System Capacity to Promote Adolescent Health: A Public Health Improvement Tool

1
System Capacity to Promote Adolescent HealthA
Public Health Improvement Tool

• A collaborative project of the
• Association of Maternal and Child Health Programs
  
• the State Adolescent Health Coordinators
  Network
• AMCHP Annual Conference March 1, 2004

2
Overview of Presentation

• AMCHP/SAHCN Partnership for Adolescent Health
• Conceptual Framework for Adolescent Health
• System Capacity for Adolescent Health A Public
  Heath Improvement Tool

3
System Capacity for Adolescent HealthPublic
Health Improvement Tool

• Development of Tool to measure capacity in seven
  key areas.
• Developed in collaboration with the John Hopkins
  University Women and Childrens Health Policy
  Center to ensure compatibility with other tools
  such as CAST-V.
• Intended to guide action planning for quality
  improvement.

4
AMCHP/SAHCN Partnership For Adolescent
HealthBackground

• Most states and some territories designate
  someone as the state adolescent health
  coordinator. In most states this position
  resides in or works closely with the Title V
  program.
• AMCHP SAHCN, recognized both the importance and
  the promise of more extensive collaboration.
• In 2001, a formal Partnership was established
  with funding from the Annie E. Casey Foundation.

5
AMCHP/SAHCN Partnership For Adolescent Health
Goals of the Partnership

• To collaboratively strengthen the capacity of
  U.S. states and territories to support effective
  adolescent health programs.
• To identify and build ownership for a common
  vision for adolescent health.
• To identify strategies and resources for
  implementing this vision in public health
  agencies and maternal and child health programs.

6
AMCHP/SAHCN Partnership For Adolescent
HealthVision for Adolescent Health

• Developed the Conceptual Framework for
  Adolescent Health
• Collaborative effort representing the consensus
  of AMCHP and Network leaders at this time
• Intended to be a living document, reviewed every
  two years to reflect changing environments and
  emerging issues.

7
Conceptual Framework for Adolescent
HealthContent Development

• Based on
• Partnership work to date
• NAHIC assessment of SAHC activities
• Interviews with MCH program directors, SAHCs, and
  known experts in the field
• Key consensus documents reflecting adolescent
  health objectives, performance measures and
  indicators

8
Conceptual Framework for Adolescent HealthWhy
Focus on Adolescent Health?

• Time of rapid growth and development
• Many life-long behaviors are established
• Foundation for adult health status
• Unique epidemiology
• Societal messages often confusing and
  contradictory

9
Conceptual Framework for Adolescent HealthKey
Terms and Definitions

• Defines four key terms
• Adolescent Health
• Healthy Adolescents
• Youth Development
• Adolescence

10
Conceptual Framework for Adolescent HealthKey
Terms and Definitions

• Adolescence
• Defined as ages 10-24.
• Included 20-24 years olds recognizing that this
  age group has many developmental and health needs
  similar to adolescents, along with some unique
  needs that are not yet well-addressed in public
  health programs targeting adults.

11
Conceptual Framework for Adolescent HealthKey
Terms and Definitions

• Adolescents
• Adolescents, youth and young persons are used
  interchangeably.
• Terms used in their most comprehensive sense,
  referring to the whole population of youth,
  including subgroups such as youth with special
  health care needs, youth of varying ethnic and
  cultural backgrounds, or socially vulnerable
  youth.

12
Conceptual Framework for Adolescent Health Key
Concepts The Role of Public Health

• Public health has a critical role to play in
  assessing/addressing adolescent health
• Organized around 10 essential public health
  services to promote adolescent health
• Incorporates basic public health principles, as
  well as youth development philosophy

13
Conceptual Framework for Adolescent Health Key
Concepts The Relationship of Adolescent Health
to State MCH/Family Health Programs

• Adolescent health is integral to family health
  and should have a special focal point within
  family health programs including
• Strong adolescent health components/programs in
  state health agencies and
• Adolescent Health Coordinators designated within
  MCH programs.

14
Conceptual Framework for Adolescent Health Role
of the Adolescent Health Coordinator

• Has the expertise and mandate to
• integrate and/or coordinate existing efforts that
  address adolescents
• promote and develop new policies, programs, and
  services that address adolescent health issues
• provide expertise to inform broader policies,
  programs and services
• forge partnerships with state agencies, other
  societal institutions, as well as with youth and
  families

15
Conceptual Framework for Adolescent Health Key
Concepts Guiding Principles for Adolescent Health

• Sound and effective foundation for adolescent
• health programs and policies provided by
• Collaboration across public and private societal
  institutions
• Comprehensive and coordinated strategic planning
• Family centered, community-based and culturally
  competent services
• Youth and family involvement
• Sound data

16
Conceptual Framework for Adolescent Health Key
Concepts Vision Statements

• for Adolescent Health
• for State MCH/Family Health Programs
• for the Partnership for Adolescent Health

17
Operationalizing A Vision for Adolescent
HealthPartnership Policy Agenda

• Goals and Objectives for implementing our visions
  for adolescent health through the AMCHP/SAHCN
  Partnership
• Prioritizes realistic and concise action steps
  for the Partnership

18
Operationalizing A Vision for Adolescent
HealthSystem Capacity Project

• Certain capacities must be in place
• The responsibility for adolescent health
  programs/initiatives should be the responsibility
  of a network of organizations, agencies, and
  individuals.
• The tool will allow assessment in seven key
  areas, leading to action planning for quality
  improvement.

19
Operationalizing a Vision for Adolescent
HealthAssessing Capacity

• Every state and territory is different.
• Despite differences, certain core systems and
  functions that must be in place.
• To accurately reflect the range of systems and
  functions that must be in place to make any
  program work, particularly a state adolescent
  health program, workgroups reviewed capacity
  literature from many fields to identify common
  themes and characteristics .

20
Operationalizing s Vision for Adolescent
HealthAssessing Capacity

• Common capacities were characterized three
  ways
• Systems - Infrastructure and capacity of agencies
  organizations, environmental situations
• Individuals - Competencies of the person
  responsible for implementing a program
• Frameworks - Topics/content that an effective
  program should address

21
System Capacity for Adolescent HealthWhat
Defines Capacity?

• Expresses overarching values/themes
• Defines the minimum, and a range of,
  infrastructure characteristics that must be in
  place for supporting adolescent health programs
  and,
• Recognizes that adolescent health is a broad
  system composed of many pieces and partners.

22
System Capacity for Adolescent Health10
Essential Public Health Services

• Essential PHS are addressed, but some are
  represented by multiple capacity areas to
  emphasize the important of the connection between
  the services.
•  For the adolescent population, different things
  that needed to be emphasized differently than
  there for general public health.
•  Diagnosing health problems for adolescents isnt
  about health hazards, its about behaviors.

23
Key Capacity Area COMMITMENT TO ADOLESCENT
HEALTH

• Engenders a formal process of recognizing youth
  as a program and policy priority in a broader
  MCH/family health development framework,
  reflected by visible, collaborative links within
  and across state agencies.
• Requires proactive support by management and
  provides a foundation for all other functions and
  systems that enable effective statewide
  adolescent health programs.

24
Key Capacity AreaPARTNERSHIPS

• Collaborative relationships established by
  MCH/familyhealth programs/staff with
  individuals, families, communities, schools,
  health providers and other agencies,
  organizations or groups interested in adolescent
  health issues.
• Characterized by broad participatory processes
  that lead to more effective problem solving and
  improvement in adolescent health.

25
Key Capacity Area PLANNING EVALUATION

• Process by which MCH/family health programs
  systematically assess and identify adolescent
  health issues, develop strategies to address
  these issues, and measure the effectiveness of
  these strategies according to standards and
  benchmark indicators.
• Requires partnerships, collaboration and
  coordination across many sectors.

26
Key Capacity AreaPOLICY ADVOCACY

• Policy is a formal plan or course of action that
  defines guiding principles or procedures that
  take place at the division, agency, state, and
  community levels for the purpose of supporting,
  promoting, or mandating adolescent health
  initiatives.
•  Advocacy is broad in scope, any activity or
  effort that speaks in favor of adolescents and
  the initiatives and functions that support them.

27
Key Capacity AreaSURVEILLANCE DATA SYSTEMS
Policy Advocacy

• Public health surveillance and data systems
  that allow for systematic collection, analysis,
  distribution and use of data to support program
  planning, implementation and evaluation for
  adolescent health.

Policy Advocacy
28
Key Capacity Area TECHNICAL ASSISTANCE

• Process by which MCH/family health programs
  share and transfer information, data, resources,
  and development opportunities with individuals,
  families, communities, and partners
• Should provide support and educational
  opportunities for the public and other
  professionals on adolescent health to build
  capacity to develop, implement, and evaluate
  adolescent health initiatives.

29
Key Capacity AreaPROGRAM SYSTEMDEVELOPMENT

• Management and coordination from the community
  level up to
• Foster coordinated supports and resources that
  promote and sustain adolescent health initiatives
  and programs.
• Assure population-based and culturally competent
  initiatives, programs, and systems.
• Employ family- and youth-centered strategies.
• Build on youth assets and potential.  

30
(No Transcript)
31
Example Commitment to Adolescent Health

• Elements of a Formal Commitment to Adolescent
  Health
• Adolescent Health Focal Point
• Financial Support
• Dedicated Staff

32
Example Commitment to Adolescent Health

• Facets of Adolescent Health Focal Point
• Written Statements
• Adolescent Framework
• Dedicated Program
• Leadership
• Marketing Communications

33
Example Commitment to Adolescent Health

• Facets of Financial SupportStaff
• Programs and Services
• Systems and Functions
• Professional Development

34
Example Commitment to Adolescent Health

• Facets of Dedicated Staff
• Collaboration
• Expertise
• Professional Development
• Job/Position Description

35
System Capacity for Adolescent HealthPublic
Health Improvement Tool

• Piloting in three states Utah, Wisconsin,
  Tennessee
• Selected to present a range of existing capacity.
• Tool materials will also be available to Title V
  programs to use on their own.

36
System Capacity for Adolescent HealthState/Local
Use of the Tool

• Orienting and training new staff
• Providing point of reference during times of
  staff turnover
• Demonstrating cross-over of adolescent health
  into other disciplines
• Identifying gaps in data and performance for
  5-year Title V Needs Assessment.

37
For Related Products

• Visit http//www.amchp.org/policy/adolescent.htm
• 2003 Policy Agenda for Adolescent Health 1/03
  PDF
• Conceptual Framework for Adolescent Health 12/02
  PDF
• Introduction to the Conceptual Framework Webcast
  Archive 8/02
• System Capacity for Adolescent Health - Project
  Introduction Audio Conference Transcript" 8/02
  PDF

38
For more information

• Sally Fogerty, MEdAssistant Commissioner, Bureau
  of Family and Community Health MA Department of
  Public Healthp [phone]sally.fogerty_at_state
  .ma.us
• Nancy Birkhimer, MPHDirector, Teen and Young
  Adult Health ProgramDept of Human Servicesp
  [phone] nancy.birkhimer_at_maine.gov
• Rena Large, Med, CHESSenior Program Directorp
  [phone]