1. Linda Summers, PhD, NP Conni DeBlieck, DNP New Mexico State University School of Nursing May 16 th 2015 1

3.  Task 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

4.  Only 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 adults

5.  Observational, cross-sectional epidemiological design  Self-administered survey Assessment 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, 231-251

6. FamilyFriendsMDs/RNsTeacher 25.2%53.2%5.1%5.8% Rated helpfulness of MDs/RNs advice ExtremelyQuite a lotModerateA littleNot at all 0% 8% 62% 15%

7. FamilyFriendsMDs/RNsTeacher 14.6%32.0%1.3%3.4% Rated helpfulness of MDs/RNs advice ExtremelyQuite a lotModerateA littleNot at all 20% 0% 20% 40% 20%

8. Talking About Health Habits FamilyFriendsMDs/RNsTeacher 18.9%39.6%3.8%4.5% Rated helpfulness of MDs/RNs advice ExtremelyQuite a lotModerateA littleNot at all 22% 0% 11% 56%

9. FamilyFriendsMDs/RNsTeacher 56.2%34.2%32.1%3.3% Rated helpfulness of MDs/RNs advice ExtremelyQuite a lotModerateA littleNot at all 7% 18% 30%28% 17%

10. Adolescents seldom spoke to health care providers and when they did, the information received was “useless” 74% of the time

11.  We 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

12.  Developed 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 12

13. Designed to help health care practitioners to...  Screen  Identify  Treat At-risk (all) adolescents for...  Physical  Sexual  Behavioral Health Problems 13

54. SBHC 2013-2014 by School

55. SBHC 2013-2014 by GENDER

57. SBHC’s (eSHQ)Dona Ana County Youth Risk Resilience Survey (YRRS) New Mexico (YRRS) USA (YRBS) Youth Risk Behavior Survey Unintentional Injury Texted or email while driving Rarely or never wore a helmet Rarely or never wore a seatbelt 6.9% 39.7 8.4% 38.7 91.% 6.2% 40.2 83.2% 7.6% 41.4 87.9 7.6% Violence Carried a weapon Bullied at school Physical dating violence 10% 2.7% 2.8 18.3 10.2 18.2 9.4 17.9 19.6 10.3 Mental Health Non Suicidal Self Harm Felt Sad or Hopeless Attempted Suicide 13% 31% 9.7 19% 30.7% 11.4 20.2 30.5% 9.4 24% 29.9% 8.0

58. SBHC’s (eSHQ)Dona Ana County Youth Risk Resilience Survey (YRRS) New Mexico (YRRS) USA (YRBS) Youth Risk Behavior Survey Tobacco Use Current cigarette smoking15.815.914.416% Alcohol Use Current Drinking26%36.628.935% Current Drug Use Marijuana19.7%24.6%27.841%

59. SBHC’s (eSHQ) Dona Ana County Youth Risk Resilience Survey (YRRS) New Mexico (YRRS) USA (YRBS) Youth Risk Behavior Survey Physical Activity, Body Weight, and Nutrition Daily Physical Activity TV viewing, computer/video more than 3 hours Five Servings of fruit or vegetables daily 81% 45.9% 35.6% 15.9 29.8 18.9 14.4 35.3 22.5 21% 32.5 21.9 Sexual Behavior Sexually Active Uses a condom Uses a reliable birth control method 50.7% 31.5% 35% 26.5 52.8 12.6% 26.8 57.2 27.5% 34% 25.3

60.  Doing the same thing over and over and expecting a different result

61.  62 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 to

62.  Decline in health status in the past two decade  Adolescent preventive service guidelines recommend confidential, comprehensive health screening preventive 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 You