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Using Teen Screen Assessments for Prevention/Intervention PlanningLinda Summers, PhD, NPConni DeBlieck, DNPNew Mexico State UniversitySchool of NursingMay 16th 2015

1Gadsden High Student Health Center

Adolescent HealthTask of enlistment is a challenge

Exploring the relation of health in their life space might help explain problems with enlistment

Life space-includes their present situation, and what they perceive as their future

Health StatusOnly age group that has not shown improvement in health status

Most of the decline can be attributed to preventable causes

Adolescents participation in lifestyle activities and behaviors that cause injuries, substance use and abuse, early and unprotected involvement in sexual behaviors, inadequate exercise and poor dietary patterns Lead to averse outcomes in the short term and chronic disease in adultsAdolescent Health DisclosureObservational, cross-sectional epidemiological design

Self-administered surveyAssessment of adolescent health concerns for 1616 high school students Standardized Tool (Dartmouth COOP)

Summers, L, Williams, J, Borges, W., Ortiz, M., Schaefer, S. & Liehr, P. (2003). School based health center viability: The application of the COPC model. Issues in Comprehensive Pediatric Nursing. 26, 231-251Talking About FeelingsFamilyFriendsMDs/RNsTeacher25.2%53.2%5.1%5.8%Rated helpfulness of MDs/RNs adviceExtremelyQuite a lotModerateA littleNot at all 0% 8% 62% 15% 15%Talking About Family ProblemsFamilyFriendsMDs/RNsTeacher14.6%32.0%1.3%3.4%Rated helpfulness of MDs/RNs adviceExtremelyQuite a lotModerateA littleNot at all 20% 0% 20% 40% 20%Talking About Health HabitsFamilyFriendsMDs/RNsTeacher18.9%39.6%3.8%4.5%Rated helpfulness of MDs/RNs adviceExtremelyQuite a lotModerateA littleNot at all 22% 0% 11%11% 56%Talking About PainFamilyFriendsMDs/RNsTeacher56.2%34.2%32.1%3.3%Rated helpfulness of MDs/RNs adviceExtremelyQuite a lotModerateA littleNot at all 7% 18% 30%28% 17%ResultsAdolescents seldom spoke to health care providers

and when they did,

the information received was useless 74% of the time

ImplicationsWe needed to develop a trust or rapport with the teen

We needed to identify risk and protective processes

We needed a systematic approach to cover general areas of risk/protective processes for the teen

Teen Screen Assessment ToolDeveloped in 2001 By NM Office of School and Adolescent Health and Health Care Providers throughout the State

Use in School-Based Health Centers (SBHC)

Modified to be used in Family Practice Residency Training at MMC

Utilize as needs assessment tool for prevention/intervention planning

12Electronic School Health Questionnaire Screen (eSHQ)Designed to help health care practitioners to . . . ScreenIdentifyTreat

At-risk (all) adolescents for . . .Physical SexualBehavioral Health Problems 13

Onate High Student Health Center

Chaparral High Student Health Center

Las Cruces High Student Health Center

SBHC 2013-2014 by School

SBHC 2013-2014 by GENDER

Risk Behaviors at a Glance SBHCs (eSHQ)Dona Ana County Youth Risk Resilience Survey (YRRS)New Mexico(YRRS)USA(YRBS)Youth Risk Behavior SurveyUnintentional InjuryTexted or email while drivingRarely or never wore a helmetRarely or never wore a seatbelt

6.9%39.78.4%38.791.%6.2%40.283.2%7.6%41.487.97.6%ViolenceCarried a weaponBullied at schoolPhysical dating violence10%2.7%2.818.310.218.29.417.919.610.3Mental HealthNon Suicidal Self HarmFelt Sad or HopelessAttempted Suicide13%31%9.719%30.7%11.420.230.5%9.424%29.9%8.0Risk Behaviors at a Glance SBHCs (eSHQ)Dona Ana County Youth Risk Resilience Survey (YRRS)New Mexico(YRRS)USA(YRBS)Youth Risk Behavior SurveyTobacco UseCurrent cigarette smoking15.815.914.416%Alcohol UseCurrent Drinking26%36.628.935%Current Drug UseMarijuana19.7%

24.6%27.841%Risk Behaviors at a Glance SBHCs (eSHQ)Dona Ana County Youth Risk Resilience Survey (YRRS)New Mexico(YRRS)USA(YRBS)Youth Risk Behavior SurveyPhysical Activity, Body Weight, and Nutrition Daily Physical ActivityTV viewing, computer/video more than 3 hours Five Servings of fruit or vegetables daily 81%

45.9%

35.6%

15.9

29.8

18.914.4

35.3

22.521%

32.5

21.9Sexual BehaviorSexually ActiveUses a condomUses a reliable birth control method50.7%31.5%35%26.552.812.6%26.857.227.5%34%34%25.3

Definition of InsanityDoing the same thing over and over and expecting a different result

A Noted Red Flag62 of the 942 high school students in the four high schools scored less then 3 on how they liked themselves and identified no one that they could talk toDecline in health status in the past two decade

Adolescent preventive service guidelines recommendconfidential,comprehensive health screeningpreventive counseling

Assessing the health status of adolescents is challenging

Personal disclosure has been associated with improved health outcomes. Pennebaker & Stone, 2003, Words of Wisdom. J Pers Soc Psychol, 85(2), 291-301.

Foundation literature

Thank You62Assessing the health status of adolescents is challenging for health care providers. Adolescents identify being there as an important quality of the health care provider.This quality facilitates a connection between the provider and adolescent, ultimately leading to disclosure of important health information. Personal disclosure has been associated with improved health outcomes.