The Role of the Federal Maternal and Child Health Bureau in Improving Adolescent Health May 14, 2009 LEAH/NAS Meeting Peter van Dyck, MD, MPH Department of Health and Human Services Health 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 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.

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, Madhavi Reddy, MSPH, Laura Kavanagh, MPP,