Posts in Adolescent-Centered Care
Incorporating Health Care Transition Services into Preventive Care for Adolescents and Young Adults: A Toolkit for Clinicians

By Patience White, Annie Schmidt, Margaret McManus, and Charles Irwin, Jr. Got Transition, June 2018.

A Preventive Care and Transition Toolkit developed by Got Transition in collaboration with University of California, San Francisco’s (UCSF) Adolescent and Young Adult Health National Resource Center. It provides suggested questions and anticipatory guidance for clinicians to introduce health care transition during preventive visits with early adolescents (ages 11-14), middle adolescents (ages 15-17), late adolescents (ages 18-21), and young adults (ages 22-25), consistent with the AAP/AAFP/ACP Clinical Report on Health Care Transition. See more (ALSO En Español)

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Aligning National Title V Performance Measures on Transition, Medical Home, Preventive Care, and Insurance: Suggested Strategies for States

by Margaret McManus, Daniel Beck, and Patience White. Got Transition 2016.

This report offers strategies for state Title V agencies that have selected transition as one of their to help them link performance improvements and innovations for transition with medical home, adolescent well care, well care for women, and adequate health insurance. See more

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The Promise and Potential of Adolescent Engagement in Health

by Margaret A. McManus. Journal of Adolescent Health. 2014:314.

This editorial discusses a new youth engagement tool developed by Sebastian et al. in the Journal of Adolescent Health and recommends incorporating transition readiness assessment in future measures of adolescent engagement consistent with Got Transition’s “Six Core Elements of Health Care Transition.” It also addresses the need to consider the continuum of adolescent engagement pertaining to direct care as well as to involvement of youth as staff, peer educators, advisory group members, and other leadership positions. See more

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A Research Agenda for Adolescent-Centered Primary Care in the United States

by Harriette B. Fox, Margaret A. McManus, Charles E. Irwin Jr, Kelly J. Kelleher, and Ken Peake. Journal of Adolescent Health. 2013:307-310. 

This commentary presents a set of prioritized research recommendations on adolescent-centered primary care developed by experts participating in The National Alliance to Advance Adolescent Health's invitational conference in 2012. The recommendations pertain to increasing adolescent and parent engagement and self-care management, improvement preventive care and identifying conditions early, and integrating physical, behavioral, and reproductive health services. The commentary also addresses federal and private foundation funding priorities related to the adolescent research agenda. See more →

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Medical Home Innovations: Where Do Adolescents Fit?

by Ian Walker, Margaret McManus, and Harriette Fox, December 2011.
This report provides a summary of the activities underway in 12 innovative medical home programs and discusses how the health needs of adolescents are being addressed. Findings are based on interviews with leaders in public, private, and multi-stakeholder programs. The report examines each of the seven principles central to the medical home model: personal provider, physician-directed practice, whole person orientation, care coordination, quality and safety, enhanced access, and payment for excellence. It describes the progress that has been made in changing primary care practices and plans underway for future improvements. See more

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State EPSDT Policies for Adolescent Preventive Care

by Harriette B. Fox, Katherine K. Rogers, and Margaret A. McManus, September 2011.
This fact sheet presents findings from an analysis of state policy documents that establish guidelines for providers delivering EPSDT preventive services to adolescents. It examines state Medicaid policies including the EPSDT periodicity schedule; comprehensive health history and developmental assessments; physical examinations, laboratory tests, and immunizations; health education; and referrals. Particular emphasis is given to the early identification of problems related to nutritional health, mental health, sexual behavior, substance use, and violence and injury potential and to health education for key topics under Bright Futures. Also examined are state policies regarding adolescents’ private time with providers. See more

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Future Directions for the Office of Adolescent Health

by Harriette B. Fox and Bruce P. Frohnen, February 2011.
This report presents the views of clinical and policy experts on how the HHS Office of Adolescent Health can best carry out its legislative charge to improve adolescent health outcomes through increased coordination. The report, based on more than 30 interviews, provides recommendations for interagency coordination around program design and evaluation, research, and health care provider training activities as well as for the coordination of efforts aimed specifically at preventing mental and behavioral health disorders and improving systems of care. Also included are perspectives on the need for a national plan to improve adolescent health. See more

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Concern for Our Teens: Opinion Leaders Speak Out on Adolescent Health

by Bruce P. Frohnen, Margaret A. McManus, Stephanie J. Limb, and Celia R. Straus, July 2010. 
This report examines the perspectives of opinion leaders in business, academia, and the military on adolescents' health and access to care. It also addresses the leaders' opinions on the role of their community in health education and public and private policy actions needed to improve adolescent health. Information was obtained through interviews with leaders from a cross section of large and small firms in both manufacturing and service sectors; public, private, and community colleges; and several branches of the military. See more →

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Parents’ Perspectives on Health Care for Adolescents

by Harriette B. Fox, Margaret A. McManus, and Shara M. Yurkiewicz, June 2010

This report presents parents’ perspectives on teen health problems and ways to better address them. It reports on what parents understand to be the most pressing health problems teens today face, what their experiences have been in accessing needed services for their adolescent children, what they see as their appropriate role in helping teens to obtain care and stay healthy, and how they think providers can help them. The report also presents parents’ recommendations for an ideal health care site for teens. Information was obtained from seven parent focus groups, including three with Spanish-speaking parents, conducted in Chicago, DC, Los Angeles, and Miami. See more →

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Adolescents’ Experiences and Views on Health Care

by Harriette B. Fox, Susan G. Philliber, Margaret A. McManus, and Shara M. Yurkiewicz, March 2010.

This report presents adolescents’ perspectives on their health care experiences and their ideas about how best to structure a health care delivery system that is responsive to their needs. It addresses several topics, including health issues facing adolescents; experiences with seeking and receiving health care; views on parental involvement; and preferences for the design, services, and staff at an ideal health site. Information was obtained through focus groups and supplemental questionnaires conducted in four cities with over 200 adolescents. See more →

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Adolescent Medicine Training in Pediatric Residency Programs

by Harriette B. Fox, Margaret A. McManus, Jonathan D. Klein, Angela Diaz, Arthur B. Elster, Marianne E. Felice, David W. Kaplan, Charles J. Wibbelsman, and Jane E. Wilson. Pediatrics. 2010; 125: 165-172.
This article examines the adequacy of pediatric residency training in adolescent medicine. It addresses several aspects of training, including the extent to which important adolescent medicine topics are covered through formal education and practical application, the types of faculty involved in training, and the opportunities to establish ongoing therapeutic relationships with adolescents. Information for the study was obtained through a 2007 survey of pediatric residency program directors and adolescent medicine faculty. See more

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Pediatricians' Interest in Expanding Services and Making Practice Changes to Improve the Care of Adolescents 

by Harriette Fox, Margaret McManus, Karen O’Connor, Jonathan Klein, Angela Diaz, and Charles Wibbelsman, September 2009.
Based on a 2008 national survey of practicing pediatricians, this fact sheet examines pediatricians’ interest in adding or expanding preventive, mental health, and reproductive health services for adolescents if payment barriers were removed. It also identifies the specific practice and staffing changes they would have an interest in making, as well as the types of support and training they perceive would be most helpful to them in providing comprehensive primary care to adolescent. See more

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Advancing Medical Education Training in Adolescent Health 

by Harriette B. Fox, Margaret A. McManus, Angela Diaz, Arthur B. Elster, Marianne E. Felice, David W. Kaplan, Jonathan D. Klein, and Jane E. Wilson. Pediatrics. 2008; 121: 1043-1045.
This commentary examines the strengths and weaknesses of four major options for establishing opportunities for training pediatricians in adolescent medicine. The options include extending the length of the mandatory adolescent medicine rotation, introducing more flexibility in residency programs to allow for formalized optional training tracks in adolescent medicine, creating a combined pediatrics/adolescent medicine residency, and increasing the availability of one-year adolescent medicine clinical training programs after completion of categorical training in general pediatrics. Information for this commentary was based on 2007 surveys of adolescent medicine fellowship program directors, pediatric residency program directors, and adolescent medicine faculty in pediatric residency programs. See more

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Adolescent Medicine at the Crossroads: A Review of Fellowship Training and Recommendations for Reform 

by Harriette B. Fox, Margaret A. McManus, Jane E. Wilson, Angela Diaz, Arthur B. Elster, Marianne E. Felice, David W. Kaplan, Jonathan D. Klein, and Charles J. Wibbelsman, April 2008.
This special report examines the current state of adolescent medicine fellowship programs. It contains information on the supply and recruitment of fellows; the nature and content of clinical, research, and leadership training; the institutional and financial challenges facing training programs today; and offers recommendations for building the field. Information was obtained primarily from a national survey of adolescent medicine fellowship program directors, along with key informant interviews, and an extensive literature review. See more

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Under One Roof: Primary Care Models that Work for Adolescents

by Marian Sandmaier, Alyssa D. Bell, Harriette B. Fox, and Margaret A. McManus, May 2007.
This report describes a model of comprehensive, interdisciplinary physical, behavioral, and reproductive health care for adolescents operating in three different health care settings — a hospital outpatient department, office practice, and community health center. The strengths and flexibility of the three models are profiled in detail, along with the financing challenges these programs confront. Information was obtained through a site visit and multiple telephone interviews with the programs' providers and administrators. See more

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