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 →
by Margaret A. McManus, Lauren R. Pollack, W. Carl Cooley, Jeanne W. McAllister, Debra Lotstein, Bonnie Strickland, and Marie Y. Mann. Pediatrics. 2013;131:1090-1097.
This article provides an analysis of US transition performance from pediatric to adult health care based on the 2009-2010 National Survey of Children with Special Health Care Needs. It examines the association of population, condition, and health care characteristics with successful transition preparation. It also identifies adolescent populations least likely to receive needed transition support and offers delivery system and payment suggestions for improvement. See more →
by Margaret McManus and Harriette Fox, May 2013.
This issue brief examines the extent to which California’s essential health benefits benchmark plan meets the needs of children and adolescents, including those with special needs. It also examines the cost-sharing requirements that will be used by health insurance plans sold in California’s Health Insurance Exchange. It identifies potential issues of concern in the benchmark’s essential health benefits, with special attention to families’ out-of-pocket cost liabilities within all five levels of coverage, including subsidized coverage. See more →
February 13, 2013
Comments from The National Alliance to the Centers for Medicare and Medicaid Services on the Proposed Rule on Medicaid, Children’s Health Insurance Programs, and Exchanges, issued on January 22, 2013, to implement provisions of the Affordable Care Act (ACA) and the Children’s Health Insurance Program Reauthorization Act (CHIPRA). See more →
Read Moreby Patience H. White, Margaret A. McManus, Jeanne W. McAllister, and W. Carl Cooley. Pediatric Annals. 2012;41:e1-e7.
This article describes a quality improvement approach for implementing health care transition supports in pediatric and adult primary care practice settings, which is based on the 2011 AAP/ACP/AAFP's Clinical Report on Health Care Transition and the Six Core Elements of Health Care Transition. It includes detailed sample tools, strategies, and lessons learned from primary care practices in the District of Columbia that have implemented the Six Core Elements. See more →
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 →
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 →
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 →
Presentations by Harriette B. Fox, Margaret A. McManus, Susan K. Maloney, Angela Diaz, and Anne Morris, November 2010.
This report summarizes the presentations at the Adolescent Preventive Services Institute at the American College of Preventive Medicine 2010 Annual Meeting. It reports on the prevalence and co-occurrence of teen risk behaviors, the underutilization of clinical preventive services for adolescents, and barriers to the delivery of preventive care. The report also presents evidence-informed strategies for improving clinical and community prevention and includes a description of the Mount Sinai Adolescent Health Center as an innovative primary care model. See more →
Read Moreby 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 →
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 →
Read Moreby 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 →
Read Moreby Harriette B. Fox, Margaret A. McManus, and Katherine N. Arnold, March 2010
Based on an original analysis of the 2007 Youth Risk Behavior Survey, this fact sheet provides national information on multiple health risk behaviors among high school students. It examines 12 types of significant health risk behaviors that include unsafe sexual behaviors, unhealthy eating and exercise patterns, mental health and substance use problems, and behaviors that contribute to violence. It reports on the prevalence and co-occurrence of these health risk behaviors and also differences by gender, race and ethnicity, and grade level. Implications for preventive interventions are also discussed. See more →
Read Moreby 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 →
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 →
by Harriette B. Fox and Margaret A. McManus, June 2009.
This issue brief documents the significant health risks and conditions of adolescents and the financing and delivery system barriers that affect their access to appropriate care. It urges Congress to consider coverage expansions under Medicaid and CHIP, benefit and payment improvements, grant programs to support interdisciplinary models of primary care, and funds to improve training for adolescent health providers. See more →
by Margaret McManus, Harriette Fox, Karen O'Connor, Thomas Chapman, Jessie MacKinnon, October 2008.
Based on a 2008 national AAP survey of practicing pediatricians, this fact sheet examines pediatricians' perspectives on the appropriate age to begin planning for transition and their practices regarding the provision of transition support services to adolescents with special needs. It also identifies the economic and non-economic barriers that pediatric practices face in providing transition services and presents options for improving training, financing, adult provider availability, and adolescent and parent education. See more →
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 →
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 →