The election of SAHM officers is now open and will conclude on Monday, January 4, 2021.

Listed below is the official slate of candidates. Candidates were asked to respond to questions developed by the Nominations Committee and their responses have been provided.

Ballots and voting passwords have been distributed to those eligible to vote. If you have any questions or if you experience any difficulties accessing the online ballot please contact SAHM Membership Services Manager, Nakeshia Betsill at 202-591-2493 or via email.

President-Elect (2021-2022) - choose 1 candidate

 

At-Large Board Member (2021-2024) - choose 2 candidates


Nominations Committee (2021-2023) - choose 2 candidates

 

President-Elect Candidates

 

Bonnie Halpern-Felsher, PhD, FSAHM  

 
Provide a brief personal statement describing your qualifications to be president of SAHM, including prior or current leadership positions in other organizations/institutions that have prepared you for this role.
 

I am absolutely honored to be nominated to serve as the next president-elect of SAHM. I am confident my passion, research, advocacy, and leadership promoting adolescent and young adult (AYA) health for the past 25 years allow me to best serve the SAHM community, AYAs, and their families. I am a tenured professor of Pediatrics, and professor (by courtesy) in the Departments of Epidemiology and Population Health and Psychiatry, at Stanford University.

I am the Director of Pediatrics’ Fellows’ Scholarship, co-leader of the Advocacy and Community Health Scholarly Concentration for the Pediatrics Residency Program, and Director of Research, Division of Adolescent Medicine.

As a developmental psychologist with training in adolescent and young adult health, I have dedicated the last 25 years to promoting AYA health, including sexual and reproductive health, substance use prevention/education, teen driving, and educational and career choices. Translating my research, I create preventions/interventions such as the evidence-based internationally recognized Tobacco Prevention Toolkit and the Cannabis Awareness and Prevention Toolkit, which have reached over 1.7 million youth. I have also served on six National Academies of Sciences committees and three Surgeon General Reports focused on improving AYA health.

I am also a fierce advocate for health. I have testified in several states about AYA access to reproductive health care, and testified in numerous cities, counties, states, and the US Congress regarding policies to address the youth vaping epidemic. As a result of some of these testimonies, laws have been set and/or changed to better serve AYAs who are more vulnerable to targeted marketing and addiction.

As the beneficiary of outstanding mentoring, mentoring is at the core of my work. I have developed and direct several mentoring programs for underrepresented AYAs interested in careers in science and medicine, and employ a diverse 20-person Youth Action Board in our lab.

As a SAHM member for over 20 years, I am excited to bring my interdisciplinary work and leadership to the SAHM community. I have demonstrated service to the SAHM community in a number of ways: serving as a member of the program committee for four years, chairing the abstract review committee for annual meetings, collaborating with the Journal of Adolescent Health (JAH) to update the SAHM abstract submission system from “paper” to online submissions, serving for three years as an elected member-at-large of the SAHM Board of Directors, and serving as the Director of Programs. During that time, I ensured that we involved AYAs throughout the entire meeting. Finally, I have been an editorial board member of JAH for 15 years. In addition to my leadership roles at SAHM, I served for three years as an elected board member of the Society for Pediatric Research (SPR), as the Adolescent Medicine representative. During my tenure for SPR, I developed and implemented a fellows’ and junior faculty scholarship mentoring program, that continues today.

I have a long-term passion and commitment to working with the SAHM community and would be greatly honored to serve as the next president of SAHM.

 

What should SAHM’s leadership do to promote diversity, equity, and inclusion in its membership, policy statements, and advocacy at local, regional and national levels

I was the first to attend college in my family, grew up low income, and was homeless for a time during my adolescent years. I was told that as a woman I should abandon my dream of graduate school and instead focus on supporting my husband’s journey through his MD/PhD program. Through persistence, mentorship, and some good fortune, I was able to achieve my education and career goals. Despite my early challenges, I am afforded many privileges as a white woman and have not experienced the impact of systemic racism. It is through these experiences that I answer this and the following questions.

Activities that SAHM leadership can and should do to promote diversity, equity, and inclusion across membership, policy statements, and advocacy include: 

  • Membership: We need to grow our membership, not just in numbers but also in the impact our members have on diversity, equity, and inclusion. To increase the value of SAHM membership, leadership can ensure that interested members have a meaningful role in SAHM, and ensure SAHM offers educational, clinical, research, and advocacy opportunities of interest to all members.
  • SAHM’s Strategic Plan: I would work with leadership and members to update SAHM’s strategic plan to include explicit goals and action items to promote diversity, equity, and inclusion, in particular to address social determinants of health. I would ensure that these goals and action items are informed by scientific evidence; SAHM members’ voices at the international, national, and regional levels; and input from AYAs and their families.
  • Policy Statements: SAHM has an inspiring policy statement, “Racism and its Harmful Effects on Nondominant Racial-Ethnic Youth and Youth-Serving Providers,” that reaffirms SAHM’s commitment to justice, diversity, equity, and respect. I would ensure the positions and actions outlined in this statement are fully put into action by SAHM members, in working with other organizations, clinicians, researchers, policymakers, and AYAs and their families, to further reduce systemic racism.
  • Putting Words into Action: We need at the core of our work to educate our membership on diversity and inclusion, unconscious bias, social justice, and health disparities that are affecting the health of adolescents and their families in the US and globally. However, it is not enough to have these statements in our strategic plan, policy statements, or education; we need to act on diversity, equity, and inclusion principles by creating specific action items SAHM and members can and will enact. As SAHM president, I will work with a diverse group of SAHM members, AYAs, and families to develop a specific action plan, and put into place a timeline to carry out the plan.
  • Advocacy: I would work with SAHM leadership and members to develop advocacy capacity. Diversity, equity, and inclusion must be an active component of every committee action plan and annual meeting. SAHM members are fierce advocates and I want to empower our diverse members to be actively engaged in advocacy that engages in these ideals. This would entail providing media and social media training, legislative advocacy training, and others. 

What role, if any, should SAHM play in addressing the problem of systemic racism in the United States, particularly as it relates to the health and well-being of racial and ethnic minority adolescents and young adults

SAHM should not only play a role in addressing systematic racism, it should be a leader in this effort. We need to address social determinants of health and address systemic racism in everything we do, focusing on systems changes as well as individual-level changes. Specifically: 

  • Healthcare: SAHM needs to advocate for a healthcare system change. We need accreditation standards that require safe spaces for all patients; requisite training for all clinicians in accredited programs; adequate health insurance for all AYAs, including for mental health services; and training to recognize and confront unconscious biases that exist in the healthcare setting, including in screening, counseling, and treating AYAs and their families. SAHM should also work with the APPD, ABP, and ACGME to ensure that all clinicians, including residents and fellows, receive education that ensures the health needs of all AYAs are met, regardless of gender, socioeconomic status, sexual orientation, insurance, and other social determinants of health.
  • Justice System: SAHM needs to advocate for justice reform, to move from punishment to treatment, including police reform. SAHM needs to be at the forefront of and lobbying for such changes.
  • Research: Rarely are the concepts of social determinants of health, unconscious bias, and social justice considered in the research we do, but these concepts must be at the forefront when designing our studies, samples, and data collection instruments. SAHM leadership and members should lobby the NIH and other large institutions to require diversity, equity, and inclusion in all research. Specifically, we need to: (a) start with diverse and inclusive research leaders who then provide training, mentorship, and support for a more inclusive research team; (b) revise our sample inclusion and exclusion criteria to ensure a diverse sample is included; (c) engage members of the community in our research, from the development of the research question to the dissemination of the findings; and (d) address race as a social construction and not a biologic construct.
  • Inclusion of AYAs and Families: I want to have a policy agenda in which we address the roots of systemic racism by engaging AYAs and their families to move this agenda forward. We need to include AYAs and their families, our ultimate stakeholders, in everything we do, from the development of our position statements to our committee work, and in developing our advocacy, policies, and programs. In so doing, we need to train and educate those working with these AYAs to ensure a meaningful and safe bi-directional working relationship between AYAs and SAHM, whereby both the AYAs and SAHM benefit, teach, learn, and thrive from this relationship.

As SAHM president, I will strive and work tirelessly to ensure that these policies, positions, and ideas are not just statements, but are actioned. I will work with the SAHM leadership, our membership, AYAs and their families. Making these changes takes us all working together, to generate new ideas and ensure those ideas are implemented. I look forward to working with all of you to make that happen.

 

What do you think is the most challenging issue to assure that all teens (regarding/regardless of race, country of origin, gender, religion, sexual orientation, abilities, and appearance) are able to reach their full potential in life? As President of SAHM and leader of experts in adolescent and young adult health, what ideas do you have for improving SAHM’s role in addressing this issue at regional, national and international levels?

There are several challenges to assuring that all AYAs reach their full potential. No doubt, as discussed above, systemic racism, disparities in the justice system, and inequitable healthcare access have significant negative impacts on AYAs. Here I will focus on a related core challenge and critical social determinant of health: education. We have a significant divide in the education of teens that widens further when there is a crisis. For example, during this COVID-19 pandemic, we are witnessing teens behind in school because they don’t have internet access, computers, or a quiet workspace. We see parents struggling to balance between keeping their children and themselves safe from COVID-19 while having to work. We see schools with resources doing well, and schools without resources struggling even more to educate students remotely, furthering the educational divide. These educational disparities existed long before the pandemic and are being further exacerbated.

SAHM leaders and members have the opportunity and responsibility to play a role in reducing the educational divide but must do so in a way that is sustained over time. There are several ways that SAHM leaders can help:

  • Educational environment: Clinicians should inquire about the educational environment of their patients: school attendance, safety, internet access, and devices for distance learning. Often youth have to work or care for younger siblings after school, thereby reducing their ability to complete homework or participate in extracurricular activities. SAHM members can work with youth and their families to develop plans, write letters, and advocate to help each patient obtain the best education possible. We also need to reach youth who are out-of-school, to support them to return to school or make action plans that help them reach their full potential.
  • School involvement: SAHM members can make a difference by volunteering in schools, educating educators and school leaders, advocating for healthier school lunches, addressing bullying on school campuses, providing education and prevention for substance use and sexual health, and so on. Our members are busy, but we can make a significant difference to our school systems, and in turn, youth. As the founder and executive director of two Toolkits, I spend a great deal of time working with schools. Health professional “champions” giving an evening talk to parents, speaking to schoolboards, or advocating for school needs, make a meaningful impact. As SAHM president, I would create a network of speakers within each state who can provide online and/or on-the-ground assistance to schools and communities.
  • AYA mentoring: As SAHM president, I would like to develop an AYA mentoring program, to mentor AYAs interested in science, health, education, advocacy, or other topics of interest. We have a wealth of talent and passion among our SAHM members. I recognize time is an issue, but mentoring can be anything from a Zoom call with an AYA to occasional meetings to full mentoring in clinics, schools, or research groups over a summer. These programs truly make a difference in the educational goals and attainment of our young people.
 

 

Paritosh Kaul, MD, FSAHM

 
Provide a brief personal statement describing your qualifications to be president of SAHM, including prior or current leadership positions in other organizations/institutions that have prepared you for this role.
 

SAHM became my academic home when I joined as a second-year pediatric resident, and I have been an active and engaged member for the past 22 years. I have been a consistent contributor and leader within and on behalf our organization, including attending every annual meeting since 1998. It is my great honor to again be nominated to run for the presidency of our beloved organization.

My leadership experience within SAHM began at the local level serving as the President of Rocky Mountain chapter and leading the School-Based Health SIG. I subsequently served as the Regional Chapter Presidents’ Representative to the SAHM Board of Directors, where I successfully extended the term of this position from two to three years. Later, as Director of Publications, I brought about systemic change to our Position Papers and Statement processes. These changes included: 1) initiation of a peer review process; 2) inclusion of an international perspective; and 3) ensuring all papers demonstrated cultural and ethnic competence. In the role of Director of Publications, I served as a non-voting member of the SAHM Board for 5 years. Additional service to SAHM was on the Program, Education, Development, and Abstract Review Committees.

Currently, I am a Professor of Pediatrics at the University of Colorado School of Medicine (UC SOM) in the Section of Adolescent Medicine. I am the Director of the longitudinal 4-year course on Culture, Health, Equity, and Society. Since 2017, I have served as the Co-Chair of the Midpoint Promotion Committee. In 2018, I was awarded the Excellence in Mentoring and Advising Award from UC SOM for my impact on the University community as a mentor to students and faculty. Nationally, I am a member of the American Academy of Pediatrics (AAP) Section on Adolescent Health (SOAH) Executive Committee, where I serve as co-chairperson of the education subcommittee and co-editor of the first ever Pediatrics supplement dedicated to adolescent health topics, which substantially expanded the adolescent health footprint within the AAP (published in May 2020). I also serve as a senior faculty advisor for the Young Professional Leadership Alliance. My service and leadership also expands to the North American Society for Pediatric and Adolescent Gynecology (NASPAG). My experience working with health care professionals and systems have contributed significantly to my growth as a physician, educator, and leader – widening my horizons and teaching me how to work, communicate, and motivate those with varied life experiences.

The global pandemic has challenged us to be innovative and persevere through uncertain times. Throughout the years, I have worked through multiple challenging transitions within SAHM: Our name change to include the word “health” (SAM to SAHM), our management structure, and two strategic plans. Being involved with SAHM during these transitions provides me with a framework for negotiating future uncertainty.

While I am a US-based adolescent medicine physician, my prior practice as an obstetrician-gynecologist in India and Family Medicine physician in rural Oman gives me a global perspective of the international issues that span the spectrum of the developing to the developed world. Professionally, I work and learn from my interdisciplinary colleagues and mentors. I am also the son of a pharmacist and brother of a social worker. My background gives me a perspective that allows me to work with all disciplines that are part of the global SAHM family.

In all the positions I have held, I have successfully created an environment and culture of bringing people and groups together to develop consensus across professionals holding various opinions. In all of these endeavors, I have made every effort to bring sensitivity, depth of understanding, and an abiding commitment to both service and building group identity. I have served in different capacities in SAHM and bring stability and a longitudinal perspective to our organization.

 

What should SAHM's leadership do to promote diversity, equity, and inclusion in its membership, policy statements, and advocacy at local, regional, and national levels?

All adolescents need acceptance irrespective of ethnicity, race, country of origin, gender, religion, sexual identity, sexual orientation, abilities, and appearance. SAHM must continue working to promote diversity, equity, and inclusion (DEI) in its membership, policy statements, and advocacy at local, regional, and national levels. We need to partner with other organizations that also prioritize these values. There is a need to establish a pipeline to the health field as early as high school and college that introduces traditionally underrepresented and underserved individuals to adolescent health as a career. SAHM should also reach out to leaders within graduate programs in medicine, nursing, psychology, nutrition, social work, and public health disciplines to create opportunities to attract them to our field by offering travel awards and mentorship with adolescent health experts. Our policy statements must continue to explicitly and implicitly promote DEI similar to how we always include an international perspective (a policy I created as Director of Publications). Our advocacy efforts should include interdisciplinary partnerships with other organizations that have developed campaigns against racism such as the American Public Health Association and the AAP. Our leaders should have a demonstrated commitment to this area of work as a part of their career trajectory; I have a demonstrated commitment to DEI efforts.

I am an immigrant who came to the US as a practicing Obstetrician and Gynecologist in India and in the Sultanate of Oman. I spent two years in the United States alone, trying to negotiate and understand the health care system. The issue regarding DEI is very personal to me because my family and I have personally experienced exclusion and inequity. I have worked tirelessly to champion this cause. My efforts have included advocating at the local School Board against the racial bigotry and exclusion my children suffered in middle and high school. During my tenure as Director of Publications, each Position Paper/Statement addressed cultural competency issues. I have served on the SAHM multicultural committee and was a co-author on SAHM’s first position paper on racial and health disparities. I have a record of accomplishments of working on DEI issues that include undergraduate medical education, work in Pediatrics and at the university level, and influencing DEI in my national leadership roles. I have created an evidence-based and effective cultural competency curriculum. Additionally, a core facet of my mentorship and scholarship has been in DEI.

These experiences have forced me as a leader to listen, adapt, and respond to a wide variety of people and circumstances. I have utilized my superior communication skills and the ability to build trust to collaborate with diverse key stakeholders to achieve common goals. I am recognized nationally as a leader in cultural competence training. The skills I have gained personally and professionally will enhance my ability to serve as SAHM President for all of our members.

 

What role, if any, should SAHM play in addressing the problem of systemic racism in the United States, particularly as it relates to the health and well-being of racial and ethnic minority adolescents and young adults?

Racism—a system of structuring opportunity and assigning value based on physical attributes unfairly disadvantages some and advantages others--drains society by wasting human resources. Racism, a social construct, is also a social determinant of health that profoundly impacts the health status of adolescents, emerging adults, and their families. Despite progress towards racial equality and equity, racism continues to have a negative impact on health and well-being through implicit and explicit biases, institutional structures, and interpersonal relationships. Failure to address racism will continue to undermine the health of adolescents, and young adults, and their families.

As the leading organization for adolescent health, SAHM must address the problem of systemic racism in the United States, particularly as it relates to the health and well-being of adolescents and young adults of color. SAHM needs to advocate for all adolescents and young adults (AYA) survivors and victims of racism and other forms of bias.

First, we need to create culturally safe medical settings where AYAs receive care. Affected care settings include large health systems, school-based health settings, college health services, community health centers, private practices, juvenile justice systems, and behavioral and mental health settings. Next, SAHM needs to facilitate the development of a workforce to lead and provide care and enhance disfranchised AYA's health and well-being that is sensitive to these issues, recognizes their own biases, and committed to dismantle racism. SAHM should continue to create professional development opportunities for established adolescent health professionals to promote cultural humility and continuing education activities that encourage self-reflection and action to dismantle racism. SAHM needs to be part of a systematic change through community engagement, education, advocacy, program development, public policy, and research.

 

What do you think is the most challenging issue to assure that all teens (regarding/regardless of race, country of origin, gender, religion, sexual orientation, abilities, and appearance) are able to reach their full potential in life? As President of SAHM and leader of experts in adolescent and young adult health, what ideas do you have for improving SAHM's role in addressing this issue at regional, national and international levels?

Many challenging issues undermine a community's ability to support all adolescents' ability to reach their full potential by fostering a growth mindset. SAHM has become a leader in addressing this issue at regional, national, and international levels through effective collaborations. Using national and global networks and partnerships with organizations focused on adolescent health will be critical for significant change. Fostering a growth mindset grounded in a youth development model in our work will better ensure that every adolescent can reach their full potential.

While proud of my accomplishments and career development today, I strive to pay it forward and give back what I have received from my colleagues, mentors, and the greater SAHM community. Serving as President of SAHM during this period of great challenge and opportunity would be an honor and privilege.

.


 

At-Large Board Member Candidates

  

Anisha Abraham, MD, MPH

 

Write a personal statement describing your prior involvement in SAHM and other organizations/institutions that has provided you the necessary experience and exposed you to situations that will enable you to make a unique contribution to the Board.  

 

I have been a member of SAHM for nearly 25 years. Over this period, I have developed strong collaborative relationships with other members working towards SAHM’s collective mission. I am currently Director of Programs, overseeing the development of our upcoming virtual annual conference in March 2021. In this role, I regularly interact and make decisions alongside fellow Board members, the Executive Staff, and Program Committee members, all of which has given me a strong understanding of our organizational leadership and strategic plan along with experience in handling change resourcefully. Having been a member of our vibrant International Chapter, has allowed me to experience first-hand the importance of bringing diverse global voices to our organization. Over the years, I have also served as the Chair of the Development Committee, President of the Chesapeake Chapter, I have been a member of the Multidisciplinary Committee and co-chair of SIGSs. All these roles have given me insight into SAHM's governance along with our advocacy, financial and membership needs all of which are relevant for a Board role. Outside of SAHM, I have been active in several NGOs and organizations such as the American Academy of Pediatrics and the Children’s Medical Foundation. As a clinician, researcher and former military physician who has lived in the US, Europe and Asia, I have worked on promoting adolescent health in different communities including at Chinese University in Hong Kong and University of Amsterdam in the Netherlands. As an educator and teen health advocate, I recently published a parenting book on Raising Global Teens, and I speak regularly on teen health issues to the media, schools, and multinational organizations. I have been strongly committed to SAHM over the years. I believe my experience in promoting teen health in the US and internationally, my background in working with complex organizations plus my avid interest in communications and advocacy, would make me a productive and effective member of the Board.

 

How can SAHM best support its members, in the US and beyond, in the current political and social climate?

The current political and social climate has worsened racial discrimination and economic inequality, leading to major upheaval in our country and beyond.

Against this background, SAHM must continue to speak out on behalf of the well-being of adolescents and unite with like-minded organizations in public advocacy efforts. We need to recognize the value of our work that is grounded in scientific research and compassionate understanding of youth. Creating forums for discussion of common experiences along with harnessing collective voices are powerful tools in catalyzing change and supporting members. Innovative platforms, such as the SAHM virtual chat series we started this year, have been beneficial for members to share challenges, pool resources and connect on advocacy efforts. Other ideas include ensuring regular newsletter- and social media updates to disseminate timely information, continuing to partner with teen health organizations to build presence in various communities, providing opportunities for advocacy training and use of standardized tool kits. Also, we need to actively promote SIGs and collaborate on policy statements with other top US and global groups on adolescent-related issues in high-impact media outlets.

 

What role, if any, should SAHM play in addressing the problem of systemic racism in the United States, particularly as it relates to the health and well-being of racial and ethnic minority adolescents and young adults? 

Since its inception, SAHM has been an organization that stands firm on its commitment to serving and empowering adolescents and creating positive change in the US and around the world. As a physician of South Asian background who works with black and brown youth, I believe we need to continue to be strong advocates and play a key role in addressing racism and discrimination. We should do this by developing and disseminating policy statements on systemic racism to broad audiences, publishing op-eds and regularly engaging with the media. We should also share cutting edge research and clinical best practices during our educational sessions and hot topics, which can then be leveraged by different communities. We need to encourage our regional chapters and national organization to take an active role in advocating to end racist systems that prevent many adolescents from living fully productive lives. Also, we need to work on solutions that will lay a new foundation of opportunity for youth affected by racism and bias. Finally, we should engage thought leaders to inform our work and provide forums for youth and young adults to safely share their views.  

 

What brings you back to SAHM, year after year?

I went to my first meeting in 1996 as an adolescent medicine fellow from Children’s National Hospital in Washington, DC. I loved the shared passion, energy and creativity that I observed at that meeting and I have attended the annual conferences ever since. SAHM has provided me with the opportunity to develop strong connections with leaders, colleagues and trainees across disciplines and communities. I am grateful for the mentorship and support I have received from this wonderful organization that has become my professional home over the years.
 

 

Todd Callahan, MD, MPH, FSAHM

 

Provide a brief personal statement describing your prior involvement in SAHM and other organizations/institutions that has provided you the necessary experience and exposed you to situations that will enable you to make a unique contribution to the Board.  

It is an honor to stand for election for SAHM’s Board of Directors. The central aims of my professional and academic career are to facilitate research and clinical care for adolescents, young adults, and families and to collaborate with colleagues worldwide to advance education and advocacy for those caring for this important population. SAHM continues to be an important catalyst for these aims.

I have been a member of SAHM since 1999 and was elected Fellow in 2010. During my twenty-one years with SAHM, I have had the privilege of serving in several leadership roles in the organization. I am completing my second term as Chair of the Research Committee, was a two-term Chair of the Awards Committee, and was a member of thesearch committee for the Editor of the Journal of Adolescent Health. I have also served as member of several SAHM committees (Awards, Credential Review, Program, Abstract Review, Research) and led Special Interests Groups in the organization.

In addition to my roles in SAHM, I am the Director of the Division of Adolescent and Young Adult Health and Professor of Pediatrics at Vanderbilt University Medical Center, and Director of the Eating Disorders Program. I am an Associate Editor of Neinstein’s Adolescent and Young Adult Health Care. I was appointed to the Adolescent Medicine Sub-board of the American Board of Pediatrics and will serve as its Chair for the next two years.

In these roles, I have been fortunate to collaborate and lead with individuals from all walks of life and from a variety of specialties and expertise—both within and outside of health care. The connecting theme for each successful venture is seeking and valuing the perspectives of all stakeholders. If elected, I will continue to seek and value the perspectives of the many stakeholders that SAHM serves.

 

How can SAHM best support its members, in the US and beyond, in the current political and social climate?

Global health, geopolitical, and social challenges spotlight the importance of SAHM, its members, and its mission. Injustice and inequity in health, opportunity, and agency are focal points in each of our respective communities and nations. I think of two principal ways that SAHM supports its members. The first is “internal support”—we turn to SAHM to connect with colleagues, develop ideas, and build consensus. The second is “external support”—SAHM can amplify messages, build coalitions and take an idea from one or a few members and project it outward to the world.

The current climate presents unprecedented opportunity and urgency for us to develop our internal and external support structure. Internally, we must continue to develop ways of engaging and supporting SAHM members virtually and asynchronously. The pandemic has made this a necessity, but given SAHM’s global membership, it has long been needed and will continue to be a priority beyond the pandemic. We should prioritize methods of engaging members in thinktanks, education, research, and advocacy using video conferencing, social media platforms, and archived programming. Future meetings should include a virtual component for those who cannot travel to the meeting’s location. We should include opportunities for researchers to present and receive feedback on their work without being physically present. Investing in these measures should broaden SAHM’s reach and increase the diversity and experience of its membership.

SAHM’s “external support” of its members will also benefit from the development of the platforms noted above. Beyond this, SAHM can support its members by advocating for them—using these platforms to call attention to health priorities and improving networking for clinicians so that providers never feel alone in their care of adolescents. It is also critical for SAHM to use its platform to shine a light on the way that the global pandemic, politics and social injustices affect the health and health care of adolescents.
 

What role, if any, should SAHM play in addressing the problem of systemic racism in the United States, particularly as it relates to the health and well-being of racial and ethnic minority adolescents and young adults?

It is impossible to be a proponent of adolescent health without addressing problems of systemic racism. Racism is a social determinant of health, with far-reaching implications for the well-being of youth, families, their communities, and the professionals who care for them. SAHM has a rich history of thought leadership and advocacy for culturally competent care and the recognition of implicit and explicit bias and its effects on education, research, and health care. SAHM members and the SAHM Diversity committee are to be commended for being champions for diversity and inclusion. In each of our endeavors, SAHM must assess its role in addressing systemic racism. Our priorities should be to:

  • Acknowledge implicit and explicit racism within our disciplines and societies
  • Diversify our membership, committees, and leadership
  • Be a leader in research, quality improvement, and implementation of culturally competent care for adolescents, young, adults, and their families
  • Advance validated metrics for assessing and addressing the impact of racism
  • Develop and promote positive youth development programs
  • Engage leaders across organizations and disciplines to coordinate programs to counter racism and to address racial and ethnic disparities

As individuals and an organization, we have an obligation to confront racism, promote diversity, and eliminate disparities for adolescents and families, our membership, colleagues, and our communities.

 

What brings you back to SAHM, year after year?

I come back to SAHM because of each of you. SAHM is a collection of individual members with a shared passion to further the health of adolescents and families. When I am with SAHM’s members I am inspired, challenged, and motivated. I turn to members of SAHM for perspective and advice on health care, research, advocacy, and personal development. I benefit from the diversity of expertise, life experiences, and passions that each of the members bring to SAHM. The community of SAHM embodies much of the resilience, creativity, and energy that I find most admirable in the adolescent population. To participate in the missions of SAHM, an organization from which I have received so much, is an honor for which I am grateful.



Angela Diaz, MD, MPH

 

Provide a brief personal statement describing your prior involvement in SAHM and other organizations/institutions that has provided you the necessary experience and exposed you to situations that will enable you to make a unique contribution to the Board.  

Since 1989, I have served as Director of the Mount Sinai Adolescent Health Center, a unique youth-centered program in NYC that provides comprehensive, confidential care to young people ages 10-26 at no cost to patients. By breaking down economic and social barriers to care, we are able to provide high-quality, compassionate care to over 12,000 young people every year who otherwise may have gone without. Our services cater to young people from some of the most vulnerable (and resilient) neighborhoods in NYC—the majority of patients are low-income people of color, and many are trauma survivors. Over the years, the Center has greatly expanded. Our services now include integrated medical, sexual and reproductive health, optical care, health education, behavioral and mental health, as well as specialized programs for HIV-positive youth, pregnant and parenting teens, LGBQ and transgender youth, survivors of violence including human trafficking and legal services. The Center also has six school-based health centers, which provide care to 24 different middle and high schools. We place an emphasis on wellness and prevention, and view our work as a critical component of broader efforts toward health equity and racial, social and economic justice. Our wonderful, dedicated and highly skilled staff partner with youth and help them heal and thrive, truly helping transform these young people’s lives.

In addition to serving as Director of the Mount Sinai Adolescent Health Center, I am the Jean C. and James W. Crystal Professor in Adolescent Health in the Department of Pediatrics and Department of Environmental Medicine and Public Health at the Icahn School of Medicine at Mount Sinai.

I was elected in 2008 as a member of the Institute of Medicine (IOM) of the National Academies, now known as the National Academy of Medicine (elected to the IOM Council in 2013 and appointed Chair of the Board on Children, Youth and Families in 2013). In addition, I have been a member of the Board of Directors of the New York City Department of Health and Mental Hygiene and President and Chair of the Board of Trustees of the Children’s Aid Society of New York. In 2009, I was appointed by Mayor M. Bloomberg to the New York City Commission for Lesbian, Gay, Bisexual, Transgender and Questioning (LGBTQ) Runaway and Homeless Youth Taskforce. In 2003, I chaired the National Advisory Committee on Children and Terrorism for the US Department of Health and Human Services.

I am active in public policy and advocacy in the U.S. and have conducted many international health projects in Asia, Central and South America, Europe and Africa. I am a frequent speaker at conferences throughout the country and around the world.
 

How can SAHM best support its members, in the US and beyond, in the current political and social climate?

The COVID-19 pandemic has highlighted and exacerbated health disparities and racial and economic injustices in the U.S. and beyond. Young people are facing serious financial anxieties, racial injustices, tremendous grief, and deep uncertainty about their present and their future. This is on top of ongoing challenges many of them face based on race, ethnicity, gender, gender identity, sexual orientation, ability, immigration status and more. These issues don’t exist in silos, and there is tremendous intersectionality of all these issues and others, in the young people we serve at the Mount Sinai Adolescent Health Center. SAHM can best support its members by providing trainings and guidelines that recognize this and help providers address this range of issues in an intersectional way. This includes the support and mentorship of BIPOC and other minority members to create a more diverse workforce. Additionally, we live in an age of increasing misinformation and distrust in medical establishments. In response, SAHM can continue to provide clear, accurate and accessible resources aimed at families and young people, and guidance and trainings for providers on how to respond to this set of circumstances.

 

What role, if any, should SAHM play in addressing the problem of systemic racism in the United States, particularly as it relates to the health and well-being of racial and ethnic minority adolescents and young adults?

SAHM should play a central role in addressing systemic racism. The health outcomes of youth don’t exist in a vacuum, and health disparities can’t be addressed without directly addressing the root cause—organizational, systemic and structural racism. SAHM’s Anti-Racism Toolkit contains useful and necessary tools to address racial inequities. SAHM should continue to expand and develop the toolkit, and provide additional anti-racism trainings, guidelines and resources that align with the suggestions put forth in “Promoting Equity and Inclusion in Adolescent Medicine.” This also includes helping diversify the adolescent medicine workforce by providing critical mentorship to BIPOC students and trainees. In addition, the organization should focus on developing and influencing policies to help young people thrive and create a more just society, such as the right to a quality education, the right to health and health care, living wages for all, justice system reform and more. These priorities align closely with those of the Mount Sinai Adolescent Health Center, which has centered its work on racial, social and economic justice and achieving equity since its humble beginning in 1968.  
  

What brings you back to SAHM, year after year?

I have dedicated my life to helping young people heal, make healthy decisions for themselves, and ultimately thrive. Many of the Mount Sinai Adolescent Health Center faculty and trainees attend SAHM year after year. SAHM provides an opportunity to come together with and learn from the incredible adolescent medicine peers from across the country. As a reliable resource on all subjects related to adolescent health, SAHM’s top-notch training, innovative thinking and relevant resources help guide the thinking and practices of the Mount Sinai Adolescent Health Center. It’s critical to have a national organization dedicated to young people’s health that can provide necessary support and guidance.
 

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Errol Fields, MD, PhD, MPH 

 

Provide a brief personal statement describing your prior involvement in SAHM and other organizations/institutions that has provided you the necessary experience and exposed you to situations that will enable you to make a unique contribution to the Board.  

As an adolescent medicine subspecialist, a physician-researcher, and a faculty member in an academic medical center, I have dedicated my career to improving the health and life outcomes of adolescents and emerging adults through clinical care, health disparities research, and medical education and training. SAHM has been my primary professional home for the past 11 years not only because the organization’s mission is so well aligned with my own but because so many opportunities exist for members, especially early career members to be involved in that mission. As a SAHM member, I have been afforded several advisory and leadership opportunities including serving on the abstract review committee since fellowship, co-leading the HIV Special Interest Group (SIG) for 4 years, co-authoring a recent SAHM position paper on pre-exposure prophylaxis, and serving as the HIV/STI sub-committee chair for 3 years. I have also been an active member and leader in my regional chapter, Chesapeake SAHM, where I served on our executive committee for the past 6 years as member-at-large, president-elect and president.

I have made significant contributions in each of these roles. I am one of the longest standing reviewers on the abstract review committee and have been a consistent source of expertise on qualitative analysis and rigor. As HIV SIG co-lead, I developed SIG programming at our annual meetings that facilitated critical discussions between senior clinicians and researchers and early career SAHM members and fostered mentorship and academic collaborations. One collaboration, which was inspired through the HIV SIG, is a textbook I am editing on HIV Prevention and Treatment for Adolescent and Young Adults that will be published next year features chapters authored by members of the HIV SIG. As chair of the HIV/STI committee, I oversaw regular efforts to ensure SAHM position statements and clinical resources on the SAHM website reflected the most up-to-date guidance on adolescent sexual health and HIV care and prevention. While serving as chapter president, our executive board identified areas where our chapter was out of compliance with the organizational structure between SAHM and the regional chapters and related fiduciary requirements. There were significant barriers to achieving this compliance including limited financial and functional capacity to operate as independent business entities. These barriers were not unique to our region, and by alerting SAHM leadership to this systemic problem, the board was able to develop a new organizational structure that would better support the regional chapters and maintain compliance with fiduciary and tax requirements.

Outside of SAHM, I am an Assistant Professor at Johns Hopkins School of Medicine where I try to embody the school’s tripartite mission of clinical care, research, and education. As a clinician, I provide primary and subspecialty care for adolescents and young adults including gender-affirming care, inclusive sexual and reproductive health care, and treatment and prevention of HIV and other sexually transmitted infections. I co-founded and co-direct the Emerge Gender and Sexuality Clinic for Children, Adolescents and Young Adults in the Center of Adolescent and Young Adult Health at the Johns Hopkins Children’s Center. We started this multidisciplinary clinic 3 years ago and provide gender affirming care to 130+ patients in Maryland and the surrounding mid-Atlantic area. I also co-direct our PrEP is for Youth Clinic which provides PrEP and other HIV prevention services to Baltimore area youth at risk for HIV acquisition. Building on this work, a colleague and I were recently awarded Ending the HIV Epidemic funding by the Centers for Disease Control and Prevention and the Baltimore City Health Department for our Virtual Online Integrated SExual Health Services (VOISES) for Youth program which focuses on providing online HIV testing and HIV Care/PrEP linkage to sexual and gender minority youth at risk for HIV.  

As a scientist, my NIH and CDC funded research focuses on using mixed methodologies to understand and reduce racial disparities in HIV among young Black, gay, bisexual and other men who have sex with men as well as the evaluation of community-engaged practices for reducing stigma and medical distrust as key barriers to HIV prevention, treatment and research. I have been afforded several opportunities to share the expertise I have gathered from my research in related fields and settings. I serve on the School of Medicine’s Diversity Taskforce, which has been tasked by the Institutional Review Board with promoting equity in research based on age, race/ethnicity, language, and gender. I am currently serving on the Community Committee for the International Society for STD Research, 2021 STI & HIV World Congress. Our committee is tasked with increasing community engagement and highlighting community based participatory research as part of the scientific program. Finally I also serve on the African American/Black expert panel for National Institute of Allergy and Infectious Diseases (NIAID)-funded COVID-19 Prevention Network (CoVPN) tasked with reviewing the US government-sponsored COVID-19 vaccine efficacy trial protocols and providing an overall report of significance, impact, ethics and recommendations for African American/Black Communities.

In my education and training role, I am the associate program director for our Adolescent Medicine Fellowship Training program and support adolescent medicine fellows training in health disparities research for vulnerable and marginalized adolescents and young adults. I am also committed to the provision of evidence-based, culturally competent care of sexual and gender minority youth and I am involved in undergraduate, graduate, and continuing medical education in this area – including the development and implementation of LGBT curricula for medical student and resident education. Because the majority of adolescents will not be cared for by adolescent medicine physicians, I believe partnerships between adolescent medicine specialists and pediatric generalists are imperative for optimizing the care of adolescent populations. I consider education and training key components of these partnerships. I was recently elected to the Executive Committee of the Section on Adolescent Health in the American Academy of Pediatrics (AAP). In this role hope to contribute to the Section’s ongoing integration of adolescent health into continuing medical education for pediatricians.

In addition to the AAP, I have also held leadership positions within several other professional organizations. As a resident, I was selected for the Academic Pediatric Association (APA) New Century Scholars (NCS) program. The goal of this program was to increase the number of minority pediatric residents who pursued careers in academic medicine. Subsequent to my own participation in this program, I served as a junior mentor for four years and on the NCS Selection and Advisory committee for another two years. As a medical student, I was a national leader in the Student National Medical Association Board of Directors where I served on the Board of Director for 5 years in several roles including, National Secretary, Regional Director, Regional Director to the Executive Committee, and at the end of my tenure, the National Chairperson of the Board of Directors. Each of these experiences will inform the perspective I will bring as a member-at-large.

I am honored to be nominated for the member-at-large position on the SAHM Board I believe my leadership and commitment to SAHM at regional and national levels long with my skills, experiences, and expertise from my work outside of SAHM are important assets I would bring to the board. I would welcome the opportunity to contribute to the work of the SAHM Board should I be elected by the membership to serve.

 

How can SAHM best support its members, in the US and beyond, in the current political and social climate?

As adolescent health clinicians, researchers, and advocates, SAHM members need access to tools and resources that will help them support youth through current and future political, social and health crises. Adolescent providers who face political and legal threats to providing evidence-based care (e.g. comprehensive reproductive health or gender affirming care), whose patients feel under constant siege from systemic racism, or have limited access to care due to COVID mitigation strategies need access to up-to-date clinical guidelines and best practices for managing these barriers to care. Researchers who are building evidence base necessary to combat care that is otherwise politicized, developing interventions that reduce health disparities impacting vulnerable adolescents, or generating or testing hypotheses about the effects of these crises on adolescent health need forums to build collaborations and disseminate findings. Advocates for protecting adolescent confidentiality, increasing access to substance use disorder treatment services, ending gun violence and promoting safer schools and communities, and increasing equitable access to music education and team sports need a strong professional organization to support their efforts. SAHM can best support its members by providing access to these and other resources members need to promote and protect adolescent health against these threats.
 

What role, if any, should SAHM play in addressing the problem of systemic racism in the United States, particularly as it relates to the health and well-being of racial and ethnic minority adolescents and young adults?

All health providers and professionals have a critical role to play in addressing systemic racism especially as it relates to health equity and health disparities. I see SAHM’s potential role as threefold: 1) supporting and elevating youth voices and activism against racism and racial injustice; 2) advocating for adolescent health clinical competencies that ensure adolescent care settings are free from racial bias and equipped with skills to address the effects of exposure to racism; and 3) equipping SAHM members with the tools and resources t to support aforementioned roles through promoting and highlighting content within annual meetings, the Journal of Adolescent Health, committee initiatives, and partnership with other professional organizations.

 

What brings you back to SAHM, year after year?

A few years ago during SAHM’s 50th anniversary, I was interviewed about what brings me to the SAHM meeting every year. Here is what I said, “What’s always struck me about the SAHM annual meeting is that we’re all passionate about adolescents, adolescent care and adolescent health and because we’re a relatively small community coming to SAHM is like coming to a big family reunion. We all know each other, we’re all very passionate and you can only walk a few steps before you run into someone you haven’t seen since the last meeting and are drawn into conversations where you can share that passion and commitment…those connections are the magic of the SAHM meetings.” Of course, SAHM is more than our annual meetings, but for me, the community of adolescent health professionals has always been central to my SAHM experience. This community has afforded me with opportunities for professional development, leadership, mentorship, advocacy and a vehicle to enact change for youth and providers who care for them.

        


 


Nomination Committee Candidates

 

 

Preeti Galagali, MD, PGDAP, FIAP 

 

It is an honor to be considered for the SAHM nominations committee. I am amongst the first cohort of Indian pediatricians formally trained in adolescent medicine, and am one of the few in India today to offer comprehensive adolescent healthcare services. I am currently on the 2021 Executive Board of the Indian Academy of Pediatrics (IAP). I was the Convener of the Technical Advisory Group, Adolescent Health, Asia Pacific Pediatric Association in 2016-18. I have been an active member of SAHM for eight years and have worked towards its mission following its core values. Currently being in a leadership position in India in this field with significant professional experience in the region, I have an opportunity to realize the vision of SAHM of being a global leader for adolescent health, well-being, and equity.

As a trailblazer in adolescent medicine in India, I have been an integral part of the IAP team that revolutionized adolescent care bringing it into mainstream pediatrics. As Chairperson of the IAP Adolescent Health Academy in 2019, I pioneered the launch of the interactive website https://aha.iapindia.org/, the Indian Journal of Adolescent Medicine, and an online learning module for teachers. I currently serve as a trainer for the National Adolescent Health Program (Rashtriya Swasthya Karyakram). My work encompasses national and international design and conduct, training programs, workshops, and conferences for health professionals and other stakeholders. As a research scientist, I have published over 70 scientific peer-reviewed publications and have given over 200 talks at professional meetings. My advocacy for adolescent healthcare in India paired with the mentorship of the next generation of adolescent specialists has resulted in an emerging workforce dedicated to adolescent health. I have received several national accolades, including the prestigious Fellow of IAP award in 2018 for outstanding contributions to adolescent medicine.

I strongly believe in partnering with adolescents, parents, teachers, non-profit organizations, community and spiritual leaders, and government to ensure holistic wellness. In terms of outreach, I have conducted over 500 public health programs for over a hundred thousand adolescents and caregivers. During the current COVID-19 pandemic, I have kept this connection alive by conducting online professional education talks, school webinars, and social media presentations. I also facilitated the launch of national online yoga modules to calm youth distress due to isolation during the pandemic.

I am the first recipient of the SAHM International Travel Scholarship. I have subsequently served on SAHM committees (Media and Communications, Nutrition and Obesity, Mental Health) and contributed to two published SAHM position statements and four pending statements. I have fostered bonds between SAHM and IAP by inviting SAHM members to India for conference talks, webinars, as members of the editorial committee of Indian Journal of Adolescent Medicine, and the IAP Digital Wellness Committee (2020-21). I was a speaker at the Annual SAHM Meets 2018-2019 and a member of the Hot Topics Selection Committee in 2019-2021. I am on the International Adolescent Health Week Committee 2021, for selecting Adolescent Health Ambassadors.

I would be delighted to serve on the nominations committee to bring an international perspective to SAHM, which is critical for transforming healthcare in low and middle-income countries where 80% of the global adolescent population lives.
 


David Inwards-Breland, MD, MPH

 

I am deeply honored to be nominated for the Society for Adolescent Medicine (SAHM) Nominations Committee. Much of my professional career as an Adolescent and Young Adult (AYA) Medicine specialist was spent as an Assistant then Associate Professor at Seattle Children’s Hospital/University of Washington. While there, I served as Clinical Director of the AYA Clinic and Founder/Medical Director of the Seattle Children’s Gender Clinic. I recently relocated to Southern California to start the Adolescent and Young Adult Medicine Division at Rady Children’s Hospital/University of California, San Diego (UCSD) and become the Co-Medical Director of the Center for Gender Affirming Care. Recently, I was promoted to Clinical Professor of Pediatrics. I have been a member of SAHM for 14 years. In preparation for being considered for the SAHM Nominations Committee, I have been actively involved within the organization. During my very first SAHM meeting, as fellow at the University of California, San Francisco, I attended the Minority Provider Dinner and was so impressed with the activism of this group that I volunteered to plan the next year’s dinner. The connections and mentorship I gained while planning the dinner strengthened my continued participation in the organization. I found like-minded professionals caring for an awesome population of youth with a lens of health equity. In total, I organized two Minority Providers dinners. I also had the honor to organize the LGBTQA+ Providers dinner when the SAHM meeting occurred in Seattle. Through my involvement in organizing events during SAHM, I have had the opportunity to meet many of the SAHM membership yielding friendships and that have collaborative connections which have continued for many years.

As a Co-chair of the Male Health Sig for 3 years, I helped organize sessions on male health topics as well as collaborated with other Sigs (STI and Minority Sigs) which continued to foster relationships with many of the SAHM membership. A highlight in my involvement in SAHM was meeting future and current leaders in the field of Adolescent Health and Medicine which allowed me to see varying leadership styles that have propelled SAHM forward. During my 2-year term on the Program Committee, I gleaned the educational and programing needs of the membership. I presented research, educational sessions, served on the Clinical services committee and recently volunteered to serve on the Publications and Editorial board. Throughout my varied experiences in SAHM, I deeply understand the mission and vision of promoting equity and well-being of all AYA by supporting AYA professionals through clinical practice, care delivery, research, advocacy and professional development. I believe my career development and institutional memory of SAHM serves me well to help make SAHM relevant for all professionals serving youth. Therefore, I am prepared and honored to serve on the SAHM Nominations Committee.
 


Elizabeth Miller, MD, PhD, FSAHM

 

What a tremendous privilege and honor it is for me to be considered for the Nominations Committee for SAHM. SAHM has been my ‘work home’ for over 15 years. After I finished my residency training in medicine-pediatrics, I was doing community-oriented primary care in a health center outside Boston. A nurse practitioner, Rita Olans, taught me how to run a school-based health center and introduced me to SAHM and the brilliant world of adolescent and young adult health. Since then, I’ve had the immense joy of learning from Maria Trent and Jean Emans (our amazing SAHM stars) through the Research and Mentoring Forum which we have led together for almost a decade. I have had the pleasure of working on the Violence Prevention SIG, chairing the Research Committee from 2013-17, and participating in the Violence Prevention Committee. I was honored to become a SAHM Fellow in 2015. Most importantly, the SAHM community has been the place I turn to for inspiration, connection, and motivation. The Nominations Committee has a vital role in helping to find and nurture the next leaders of our diverse SAHM family. Thank you for the opportunity to help guide the growth of this dynamic organization that has given so much to me.



Lilian Wong, MD, FSAHM

 

I am a Paediatrician from Hong Kong with further trainings on Adolescent Medicine at UCSF and Master of Public Health at Chinese University of Hong Kong (CUHK). Currently I am the Honorary Associate Professor at both Department of Paediatrics and School of Public Health of CUHK.

I have been a member of SAHM for 17 years and attained SAHM Fellowship in 2011. My first SAHM Meeting was in Seattle in 2003 which has consolidated my mission to serve young people through different capacities. SAHM is like a big family to me where I have been inspired by many passionate professionals dedicated to adolescent health. I served SAHM as the President of the International Chapter from 2005-2007 which was one of my most memorable experiences in working with international folks. I have also involved in other SAHM committees including Program Committee, Abstract Review Subcommittee and have been members of various SIGS.

Internationally, I have served International Association for Adolescent Health (IAAH) as Regional Vice President from 2009-2017. In the past decade, I have been working closely with International Pediatric Association (IPA), Asia Pacific Pediatric Association (APPA) and American Academy of Pediatrics (AAP) in organizing regional meetings and worked as APPA Advisory Board Members and Chairman of Technical Advisory Group on Adolescent Health from 2016-2018. Currently, I am Member of APPA Standing Committee and Secretary of APPA Ethics Committee since 2018. Hopefully, all these international connections would facilitate me to take up the tasks of the Nomination Committee.

Working as paediatrician in Hong Kong for more than 26 years has given me the opportunity to serve children and adolescents in both public and private sectors. Besides clinical work, I have actively involved in research and teaching of paediatric undergraduates and master students at School of Public Health. Locally, I have been the President of the Hong Kong Paediatric Society (2014-2016), the first professional paediatric body established in Hong Kong in 1962. I am now the Secretary General of the Hong Kong Paediatric Foundation, a local organization focusing on promotion of child health and serving disadvantaged children and families. We have composed a number of Position Statements on burning child health issues. In 2018, I was appointed as a Member of “Commission on Children (CoC)”, established by HKSAR Government to safeguard the rights of children in Hong Kong. Now I am the Vice-Convenor of the “Working Group on Research and Public Engagement” of CoC.

In recent years, I have involved in policy development for children in Hong Kong. In 2015, we have formulated the first “Proposal on Child Health Policy for Hong Kong” and submitted to the government as a prototype. In 2019, we have published a Paper on “Promotion of Adolescent Mental Health in Hong Kong—The Role of a Comprehensive Child Health Policy” at the Journal of Adolescent Health. It would be my great honour to be considered for a member of the Nomination Committee and render my humble service to SAHM at a different capacity.

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