Hoover Adger

Workforce Competencies in Behavioral Health: An Overview

Competency-based training approaches are being used more in healthcare to guide curriculum content and ensure accountability and outcomes in the educational process. This article provides an overview of the state of competency development in the field of behavioral health. Specifically, it identifies the groups and organizations that have conducted and supported this work, summarizes their progress in defining and assessing competencies, and discusses both the obstacles and future directions for such initiatives. A major purpose of this article is to provide a compendium of current competency efforts so that these might inform and enhance ongoing competency development in the varied behavioral health disciplines and specialties. These varied resources may also be useful in identifying the core competencies that are common to the multiple disciplines and specialties.

Problems of alcohol and other drug use and abuse in adolescents

In summary, although there has been much progress, alcohol and other drug use and abuse in adolescents remains a major medical and public health problem. Epidemiological studies of adolescents and young adults provide important information about the frequency, quantity, and types of drugs used among these populations. A number of theories on causation and initiation of use of alcohol and other drugs have been postulated, and each adds important new information to the field. Impressive gains have been made in the identification of risk profiles which lead to alcohol and other drug use. Although this work has been comprehensive in its approach, studying the influences of family and peer factors, psychological and biological variables, and environmental and demographic characteristics, many questions remain unanswered with regard to the distinguishing features of those at risk who progress to problem use. Additionally, although treatment programs have been developed specifically to meet the special needs of adolescents, treatment outcome studies and better assessment procedures to determine which adolescents need which specific types of treatment are still needed. Finally, effective physician education strategies are needed to ensure appropriate practice behaviors among health care providers, who should be an important link in the coordination of efforts as the health care community responds to the problem of alcohol and other drug abuse.

Microflora of the urethra in adolescent boys: Relationships to sexual activity and nongonococcal urethritis*

Urethral cultures were obtained from 90 adolescent youth, 16 of whom denied previous sexual activity. Among the sexually active boys was a group of 32 with clinically significant pyuria, consistent with the diagnosis of urethritis, on a first-part urinalysis (FPU) specimen. To relate differences in urethral microflora to sexual activity, 42 sexually active patients with a negative FPU were compared with the never sexually active group. The profile of anaerobic, but not aerobic, bacteria isolated from the urethra was related to the presence or absence of previous sexual activity. Mycoplasma species and Ureaplasma urealyticum were isolated from sexually active patients only, and may be markers of sexual activity in adolescent boys. Of the 32 patients with FPU evidence of urethritis, 22 (69%) had cultures positive for Chlamydia trachomatis, and an additional three (9%) had cultures positive for Neisseria gonorrhoeae. The findings in sexually active patients with a positive FPU were otherwise similar to those of sexually active patients without evidence of urethritis. C. trachomatis appears to be the most important agent of urethritis among adolescent boys with a positive FPU.

Adolescence as a Critical Stage in the MCH Life Course Model: Commentary for the Leadership Education in Adolescent Health (LEAH) Interdisciplinary Training Program Projects

The Life Course Perspective (LCP), or Model, is now a guiding framework in Maternal and Child Health (MCH) activities, including training, supported by the Health Resources and Services Administration’s Maternal and Child Health Bureau. As generally applied, the LCP tends to focus on pre- through post-natal stages, infancy and early childhood, with less attention paid to adolescents as either the “maternal” or “child” elements of MCH discourse. Adolescence is a distinct developmental period with unique opportunities for the development of health, competence and capacity and not merely a transitional phase between childhood and adulthood. Adequately addressing adolescents’ emergent and ongoing health needs requires well-trained and specialized professionals who recognize the unique role of this developmental period in the LCP.

Office approach to drug abuse prevention

The onset of tobacco, alcohol, and other drug use generally occurs during adolescence. While many teens experiment with these substances, a significant number use them to the point that their behavior interferes with school, family, social relationships, and general productivity. It is the pediatricians responsibility to identify young people who are at risk for the subsequent use of these substances and initiate a carefully designed prevention program in the office setting.

The status of adolescent medicine: Building a global adolescent workforce

Abstract Remarkable public health achievements to reduce infant and child mortality as well as improve the health and well-being of children worldwide have successfully resulted in increased survival and a growing population of young people aged 10–24 years. Population trends indicate that the current generation of 1.8 billion young people is the largest in history. However, there is a scarcity of dedicated resources available to effectively meet the health needs of adolescents and young adults worldwide. Growing recognition of the pivotal roles young people play in the cultures, societies, and countries in which they live has spurred an expanding global movement to address the needs of this special population. Building an effective global workforce of highly-skilled adolescent health professionals who understand the unique biological, psychological, behavioral, social, and environmental factors that affect the health of adolescents is a critical step in addressing the health needs of the growing cohort of young people. In this review, we aim to: 1) define a global assessment of the health needs for adolescents around the world; 2) describe examples of current training programs and requirements in adolescent medicine; 3) identify existing gaps and barriers to develop an effective adolescent health workforce; and 4) develop a call for targeted actions to build capacity of the adolescent health workforce, broaden culturally relevant research and evidence-based intervention strategies, and reinforce existing interdisciplinary global networks of youth advocates and adolescent health professionals to maximize the opportunities for training, research, and care delivery.