise: Dr. Lau has been providing care for transgender youth in a multidisciplinary clinic since 2013. She has been invited to speak locally and nationally on transgender health. She also conducts research with transgender youth. Dr. Jarin has spoken at The North American Society of Pediatric and Adolescent Gynecology Annual Clinical and Research Meetings and Annual Gender Spectrum Conferences on the care of transgender adolescents. He has had his research on transgender youth published in Pediatrics, Pediatric and Adolescent Oncofertility, Contemporary Ob/Gyn, and Postgraduate Obstetrics and Gynecology. Dr. Chapman is the director of mental health services in a multidisciplinary transgender youth clinic and has spoken locally, nationally, and internationally on mental health issues among transgender youth.

Adolescent Health Policy in Practice: Tools to Achieve Health Equity and Justice for Adolescents
Andricus A. Hutcherson, M.P.P.1, Krishna K. Upadhya, MD, MPH2, Aixa Y. Alemán-Díaz, M.A. Public Policy3, Stephanie Q. Quiring, JD4
1Indiana University; 2The Johns Hopkins University of Medicine; 3University of St. Andrews; 4Indiana University School of Social Work

Track: Public Health/Advocacy

Description: Policy formulation and implementation are primary mechanisms for driving public health strategies, programs and services. Public health researchers and practitioners are key stakeholders who influence policy development, decision making, and oversight of programs and services. Recent shifts in federal, state, and local policies have changed program criteria and funding formulas that have traditionally supported the work of researchers and practitioners. There is rising concern on how these changes will adversely affect access to resources that support research and programs for vulnerable populations in the US and around the globe. This workshop will describe US and international legislative and policy priorities in adolescent health, and examine strategies for integrating science, strategic planning and technology tools to create policies that help organizations address these shifting criteria. In addition, participants will understand how to use these tools and strategies to increase the effectiveness of advocacy goals. This workshop will be led by policy experts who have developed, managed, and implemented legislation, policies, programs and services at the federal (Executive and Congress), state, and local levels of government. Their substantive areas of expertise include: grassroots advocacy, lobbying, criminal law, mental health, workforce development, poverty reduction, economic development, strategic planning and evaluation, and building public\private partnerships.

Educational Objectives:
  1. Understand the governance landscape where domestic and global health strategies, policies and programs for adolescents are shaped, funded, and implemented.
  2. Understand the funding and legislative priorities set by the Executive Branch and Congress, fiscal and programmatic implications, and areas where researchers and practitioners can take part in influencing policies to improve health outcomes.
  3. Learn how to develop effective advocacy campaigns and incorporate tools and communication strategies to help health experts maximize their organization's sphere of influence with government officials and policy stakeholders in the US and around world
Faculty Expertise: Hutcherson, adjunct professor at Indiana University, has worked over 15 years teaching policy, developing legislation, policies, and providing political strategy and advocacy consulting services to elected officials, government agencies, non-profit organizations, and companies in Chicago, San Francisco and Washington, DC. Dr. Krishna Upadhya, an Assistant Professor of Pediatrics at Johns Hopkins School of Medicine, has been involved in federal and local policy advocacy and translation of research findings to inform policy development. Aixa Y. Alemán-Díaz is Policy Advisor for the WHO Collaborative Centre for International Child and Adolescent Health Policy at the University of St Andrews School of Medicine, she has also served as legislative counsel in the US Congress and Presidential Management Fellow at the US Department of Housing & Urban Development. Stephanie Quiring is an attorney who worked as policy advisor for the National Alliance on Mental Illness Indiana.

A Nepali Approach to Adolescent Medicine: Collaborative Curriculum Development in the Developing World
Betsy L. Fine, MD
University of Washington

Track: Training/Education

Description: One of the most effective ways to improve teen access to high quality health care is to provide training in Adolescent Medicine in pediatric post-graduate programs in developing countries. However, collaborating with international faculty to create an adolescent curriculum for a new pediatric residency in Nepal challenges the concept of a single standardized adolescent medicine syllabus. Developing a curriculum for an emerging nation requires the evaluation of the process by which we choose what to include as core elements and how we teach them. Nepal is an evolving economy with a disproportionately large number of youth – nearly 30% of the population. The public health issues of child marriage and early child bearing, domestic violence, and contraception education influence what should be taught. In such a setting, there is a clear need to address learners needs, to assess public health issues, as well as to develop faculty training - an approach applicable to any setting. In this interactive workshop we will address the issues of curriculum development as approached by an American trained faculty member working in collaboration with an international faculty to create an academically relevant and practical adolescent medicine curriculum. The case study is that of a new Nepali medical school with a mission to recruit and train physicians for rural practice that is tasked with developing a pediatric residency. The workshop will provide an approach to international curriculum development as we create an Adolescent Medicine rotation for Patan Academy of Health Sciences in Nepal.

Educational Objectives:
  1. Demonstrate the tools and techniques to assess learners competencies and deficiencies in a global setting.
  2. Establish a hierarchy of critical curricular areas based on the most pressing adolescent health problems in a developing nation.
  3. Create a program for faculty development in Adolescent Medicine to support a curriculum collaboratively produce in an international setting.
Faculty Expertise: I have been a faculty member at post-graduate programs for 24 years teaching at both Family Medicine and Pediatric Residencies affiliated with the University of Washington. During my tenure I have had the opportunity to develop and utilize innovative curriculum which are primarily experiential. Most recently I have collaborated with a team of behavioral health and educational professionals to develop a program to train primary care physicians in Pediatric Behavioral Health. My global health experience has also spanned my career working in the Ivory Coast, Haiti, Pakistan and Nepal.

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