Supported by an educational grant from Merck

ROADMAP TOTEEN HEALTH

This counseling tool has been developed by the American Academy of Nurse Practitioners

Table of Contents andKey TakeawaysHealthcare Provider: Please use this table of contents to

determine which sections of this educational tool to share with your patient and their parent(s)/guardian.

THE LEADING RISKS TO TEEN HEALTH …………………………………..

1

HEALTHY BODY WEIGHT AND HEALTHY EATING ………………………

2

PHYSICAL ACTIVITY ………………………………………………………….9

PROTECTION FOR YOUR SKIN ……………………………………………...

13

SLEEP AND TEENS …………………………………………………………… 14

IMMUNIZATIONS FOR TEENS ……………………………………………..15

TEEN SAFETY ………………………………………………………………….19

SEXUAL HEALTH …………………………………………………………….. 21

TOBACCO USE ………………………………………………………………..23

ALCOHOL AND DRUG USE …………………………………………………27

MENTAL AND EMOTIONAL HEALTH ……………………………………..30

1

Unhealthy dietPhysical inactivity

Accidents and injuriesinjury from othersTobacco product usealcohol or drug use

The Leading Risks to Teen Health

2

●Eat a healthy diet

●Maintain a healthy body weight

●Be active 30 to 60 minutes each day

●Don’t use any kind of tobacco products

●Avoid second hand smoke

●Don’t drive if you have been drinking or using drugs

●Don’t text or use a cell phone when driving

●Don’t use drugs or alcohol

●Don’t ride with drivers who are distracted, have been drinking, or using drugs

●Always wear your seat belt

●Use the right safety equipment for activities

●Remember: the “safest” sex is no sex

●If you choose to have sex, practice safe sex

●Avoid people and places where you might be hurt

●Talk with a trusted adult if you feel sad, upset, or depressed

●Stay up to date on your immunizations

Tips to Help you Stay Healthy

A healthy body weight is based on your:

Healthy Body Weight

●Age

●Height

● Weight

●Sex

3

Your body mass index (BMI) is a number based on yourHeight and weight that indicates your amount of body fatAnd helps screen for weight categories that may lead toHealth problems.

100

95

90

85

80

75

70

65

60

55

50

45

40

35

30

25

20

15

1050

PER

CEN

TIL

E

BEST BODY WEIGHT

OBESEOVERWEIGHT

UNDERWEIGHT

What is a Healthy Diet?

4

The eatwell plateUse the eat well plate to help you get the balance right.

It shows how much of what you eat should come from each food group.

Fat—daily fat intake 25% to 35% total calories per day• Less than 10% from saturated fat and no trans fats

FOOD GROUP SERVINGS PER DAY

Grains (whole grain breads, cereals, rice, pasta) 6 to 11

Vegetables and fruits 5 to 9Protein (meat, tofu, beans) 2 to 3Dairy (milk, yogurt, cheese) 2 to 3

Vegetables & Fruits

Grains

DairyFood & Drinks

high in fat and/or sugar

Protein

A healthy diet is balanced with all kinds of foods in the following groups:

5

The Benefits of Healthy EatingHealthy eating helps you…

●Stay at your best body weight

●Think more clearly

●Feel good about yourself

●Have healthier hair, nails, and

skin●Have more energy and feel

stronger

●Improve your sleep

●Lower your chance of illnesses, such as:

CancerDiabetesHeath diseaseHigh blood pressureStroke

6

●Eat regular meals, starting with breakfast●Eat healthy snacks in between meals●Eat at least 5 fruits and vegetables each day●Watch the size of food portions●Eat only when you feel hungry●Stop eating when you feel full●Drink at least 8 glasses (8 ounces each) of

water each day●Read and understand food nutrition labels●Make healthy choices when eating out●Limit amount of fast foods, soda, desserts,

and junk foods

CALORIC INTAKE CHART

ACTIVITY LEVEL * FEMALES MALES Low 1800 calories 2200 calories Medium 2000 calories 2400 to 2800 calories High 2400 calories 3000 cal

Tips to Help you Eat aHealthy diet

7

How to Read Food Nutrition Labels

8

Tips for Healthy Weight Loss●Set a weight loss goal with

your health care provider

●Try for slow weight loss,

about 1 to 2 pounds per

week

●Choose healthy foods

●Eat meals on a smaller

plate

●Don’t skip meals or wait too

long between meals

●Eat more salads, veggies,

and fruit

●Eat slowly and chew well

●Drink at least 8 glasses of

water each day

●Watch the size of food

portions

●Read and understand food

nutrition labels

●Make healthy choices when eating out

●Don’t deprive yourself of

your favorite foods

●Limit amount of fast foods,

soda, desserts, and junk

foods

●Keep a food diary and write

down what, how much, and

when you eat

●Be active 30 to 60 minutes

each day

●Limit the time you spend on

the computer

●Limit your time spent on

video games, the phone,

and watching TV

•Reach and stay at your best body weight

•Help you think

clearly

• Improve your

strength, endurance,

and energy

•Help you feel

positive

• Improve your sleep

•Lower your chances

of injuries

• Improve the way you look

• Lower your chance of

illnesses, such as:Cancer

Diabetes

Heart disease

High blood pressure

Stroke

Being active helps you:

The Benefits of RegularPhysical Activity

9

10

Planning for RegularPhysical Activity

●Stretch and warm-up first●Cross-train to develop different parts of your

bodyStrength-train 3 times per week with 1 day of

rest in between Focus on major muscle groups in your upper

body, core, and legsStay flexible by doing yoga, Pilates, or T’ai chiIncrease your heart rate by doing aerobic

activities (dancing, walking, running, cycling, swimming basketball, soccer, etc.)

● Stretch and cool down●Find activities you can do at home that are on

TV, videos or the internet● Pick activities you enjoy doing by yourself● Pick activities that you can do with your family

and friendsTEAMSPORTS INDIVIDUAL ACTIVITIES

Such as baseball, football, basketball, hockey, soccer, or cheerleading may:

•Help you make new friends and spend time with them•Help you feel part of a group with a shared goal•Have fun playing with others for a shared goal

Such as bicycling, running, swimming, and walking may:

•Make you feel independent•Be easier to fit into your schedule•Allow you to set your own goals•Give you some fun time on your own

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Tips to Help you Start andStay physically Active●Set specific, realistic goals

●Make a contract with yourself or another person●Start with small steps and take it slow●Keep an activity log and write down each activity you

do and how long●Give yourself time for being active to become a habit●Mix it up by doing strength, aerobic, stretching, and

flexibility activities●If you stop for a while, remember you can start again●Write down your progress as you become stronger,

work out longer, more often, and feel more healthy●Ask for support from family and friends

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●Use the right kind of safety equipment for your sport such as:

The right kind of helmet for cycling, skating, skateboarding, or contact sports

Eye protection for soccer, basketball, racquetball, and snow sports

A face guard for football, hockey, and baseballA mouth guard for contact sportsWrist, knee, elbow, and shin guards for inline skating,

scooters, and skateboardingWear sunscreen and sunglasses when outsideMales should wear a protective cup to protect their

testicles●Wear the right kind of shoes, fitted correctly, and tied●Take 10 to 15 minutes to warm up●Drink plenty of water before, during and after being

active●Know and follow the rules of the game in team sports●Stick to a regular practice schedule●Rest between workouts●Don’t’ work out when sick or injured

Tips to Stay Safe DuringPhysical Activity

Tips for Year-RoundSkin Protection

13

●Try to stay out of the sun from 10 AM to 4 PM

●Wear long sleeves and long pants

● Wear a hat with a wide brim

●Use sunscreens with SPF 30 or higher●Put on 2 coats of sunscreen, 20 minutes apart at

least 30 minutes before going outside

●Re-apply sunscreen every 1 to 2 hours●Wear sunglasses with UVA and UVB light-absorbing

lenses

●Never use tanning beds

DOS DON’TS

● Go to bed around the same time each night

● Get up at the same time each morning

● Avoid bright light in the late evening

● Turn off your computer, TV, and phone

● Make sure your bedroom is quiet, dark, and relaxing

● Pick relaxing activities (reading or warm shower) before bedtime

● Drink or eat any foods with caffeine late in the day

● Eat, drink, or exercise just before you go to bed

● Use tobacco or drink alcohol● Start stimulating activities

before bedtime (study, texting, conversations)

● Change your sleep pattern more than 2 to 3 hours on weekends

14

Health Benefits of Sleep for TeensGetting enough sleep helps you…●Improve your

performance in school

●Listen, learn, think, and solve problems

●Have healthier skin

●Stick to a healthy diet

●Feel better physically and mentally

●Lowers your chances of getting sick

TIPS FOR HEALTHY SLEEP

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Why Teens Need Immunizations

●Shots are not just for little kids●Teens need vaccines or immunizations to “boost”

the ones they received as children●Teens also need vaccines to avoid infections that

are problems that occur in the teen years●If you missed your pre-teen immunizations, you

need to “catch-up”●There are many serious diseases that are

prevented by vaccines●Vaccines are safe●Teens should keep a copy of their immunization

record and know when their next shots are due.

VACCINEAGE

11 to 12 13 to 18

Tetanus, diphtheria, pertussis

1dose1 dose for catch-up if

needed

HPV 3 doses3 doses for catch-up if

needed

Meningitis Meningococcal 1 dose1 dose for catch-up if

needed

Influenza 1 dose each year 1 dose each year

Pneumonia Pneumococcal Certain high-risk groups Certain high-risk groups

Hepatitis A2doses

For high-risk groups2 doses for catch-up if

needed

Hepatitis B

3 doses for catch-up regardless of risk (or 2 doses of adult vaccine

ages 11-15)

3 doses for catch-up regardless of risk (or 2 doses of adult vaccine

ages 11-15)

Measles, mumps, rubella2 doses for catch-up if

neededCatch-up if needed

Chicken pox (varicella) 2 dosesSeries for catch-up if

needed

16

Recommended Immunizationsfor Teens 11 to 18 Years

•

17

Why Are ImmunizationsImportant to Your Health?

Tetanus: A bacterial infection that causes stiffness of the jaw and other muscles that can cause:

Painful muscle spasms

DeathHPV (Human Papilloma Virus): A virus that causes genital warts, the most common sexually transmitted infection (STI) that can cause:Cervical cancerGenital warts in males and femalesOther kinds of cancer

Meningitis: A viral or bacterial infection that causes inflammation and swelling in the brain and spinal cord that can cause:SeizuresBrain or kidney damageLoss of eyesight or speechLearning disabilitiesParalysis

Influenza or the flu: A virus that causes a respiratory illness that can cause:Death, especially in people with other health problems that weaken their immune system

18

Why Are ImmunizationsImportant to Your Health?

Pneumonia (high risk teens only): Inflammation of the lungs caused by a virus, fungus, or bacteria that can cause:Fluid in the lungsSerious respiratory problemsInfection that spreads in the bloodstream throughout the body

Hepatitis: A viral infection that can cause 3 types of the infection (A, B, or C)that can cause:Liver damageLiver cancerDeath

Measles: A virus that lives in the nose and throat that can cause:Ear infectionsBronchitis or laryngitisPneumoniaBrain inflammation

mumps: A virus that causes painful swelling in the glands below and in front of the earsthat can cause:Swelling of the testicles that may cause infertilityInflammation of the ovariesBrain inflammation, meningitis, or loss of hearingChickenpox or varicella: an infection caused by the varicella zoster virus that causesfever and an itchy rash that can cause:Skin infectionsBrain swellingPneumonia

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Tips to Help You Stay Safe

●Always wear a seatbelt when driving or riding in a car

●Always wear a helmet when you ride your bicycle, a

motorcycle, or as needed for sports

●Don’t drive if you have been drinking or using drugs

●Don’t text or use a cell phone when driving●Don’t ride with drivers who are distracted, have been

drinking, or using drugs

●Stay away from places and people where you may be

hurt

●Stay away from persons who are quick to get angry

●Learn how to control your own anger

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Tips to Keep You fromBeing Hurt by Others

WHAT TO DO IF YOU OR OTHERS ARE HURT●If you are hurt or attacked, call 911 and get help from your parent(s)/guardian or a trusted adult

●Ask for medical care if you need it

●If someone else has been hurt or attacked, call 911 or get help from a trusted adult

●If you feel that you someone is trying to hurt you, try to get to a safer place or safer people

●Stay in areas where there are other people

●Stay away from people carrying guns, knives, or other weapons

What to Consider if You’reThinking about Having SexHaving sex can …

●Lead to pregnancy

●Cause feelings or emotional reactions you did not expect

●Put you at risk for dating violence

●Increase your chance of getting a sexually transmitted

infection (STI)

HOW CAN YOU PREVENT A SEXUALLY TRANSMITTED INFECTION (STI)?

●Use latex condoms when having all types of sexual intercourse, including oral and anal sex

●Know the right way to use condom

●Use a new condom with each new sexual act

●Talk with your partner aboutsafe sex and their exposureto STIs

Chlamydia Genital Herpes HPV Gonorrhea

Hepatitis HIV Syphilis Trichomonas

21

Remember:Not having sex is always a choiceYou can still show caring by hugging, holding hands, and giving your partner loving massages●Talk with your partner about your needs, limits, and feelings●Choose to do sexual behaviors that feel comfortable to you

Plan ahead:Make sure you have a latex condomMake sure you know how to use a condom●Use latex condoms with all kinds of sexual intercourse, including oral and anal sex●Use a new condom each time●Remember when you have sex with your partner, you are exposed to everyone your partner may have had sex with●If you have unprotected intercourse, see your health care provider (women should see their provider within 3 days)●See your healthcare provider if you think you have a STI, are pregnant, have questions about sex, or feel that you are not safe

22

Tips to Safer Sex ifYou Choose to Have Sex

Tobacco Health Effects●Hurts your lungs and

can lead to more frequent asthma attacks, coughing, and respiratory infections

●Causes your skin to be dry, yellow, and wrinkled at an earlier age

●Limits amount of oxygen that reaches your muscles, making it harder to be physically active

●Causes long-term effects such as cancer, emphysema, heart disease and infertility

●Causes addiction●Makes you feel anxious,

nervous, moody, and depressed

●Causes headaches and dizziness

●Stains your teeth and causes bad breath

●Makes your clothes and hair smell

●Changes the taste of foods

●Makes your heart work harder when you are physically active

●Tobacco product smoke contains more than 4000 chemicals with nicotine the most common and addictive “ingredient”.

toluene(IndustrialSolvent)

Hexamine(BarbecueLighter)

Stearic acid(Candle Wax)

CarbonMonoxidearsenic

(Poison)

Butane(LighterFluid)

acetic acid(Vinegar)

methane(Sewer Gas)

Nicotine(Insecticide)

ammonia (Toilet Cleaner)

Cadmium(Batteries)

Methanol (Rocket

Fuel)

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Smokeless tobacco

●Smokeless tobacco (also called spit tobacco, chewing tobacco, chew, and dip) has 2 forms

√Snuff

√Chewing tobacco●Snus is a moist, smoke-free, spit-free form

of smokeless tobacco●Smokeless tobacco has 28 substances in it

that can cause cancer●Use of smokeless tobacco can lead to

nicotine addiction and make it more likely

you will smoke cigarettes●Smokeless tobacco can cause:

√Low or abnormal sperm count that can lead

to infertility

√Gum disease

√Pre-cancerous lesions in the mouth that look

like white patches

√Cavities

Tips to Help YouQuit Using Tobacco

●Get a check-up and set a date with your health care provider to quit

●Find a friend who will quit with you

●Get support from friends and family members

●Wash all your clothing to get rid of the tobacco smell

●Avoid triggers that make you want to smoke

●Switch to gum, carrot sticks, or sunflower seeds instead of using tobacco

●Be ready for the physical and emotional effects of quitting such as:

√Headache, fatigue, dry mouth, sore throat, urge to eat more, feeling crabby, jumpy or depressed

●Remember the withdrawal symptoms last for only a short time and the benefits of quitting start right away

●Keep busy and distracted

●Some quit best old-turkey

Throw away all of the tobacco products you use

●Others quit best if they slowly lower the amount of tobacco they use

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●Second-hand smoke is:

√Smoke that is exhaled by a smoker√Smoke that comes from the end of a lighted cigarette, pipe, or cigar

Tips to Avoid Second-Hand Smoke

●Stay away from second-hand smoke at school and work

●Ask family members you live with to smoke

outside or quit smoking

●Don’t ride in the car with someone who is

smoking

●Stay away from public places that do not ban

smoking

What is Second-Hand Smoke?

26

Short- and Long-term Effectsof Drugs and Alcohol●Confused thinking and

memory loss

●Slower reaction times

●Loss of balance

●Slurred speech

●Distorted or blurry vision and hearing

●Bad breath

●Poor performance at school

●Difficulty having an erection

●Accidental injury to yourself or others

●Alcohol poisoning, accidental overdose, and death

●Increased risk of sexual assault or high-risk sexual behaviors

●Addiction and the development of tolerance so you need more to have the same effect

●Unhealthy diet and serious vitamin deficiencies

27

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●Say no with or without an explanation or reason

●Say no and ‘blame’ an adult for your refusal●Have a plan to leave if you are someplace where

others are using alcohol or drugs

●Be the ‘designated driver’

Tips to Avoid UsingDrugs and Alcohol

29

Tips to Stop UsingAlcohol and Drugs

●Learn more about the harmful effects of alcohol and drugs

●Get a check-up and set a date with your health care provider to quit

●Find a friend who will quit with you

●Get support from friends and family members

●Throw away all of the alcohol or drugs you use

●Eat healthy foods, drink plenty of juice and water, and get enough sleep

●Prepare for the physical and emotional effects caused by quitting

●Join a support group such as Alcoholics Anonymous or Narcotics Anonymous

●Stay away from people, situations, and places that make you want to drink or use drugs

●Keep yourself busy and distracted

●Reward yourself each time you do not use alcohol or drugs when you have a craving

Eating Disorders can cause:

●Heart disease including an abnormal heart rate and heart

failure

●Low red blood cell count (anemia) that causes fatigue

●Weak immune system that increases your chances of getting

infections

●Kidney problems

●Stopping your regular menstrual periods

●Thinner, weaker bones that increase your chances of breaking

a bone

●Stomach problems● Eating when you are not

hungry

● Eating large amounts of

food

● Eating alone or in secret

● Hiding what you have

eaten

● Using diet pills, diuretics,

or laxatives, especially

after eating large amounts

of food

● Making yourself vomit

● Feelings of disgust,

embarrassment, shame, or

guilt about food and eating

●A negative body image●Exercising too much●Strictly limiting the amount

of food you eat●Weighing the foods you

eat, counting calories, and strictly monitoring portion sizes

●Being very concerned with how much you weigh

Eating disorders

Signs of Eating Disorders

30

Signs of Mental orEmotional Problems

●Sad or hopeless for no reason●Irritable or angry●Crying a lot●Anxious, restless, fearful, or worried a lot●Feeling guilty, worthless, or embarrassed

●Use of alcohol or drugs

●Dieting or over-exercising

●Hurting yourself or doing risky behaviors

●Acting violently toward others

●Thinking about suicide

31

●Wanting to be alone and not spend time with friends and family

●Loss of interest in your usual activities

●Changes in your eating and sleeping habits

●Physical symptoms such as blushing, sweating, trembling, and feeling sick to your stomach

●Feeling tired or loss of energy

●Having trouble concentrating

●Not completing tasks

●Poor performance in school

Changes in usual behaviors . . .

Feelings . . .

Start of new behaviors . . .

Getting Help for a Mental orEmotional Problem

●Talk with your parents(s)/guardian, or another trusted adult

●See your health care provider

●If you are given medication, make sure you take it as prescribed and don’t stop taking it suddenly

●Join a support group

●Stay active

●Stay in touch with your friends and family even if you feel like being alone

●Eat a healthy diet, get regular activity, and the right amount of sleep

●Try to stick to your usual routine

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●You feel afraid of your partner or afraid of what your partner will do to you if you break up

●Your partner calls you names, makes you feel stupid, criticizes you, or puts you down

●Your partner is very jealous

●Your partner tries to cut you off from your friends and family

●You feel afraid of your partner if you say “no” to touching or sex

●Your partner blames you for his or her violent behaviors

Signs of an Unsafe Relationship

You may be in an unsafe relationship if: ●Your partner physically

hurts you

●Your partner is really nice sometimes and then changes and becomes really mean

●Your partner promises not to hurt you any more but then repeats his or her behavior

●Get to know a person first before becoming close or intimate

●‘Hangout’ in groups first

●Find out if you share similar interests

●Have relationships based on respect and honesty

●Make sure your parent(s)/ guardian(s) know your friends

●Let your parent(s)/ guardian(s) know where you are going, who you are going with, and when you will be home

●Make sure you can get home or to a safe place on your own by driving yourself or having enough money to take the bus or taxi

●Know the address and phone numbers of people you trust and can call if you need help

●If you don’t feel safe, talk with your parent(s)/ guardian(s), or other trusted adults such as a teacher, minister, or your health care provider

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Tips to HaveSafe Relationships