Workshops: Wednesday, March 14

1:00 - 2:30 p.m. Sessions

UNITY Consortium’s Three Cs Approach To Improve Adolescent Immunization Coverage: Implementing Confident, Concise, and Consistent Vaccination Recommendations and Overcoming Communication Challenges

Gregory Zimet, PhD, FSAHM1, Kathleen Garrett, MA, CTTS2
1Indiana University School of Medicine; 2Colorado School of Public Health/Colorado School of Medicine

Track: Clinical Foundation
Description: Universal childhood and adolescent immunization is an important tool to promote public health equity and reduce health disparities globally. In the US, there are immunization coverage gaps for ACIP-recommended vaccines for adolescents, particularly for HPV (first dose, series completion) and MenACWY (booster dose). These gaps are partially due to inconsistent and sometimes weak recommendations by healthcare providers, which may occur due to updates to vaccination guidelines, communication challenges for specific vaccines (e.g., HPV, MenB), and/or anticipation of parental hesitancy. This workshop will focus on UNITY Consortium’s Three Cs (3Cs) approach to the provider vaccine dialogue with parents/teens. The approach strives to simplify and strengthen provider recommendations with a bundled, equal emphasis amongst vaccines and same day vaccination recommendations. An assessment of parental disposition and the application of simple motivational interviewing techniques is also part of this approach. 3Cs not only has the potential to save providers time and encourage parental consent for recommended vaccines but also to create an age-based vaccination framework, particularly timely and relevant for acceptance of the new 16 year old platform. The 3Cs approach is most impactful when embraced by the entire office (e.g., physicians, physician assistants, nurse practitioners, nurses, and office staff) and incorporated across office processes to facilitate consistent communications with parents/adolescents. This multidisciplinary workshop, therefore, is relevant for all health professionals who are involved with adolescent immunization. Also, while focused on the US vaccination schedule, many of the skills that will be taught are applicable to immunization efforts in countries around the world.
Educational Objectives: 
  1. Identify the elements of a strong provider recommendation for adolescent vaccinations routinely recommended at the 11, 12, and 16 year office visits
  2. Determine differences in parental disposition relating to vaccination consent and identify when and which motivational interviewing techniques can be applied
  3. Verbalize and initiate incorporation of Three Cs (confident, concise, consistent) provider recommendations for adolescent vaccines
Faculty Expertise: Dr. Zimet has conducted extensive research on attitudes and communications related to the acceptance/refusal of adolescent vaccines. His studies have involved evaluations of adolescents and young adults, parents of adolescents, and health care providers as well as assessments of various vaccine communication intervention strategies. His research has included collaborations with domestic as well as international investigators. Ms. Garrett is a member of the Motivational Interviewing (MI) Network of Trainers. She has trained over 1,000 health care providers in the clinical application of MI. Since 2013, Ms. Garrett has actively engaged in research applying MI as a communication intervention strategy to help improve adolescent vaccination rates. Dr. Zimet and Ms. Garrett collaborated on UNITY Consortium’s Three Cs quality improvement project that was implemented in three pediatric practices in Nevada, New Jersey, and Indiana. (


Developing Training Programs in Adolescent Health: An international perspective
Daniel Hardoff, MD1, Joan-Carles  Surís, MD, MPH, PhD2, Helena Fonseca MD MPH PhD3; Irene N Melamed MD MSc4; Lilian Wong MD MPH5; Abigail Harrison Wong MD6
1Israel Center for Medical Simulation – MSR; 2University of Lausanne’s Medical School; Faculty of Medicine of the University of Lisbon, Portugal; 3Latin American Faculty of Social Sciences, Argentina; 4Latin American Faculty of Social Sciences, Argentina; 5Board of Directors of the Hong Kong Pediatric Foundation; 6University of the West Indies, Kingston, Jamaica

Track: Training/Education
Description: The International Association for Adolescent Health (IAAH) declared in a position statement that adolescent medicine and health is a unique branch requiring special training. Formal fellowship programs in adolescent medicine have been developed in the US, and later on in Canada and Australia. However, the need for training programs in adolescent health has been acknowledged in many countries all over the world and different training modalities that are not recognized as formal fellowships have been developed for healthcare professionals as well as for undergraduate students (e.g. the website based program – EuTEACH; the UK Adolescent Health Project; post-graduate courses; simulation-based workshops). This workshop is designed both for international adolescent healthcare professionals who want to start a training program in adolescent health (no matter how small) and for those who are already involved in operating one. Participants will be able to share views and experiences with international peers, and those who are in the process of developing or wish to start with such programs in their countries or their medical centers will have the opportunity to learn about a variety of training programs that may be applicable for them. In light of this meeting’s main theme, this workshop is timely for adolescent healthcare providers who see a future for adolescent health equity in preparing a younger generation of professionals for the mission of comprehensive caring for adolescents’ health.
Educational Objectives: 
  1. Exposure to different modalities of training programs in adolescent health (long-term post-graduate courses; intensive short-term courses; simulation-based workshops; internet-based self-education programs).
  2. Understanding barriers to the establishment of training programs in adolescent health and the need for a stepwise approach in the development of such programs.
  3. Provision of opportunities for participants to share views and start networking with international professionals who have already gained experience in developing educational programs in adolescent health.
Faculty Expertise: Dr. Hardoff: A pediatrician trained in adolescent medicine (1981-83), involved in the development of 6 community-based adolescent health centers in Israel. Until 2006 – Adolescent Medicine Division director at the Bnai-Zion Medical Center in Haifa. Dr. Hardoff is a co-founder of the Israel Society for Adolescent Medicine. He operates simulated-patients-based programs regarding communication with adolescents. Dr. Hardoff was a co-director of 3-year post-graduate diploma courses in adolescent medicine at the Tel Aviv University. Prof. Surís: A pediatrician trained in adolescent health (1990-92). He was involved in teaching adolescent health in Spain (1992-2003) and currently (since 2003) in Switzerland. He is one of the founders of the EuTEACH program and was the director of its summer school (2008-2013). He is currently the director of a summer course on adolescents with chronic conditions and responsible for the pediatrics module at the University of Lausanne’s Medical School where he teaches adolescent health.

3:00 - 4:30 p.m. Sessions

"Socioeconomic Disparities: Prevention and Treatment of Obesity in Adolescents”
Marsha B. Novick, MD, FAAFP1, Heather Twible, RDN, CD2, Erik Schlocker, MSW, LICSW2, Alicia Dixon Docter, MS, RDN2
1Penn State Health, Penn State Milton S. Hershey Children's Hospital; 2Seattle Children's Hospital
Track: Clinical Foundation
Description: Childhood and adolescent obesity continues to be one of the most important international and national public health concerns. In the United States, poor diet coupled with a sedentary lifestyle is now the leading cause of preventable death. According to the National Health and Nutrition Examination Surveys (NHANES), approximately 20% of American adolescents are obese. Although reports from the Centers for Disease Control and Prevention (CDC) suggest that the youth obesity epidemic in the United States has plateaued, this trend masks a growing socioeconomic gap: According to NHANES and the National Survey of Children’s Health, the prevalence of obesity among high-socioeconomic status adolescents has declined over the past decade, whereas the prevalence of obesity among their low-socioeconomic status peers has continued to increase. This workshop highlights these data trends and explains causes of the growing disparities in adolescent obesity, including issues such as food deserts and decreased physical activity disparities in lower socioeconomic populations. The goal of this workshop is to present a practical and evidenced-based approach on how to identify vulnerable adolescents and to promote a healthy lifestyle, including a discussion of the 5-2-1-0 Plan and physical activity recommendations.
Educational Objectives: 
  1. Identify current concepts and causes for the increasing socioeconomic disparities in adolescent obesity.
  2. Apply the AAP’s guidelines for the staged approach to the management of childhood obesity, including the 5-2-1-0 Plan and screening for food insecurity
  3. Identify components of a practical, stepwise approach to treating childhood obesity in a busy outpatient office setting
Faculty Expertise: Marsha Novick, MD, FAAFP, Family Physician, Associate Professor of Pediatrics, and Director of the Pediatric Weight Loss Program at Penn State Medical Center, specializes in obesity medicine. She lectures through the Pennsylvania AAP and the AAP’s Section of Obesity and serves on the American Board of Obesity Medicine Advisory Board. Heather Twible, RD, Clinical Dietitian at Seattle Children's Hospital, currently cares for adolescent patients with obesity as part of a multidisciplinary team that offers a developmentally appropriate approach to the treatment of obesity. Erik Schlocker, LICSW, Adjunct Faculty and lecturer at University of Washington School of Social Work and UW LEAH (Leadership Education in Adolescent Health) faculty, is a social worker in the Division of Adolescent Medicine at Seattle Children's Hospital. Alicia Docter, MS, RDN, manager in Nutrition and Adolescent Medicine Dietitian at Seattle Children's Hospital, is UW LEAH core faculty and clinical instructor with the UW School of Nursing.

Global Initiatives in Educating and Training the Adolescent Health Workforce: Applying New Guidelines, Models, and Technology
Patricia K. Kokotailo, MD, MPH1, Irene Melamed, MD, MSc2, Susan M. Sawyer, MBBS, MD3
1University of Wisconsin School of Medicine and Public Health; 2Latin American Faculty of Social Sciences; 3The University of Melbourne

Track: Training/Education
Description: New investments are needed to build the future workforce for policy, programing, research and clinical care in adolescent health and medicine across the world, both in high income settings as well as in resource-poor settings where most adolescents live. A number of educational and clinical standards, competencies and resources have recently been developed by the World Health Organization (WHO) and other organizations, such as the American Board of Pediatrics. Dissemination of best practices in education and determination of the quality of education remain a challenge. In this interactive, multidisciplinary workshop, we will present recent guidelines, recommendations and competency-based standards for educating undergraduates, postgraduates and practicing physicians, which focus on both resource poor and other nations. These will be framed within the context of the Global Strategy for Women’s Children’s and Adolescents’ Heath, the 2016 Lancet Commission on Adolescent Health and Wellbeing, and the 2017 Global Accelerated Action for the Health of Adolescents (AA-HA!) from the WHO. Evidence-based pedagogical techniques will be discussed and newer methods of teaching and learning, such as use of Massive Open Online Courses (MOOCs) and other online resources will be demonstrated. Discussion of practical use of social media in teaching is planned. The potential to incorporate such educational techniques in a recently developed conceptual framework will be included. Participants will work in small groups to share resources and develop implementation strategies that are aligned to their own educational structures, with attention to multidisciplinary learning and cultural issues.
Educational Objectives: 
  1. Describe the current standards, guidelines and recommendations for competency-based, evidence-informed education in adolescent health, with emphasis on the needs of low and middle-income countries, for multidisciplinary education.
  2. Describe effective pedagogical techniques in adolescent health, including online educational resources such as Massive Open Online Courses, to provide sustainable education at all learner levels and enable better measurement of quality in education.
  3. Describe how educational resources and pedagogical techniques can be incorporated into a conceptual framework and strategize steps in instituting application of educational programs at institutional, regional, national, and international levels
Faculty Expertise: All three faculty are highly experienced clinical educators in adolescent health. In addition, Prof. Kokotailo is the lead author of the Adolescent Entrustable Professional Activities Curriculum for the American Board of Pediatrics. She and Prof. Sawyer recently worked with the World Health Organization reviewing competency-based education and training in adolescent health. A paper on this work, including the development of a conceptual model for educational implementation, is currently under review at the Journal of Adolescent Health. Prof Sawyer led the development of the first Massive Open Online Course (MOOC) on global adolescent health, a highly scalable educational intervention. Her Centre also runs a multidisciplinary, fully online Certificate, Diploma and Master Program in Adolescent Health and Development at The University of Melbourne, Australia. Based in Argentina, Prof. Melamed works with many different online programs in Latin America, and has interests in continuing professional education, bioethics, and primary care initiatives.

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