The Role of the Federal Maternal The Role of the Federal Maternal and Child Health Bureau in and Child Health Bureau in

Improving Adolescent HealthImproving Adolescent Health

May 14, 2009May 14, 2009LEAH/NAS MeetingLEAH/NAS MeetingPeter van Dyck, MD, MPH

Department of Health and Human ServicesHealth Resources and Services Administration (HRSA)

Associate Administrator, Maternal and Child Health Bureau (MCHB)

MCHB and Adolescent Health

• Longstanding interest in adolescent health• Mission to provide national leadership in

promoting the health, development, safety, & social and emotional well-being of school-aged children, adolescents, & young adults

• Alignment with the recommendations of NRC/IOM report, Adolescent Health Services: Missing Opportunities

MCHB Investments

• $5.8 Million Annually

– Office of Adolescent Health $3.2M

– Training Programs $2.6M

Office of Adolescent Health

• Adolescent health– Comprehensive approach– Support to State Title V MCH Programs– Leveraging of partnerships– Connections to large Federal efforts addressing youth

issues

• School health – School mental health– School-based health centers– Partnership among health, nutrition and education

organizations– Connections to other Federal school health efforts

State Title V Programs and Adolescent Health

• Nearly every state has a state adolescent health coordinator

• Challenges– Staff turnover– Varying levels of staffing and seniority of

position– Categorical funding streams– Serious budget constraints

State Adolescent Health Performance Measures

• 75% of states have at least one performance measure that specifically targets adolescents

• 39% of states have at least 2 such performance measures

• Most common problems addressed:– Teen pregnancy– Tobacco– Obesity/Nutrition– Substance abuse– Access to care– Unintentional injury

National Initiative to Improve Adolescent Health

• Frames Office of Adolescent Health (OAH) grant programs

• Grew out of Healthy People 2010• Stimulates national efforts to improve the health,

safety & well-being of adolescents & young adults • Co-facilitated by MCHB/OAH & CDC/DASH• Partnership with close to 30 organizations, largely

grantees• Leverages efforts beyond those directly supported by

the Office of Adolescent Health

National Initiative to Improve Adolescent Health

5 Goals:

• Elevate national, state, and community focus on, and commitment

• Increase access to quality services

• Address the influence of social determinants

• Improve health and safety outcomes

• Eliminate disparities

Adolescent Health Programs

• Adolescent and Young Adult Health National Centers Program (AYAH)

– National Adolescent Health Information and Innovation Center

– Public Policy Analysis and Education Center for Adolescent and Young Adult Health

– Adolescent Health Resource Center for State Maternal and Child Health

– Partnership to Promote Adolescent Health in States

• Partners in Program Planning for Adolescent Health Program (PIPPAH)

School Health Programs

• Mental Health in Schools Program• National Center on School-Based

Health Care• National Coordinating Committee

on School Health and Safety (NCCSHS)

Adolescent Health Training Programs

• Training first funded in the 1950s, with Adolescent Medicine Fellowships at 5 sites.

• 1976 - Interdisciplinary Programs train in Adolescent Medicine, Psychology, Nursing, Nutrition and Social Work.

Adolescent Health Training Programs

• Prepare Pre- and Post- Doc Fellows to Assume Leadership Positions in Interdisciplinary Settings.

• Each Year, 848 Individuals Receive Training in LEAH Programs; 60 are Long-Term; 788 are Short-Term.

• In FY 2008, MCHB Funded Seven LEAH Programs, with Annual Awards Totaling $2,588,967.

• In FY 08, 28 Fellows Entered into Adolescent Medicine Fellowships (MCHB and non-MCHB Supported).

LEAH Collaborations

• Faculty Members of LEAH Participated in IOM/NRC Report- Adolescent Health Services: Missing Opportunities. Collaboration Facilitated Today’s Meeting to Highlight Training Aspects of Report.

• Seven Programs Work Together to Develop Training Conference Calls for State Adolescent Health Coordinators.

http://leah.mchtraining.net

Conclusions

• MCHB’s adolescent health activities align with Adolescent Health Services: Missing Opportunities.

• Today’s meeting focuses on workforce preparation and our LEAH training program serves as a cornerstone for the Report’s 7th recommendation.

• Other Bureau adolescent health activities focus on infrastructure building in adolescent health.

Program Contacts

Trina Anglin, MD, PhD, tanglin@hrsa.gov

Madhavi Reddy, MSPH, mreddy@hrsa.gov

Laura Kavanagh, MPP, lkavanagh@hrsa.gov

http://www.mchb.hrsa.gov/training

http://leah.mchtraining.net