Strengthening Interdisciplinary Training Programs in Adolescent Health

1
Strengthening Interdisciplinary Training Programs
in Adolescent Health

• Donald P. Orr, MD
• Professor
• Director, Indiana LEAH

Section of Adolescent Medicine
School of Medicine
.
2
Missing Opportunities Recommendations

• Competencies in adolescent health care in
  provider training certification
• Expand and sustain interdisciplinary training
  programs
• Leaders
• Specialists
• Scholars
• Educators

3
Adolescents

• 2005 estimated 63,000,000 adolescents 10 24
  years in U.S.
• Increasingly proportion are ethnic/racial
  minority
• Majority are well with straightforward health
  needs
• Sizable minority have more complex problems often
  related to social/behavioral issues

4
Adolescent Medicine Physician Specialists

• Board certified 547
• 7 states without board certified specialist
• Almost all are located in academic centers
• 26 ACGME accredited fellowship programs
• 69 in training (28 year 1)

5
Adolescent Health Workforce

• Adolescents have multiple needs
• Workforce must be diverse in depth breadth
• Medicine
• Nursing
• Psychology
• Dietetics
• Social Work

6
Adolescent Health Workforce

• Competent primary care generalists in all
  disciplines
• Specialists in all disciplines
• Educate the workforce
• Generalists (Primary care)
• Specialists
• Conduct research
• Consult on adolescents with complex problems
• Inform policy makers

7
Training Models for Professionals in Adolescent
Health

• Unidisciplinary
• Inter-, multi-, transcisciplinary

8
MCH Interdisciplinary Training

• Leadership Education in Adolescent Health
• Leadership Education in Neurodevelopmental
  Disabilities
• Pediatric Pulmonary Centers
• Schools of Public Health

9
LEAH History

• 1950s Supports individual medicine fellows
• 1960s Supports Society for Adolescent Medicine
• 1970s Supports 9 interdisciplinary AHTPs
• 1980s Supports 6 interdisciplinary AHTPs
• 1990s Supports 7 LEAH programs
• 2000s Will there be the resources for new
  programs with adequate funding?

10
LEAH Training Model

• Prepare for leadership positions in adolescent
  health
• Interdisciplinary core faculty trainees
• Medicine
• Nursing
• Social Work
• Psychology
• Nutrition/dietetics

http//leah.mchtraining.net/
11
Leadership Development

• Curriculum for leadership
• Models in program
• Mentors clinical and research
• Opportunities to build skills/practice
• Trainees introduced to the public

12
Increasing demand for training

• All programs train all disciplines
• Provide technical assistant to state, regional
  and national Title V
• Continuing education
• Develop and participate in web casts distance
  education
• Expand youth and parent training involvement

13
LEAH 1992 - 2009
Baylor Boston Childrens Hospital Indiana
University Johns Hopkins University University
of California San Francisco University of
Rochester University of Minnesota
14
Achievements

• Chronic Illness Transition of care
• Annual Conferences -- Baylor
• Community Asthma Initiative -- Boston
• Web-based national diabetes resources road maps
  for patients/parents/providers -- Indianapolis
• Educating professionals
• Adolescent Actors Teaching Program -- Minnesota
• Statewide Adolescent Health Collaboratives
  California, Rochester, Indiana
• State Health plans for adolescents --
  Indianapolis
• Health Disparities Hopkins, Boston

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Achievements

• Leadership all programs
• Advisory to NIH/CDC/MCHB/foundations
• Grant reviewers federal private funders
• Professional organizations
• Adolescents
• Web-based health information sites Boston,
• Youth Development initiatives training --
  Rochester
• Provision of health care all programs
• Policy all programs
• National Adolescent Health Infomration Center
  San Francisco

16
LEAH Graduates 1992 2008 N 806
Other countries
Africa Australia Canada China Denmark England Indi
a Israel New Zealand Pakistan Portugal Sweden Swit
zerland Thailand Taiwan
17
LEAH Graduates 1992 2008Discipline N 802
18
LEAH Graduates 1992 2008Current Position N
802
19
Alumni

• Kendrin Sonneville, MS, RD, LDN (Boston) One
  Step Ahead Program
• Bonnie Halpern-Felsher, PhD (San Francisco)
  High School Training Program for disadvantaged
  youth
• Kathy Salwin, DSN, RN (Indianapolis) Dean of
  Research, University of Wisconsin Milwaukee
• Joel Brenner, MD (Baylor) Sports Medicine
  Adolescent Medicine program, E Virginia
  University

20
Alumni

• Renata Arrington-Sanders, MD, MPH (Hopkins)
  Asst Professor, Hopkins
• Diane Neumark-Sztainer, PhD, RD (Minnesota)
  Professor, U of Minnesota
• Adriene Stith-Butler, PhD (Rochester) Senior
  Program Office, IOM

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Why invest in Interdisciplinary Training?

• Prepares workforce for adolescent health
  (generalists specialists)!
• Develops and improves the systems of care that
  provide necessary, coordinated, quality health
  care.
• Graduates improve the health of the next
  generation of young adults.

22
Why invest in Interdisciplinary Training?

• Research can advance health care delivery
• Leadership can impact youth health locally,
  regionally, nationally and around the world.

23
Strengthening Interdisciplinary Adolescent
Medicine Training

• Greater investment to expand and adequately fund
  interdisciplinary training programs
• LEAH represents 6.3 of MCHB training dollars
• Public, private and industry/health care systems
• Schools/departments
• Adolescent medicine fellowship programs must
  conduct more funded research
• Current research of majority of adolescent
  medicine training programs is insufficient to
  support T32
• Creative use of existing funding mechanisms for
  research training-- Leverage funding
• Training dollars
• Research dollars
• Expansion of certification to other disciplines