January 2016 Newsletter Article

The Maternal and Child Health Bureau

How the Maternal and Child Health Bureau Addresses Adolescent and Young Adult Health: A Snapshot of Programs

The Maternal and Child Health Bureau (MCHB) has a long track record of formal programs that address adolescent health. School-based strategies form an important part of MCHB’s portfolio. This article summarizes current activities.

The MCH Title V Block Grant addresses adolescent health in two ways. The large majority of states support the position of State Adolescent Health Coordinator. There is considerable variation across states in the types of programming addressed by this position, but teen pregnancy prevention is currently the modal issue. In addition, the size of states’ adolescent health programs varies. Individual state adolescent health coordinators receive supportive resources from the National Network of State Adolescent Health Coordinators (NNSAHC), which itself is supported by the Adolescent and Young Adult Health National Resource Center. URL:

The transformation of the MCH Title V Bock Grant includes a new set of national performance measures (NPMs) that are organized by MCH population health domain. Adolescence is recognized as one of the six identified domains. Each state and jurisdiction is required to select at least one of the four NPMs formally designated to address an important adolescent health issue as part of its 5-year State Action Plan for addressing its priority needs. URL:

  • NPM #7: Injury prevention (rate of hospitalization for non-fatal injury/100,000 population children ages 0 through 9 and adolescents 10 through 19) – 28 states and jurisdictions
  • NPM #8: Physical activity (percent of children ages 6 through 11 and adolescents ages 12 through 17 who are physically active at least 60 minutes a day) – 27 states and jurisdictions
  • NPM #9: Bullying (percent of adolescents ages 12 through 17 who are bullied or who bully others) – 17 states and jurisdictions
  • NPM #10: Adolescent well-visit (percent of adolescents ages 12 through 17 with a preventive medicine visit in the past year) – 38 states and jurisdictions

The Adolescent and Young Adult Health National Resource Center (AYAH-NRC) promotes the comprehensive healthy development, health, safety and well-being of adolescents and young adults, ages 10-25 years, and addresses their major health issues by strengthening the capacity of State Title V MCH Programs, and their public health and clinical partners, to better serve these population groups. Using the methodology of a state-based collaborative improvement and innovation network (CoIIN), a type of learning collaborative with shared accountability, it focuses on five priority areas: Access and use of health services; quality; integration of state public health systems, health care delivery systems, insurers, and community efforts; equity; and accountability through monitoring population-level health, safety and well-being and measuring state-specific performance. The AYAH-NRC also provides technical assistance and resources to the states and jurisdictions that have selected NPM #10, the proportion of adolescents with a preventive medicine visit in the past year. The AYAH-NRC develops resources relevant to its areas of focus. The awardee is the University of California, San Francisco, which works closely with its three partnering sub-recipients, the University of Minnesota’s State Adolescent Health Resource Center, the University of Vermont College of Medicine’s National Improvement Partnership Network, and the Association of Maternal and Child Health Programs. This cooperative agreement program, which has a project period of 2014-2018, is administered by MCHB’s Division of Child, Adolescent and Family Health, and the total annual investment is $1.35 million. URL: Adolescent and Young Adult Health National Resource Center

The MCH Research Network on Adolescent and Young Adult Health was inaugurated in 2014 to support the creation of a transdisciplinary, multisite research network with the goal of accelerating the translation of developmental science into MCH practice, promoting scientific collaboration, and developing additional research capacity in the field of adolescent health. It emphasizes access to and quality of adolescent health care, integration of behavioral health into primary care settings, developmental neuroscience, developmental transitions, and medically underserved populations. The single awardee, which has a project period of 2014-2017, is the University of California, San Francisco. Funded by MCHB’s Division of Child, Adolescent and Family Health and administered by MCHB’s Office of Epidemiology and Research/Division of Research, the total investment for this cooperative agreement program is $320,000 per year. URL: MCH Research Network

Launched in 1977, the Leadership Education in Adolescent Health (LEAH) Program provides interdisciplinary leadership training and faculty development in adolescent health for five core disciplines: Medicine, nursing, nutrition, psychology, and social work. The LEAH Program prepares advanced long-term trainees for leadership roles in academic, public health and public policy sectors and ensures high levels of clinical competence. Training encompasses a wide range of concerns affecting the health and well-being of adolescents, including biological, developmental, mental and behavioral health, social, economic, and environmental issues. The seven awardees include: Boston Children’s Hospital, Indiana University, Johns Hopkins University, University of Alabama at Birmingham, University of California, San Francisco, University of Minnesota, and University of Washington. The current project period is 2012-2017 and the program is administered by MCHB’s Division of MCH Workforce Development. The total investment is approximately $2.6 million per year. URL:

The National Center on Health Care Transition for Youth with Special Health Care Needs serves as a national resource for health care professionals, families, youth, and state policy makers focusing on the transition of young adults, particularly those with special health care needs (SHCN), from pediatric to adult systems of health care services. It improves the transition process by increasing the number of clinicians with the knowledge and skills to care for this population in the adult system of care. Examples of key activities of this program include: Supporting efforts to equip youth and young adults, especially those with SHCN, with knowledge and skills to promote self-determination and successfully navigate adult systems of care; promoting training for pediatric residents, medical students and graduate-level students in clinical and public health training programs in the relevant core competencies; promoting policies and practices to assure youth and young adults, especially those with SHCN, access to uninterrupted quality health care through a medical home; developing youth and parent leadership in advocating for needed transition supports and participating in transition quality improvement efforts; promoting relevant health system measurement, performance, and payment policies; and serving as a clearinghouse for current transition information, tools, and resources. The awardee, which has a project period of 2013-2018, is the National Alliance to Advance Adolescent Health. This cooperative agreement program is administered by MCHB’s Division of Services for Children with Special Health Needs and the total annual investment is $436,000. URL:

The Collaborative Improvement and Innovation Network on School-Based Health Services improves the quality of school-based health centers (SBHCs) and comprehensive school mental health systems (CSMHSs) and both expands the number of students served and improves the sustainability of SBHCs and CSMHSs through the spread of innovative and practical policy and finance approaches. Key program strategies include: Developing and implementing field-generated standardized national performance measures; using learning collaboratives to set common aims and benchmarks, develop coordinated strategies, apply rapid test cycles with real-time data, and support capacity building; providing technical assistance nationwide to states and communities and organizations regarding policy and finance approaches for developing and sustaining these two types of programs; and ensuring active use of findings and promising practices by constituents. The project period of this cooperative agreement is 2014-2018. The awardee is the School-Based Health Alliance, which works closely with its partnering sub-recipient, the Center for School Mental Health at the University of Maryland’s School of Medicine. The program is administered by MCHB’s Division of Child, Adolescent and Family Health, and the total annual investment is $700,000. URL: Collaborative Improvement and Innovation Network on School-Based Health Services


What You Can Do to Prevent Environmental Hazards from Harming Children

Workshop before the International Congress of Pediatrics
Vancouver, British Columbia
August 17, 2016
8 am - 4 pm

The International Pediatric Association (IPA) is sponsoring this 1-day workshop on August 17 in Vancouver. The International Congress of Pediatrics will be held on August 17-22. The workshop is designed for pediatricians who want to learn how to protect children from hazards in the environment and those who plan to teach other providers about children's health and the environment.

Learning Objectives

  • Learn how to be an advocate for children and protect them from hazards in the environment;
  • Identify risks to children from secondhand smoke, chemicals (e.g. lead, mercury, pesticides), air, water and food contaminants, emerging issues (e.g. global climate change), and other environmental hazards;
  • Describe how to recognize, diagnose, prevent and manage adverse effects linked to these environmental risk factors;
  • Describe why children may be at increased risk of adverse health outcomes and developmental consequences from environmental exposures to chemical, physical and biological agents;
  • Describe when and how the fetus, the child and the adolescent may be exposed to environmental hazards in different rural and urban settings;

If you are interested in attending, detailed information can be found here:

Ruth A. Etzel, MD, PhD

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