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Problem:
Despite improved adoelscent health indicators, mortality and morbidity remain high for US teens; ethnic disparities persist. In 2002, we conducted a national needs assessment to define our focus of training (i.e.,leadership, cultural competence, health systems, advocacy, research).
Goals and Objectives:
Goal 1: Prepare the next generation of adolescent health practitioners with leadership knowledge/skills in public health and academics, to influence healthy youth development, through leadership development.
Objective 1: Thirteen post-graduate medical fellows will qualify for sub-baord examination in Adolescent Medicine by Year 5. A the end of Year 3, 5 medical fellows had qualified; and an additional 5 are on course for completion and qualification by the end of Year 5.
Objective 2: Post-graduate health professionals will have completed a one-year LEAH fellowship: 5 Master's prepared and two doctoral Nursing fellows; 5 Master's or post-doctoral Nutrition fellows; 5 post-doctoral Psychology fellows; 5 Master's or post-doctoral Social Work fellows.
Objective 3: Each fellow will have submitted at least one manuscript per year to a peer-reviewed journal.
Goal 2: Assuring technical assistance to Maternal and Child Health.
Objective 1: Provide technical assistance to at least 10 state health departments, half of which will be in the Upper Midwest.
Objective 2: Information will be disseminated at least twice annually to all State Adolescent Health Coordinators.
Objective 3: Participation in at least 15 key state, regional and national task forces and boards of professional organizations that address health and development of youth.
Goal 3: Expanding the University of Minnesota's capacity in adolescent health.
Objective 1: A minimum of 5 graduate level courses will be offered for credit annually across the Academic Health Center.
Objective 2: All Pediatric residents will complete a month of training in adolescent health through the University of Minnesota's LEAH Program.
Objective 3: All Pediatric Nurse Practitioner students, Medicine-Pediatrics, and Pediatric residents will learn interviewing skills through the Adolescent Actors Teaching Project. Training will also be conducted for some Internal Medicine, Family Practice, and Psychiatry residents also receive this training.
Goal 4: To support continuing education for local, state, and regional MCH health professionals.
Objective 1: One 1-to-2 day training program per year will be offered in Upper Midwest state.
Objective 2: At least three local or regional training workshops annually will be developed and delivered in conjunction with partners in the MCHB Training Consortium.
Objective 3: LEAH faculty will present at least 30 local, regional, and/or national presentation annually to community groups, organizations and/or agencies.
Goal 5: Addressing health disparities for 10- to 24-year-olds, providing training opportunities related to early, middle, and later adolescent years.
Objective 1: 30% of trainees will come from the Upper Midwest region of the United States.
Objective 2: 25% of all trainees years 1-5 will come from under-represented populations.
Objective 3: At least 23,000 adolescent males and females from African-American, American Indian, Asian-American and Euro-American racial/ethnic groups across a wide range of SES levels from both urban and rural communities will be served annually through clinical and community programs.
Methodology:
We prepare health care professionals (medicine, nursing, nutrition, psychology, social work) for leadership positions in academic, public health, and community sectors. All fellows have previous educational and work experience in adolescent-related areas; and have demonstrated capacity for leadership. Desired applicants' goals extend beyond primary individual patient/client care. We seek those whose work efforts will enhance adolescent health care by training others; research; and development of service models in adolescent health care. Designed for master's, doctoral and post-doctoral fellows; with focus on minority applicants. Fellowships vary in duration; physicians, 2-3 years; other disciplines, full completion of LEAH curriculum requirements necessitates a 12-month full-time program over 1 or 2 years. The curriculum is a four-component model: Leadership Knowledge and Skills; Adolescent Health Knowledge and Skills; Clinical Knowledge and Skills; Focal Areas of Expertise. The four components are a vehicle for intensive research and clinical development in a defined focal area, plus leadership preparation for professional work in either academic, public health, or community settings. Clinical requirements for fellows take place in a variety of clinical sites. All fellows are required to complete a research project, which will lead to submission of an abstract for presentation at a national meeting and a manuscript to a peer-reviewed journal.
Coordination:
UMN students in any MCHB-supported training programs can participate in our training offerings. We are linked to Minnesota's Title V program, Family Planning (Title X), and Services for Children with Special Health Care Needs. Our faculty serve on the NIIAH by the Year 2010 Steering Committee. Close collaboration exists with Office of Adolescent Health through the cooperative agreement of the Konopka Institute to provide technical assistance and training to State Adolescent Health Coordinators.
Evaluation:
Fellows work with faculty mentors to develop their annual Individual Learning Program (ILP), which is used in conjunction with regular evaluation sessions between mentor and fellows. Each fellow has a Scholarship Oversight Committee which further evaluates the fellow's progress. Every 5 years, we conduct a needs assessment about adolescent health training and education, whereby we survey current and past fellows; regional MCH Directors; and State Adolescent Health Coordinators.
Experience to Date:
In 2005-2006, 8 long-term fellows were graduated by the University of Minnesota’s LEAH program. The core faculty wrote 54 manuscripts, book and book chapters, many involving co-authorship with fellows and former fellows. They obtained 13 continuation grants (>$4.5M); and 4 newly-funded grants (>$1.3M), including extension of a $2.6 million CDC grant for adolescent health protection research training, increasing the research training capacity of our LEAH fellowship program. Faculty gave over 100 continuing educational presentations internationally, nationally and locally. They served as consultants to U.S. federal agencies including MCHB, CDC and at a White House conference on Helping America’s Youth. They consulted for numerous state health, education and human service departments, and served in numerous positions for professional organizations (e.g., Society for Adolescent Medicine, Society for Eating Disorders, American Public Health Association, Academy for Eating Disorders). They provided expertise to the media (Washington Post; Boston Globe; USA Today), and served as reviewers for over 21 journals. They served on the Board of Directors and Scientific Advisory Committees of several national organizations, including the National Dairy Council, Alan Guttmacher Institute, and National Campaign to Prevent Teen Pregnancy. In addition, they were consultants to several foundations (e.g., Robert Wood Johnson Foundation, Blue Cross/ Blue Shield Foundation, Kellogg Foundation).
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