GOALS & OBJECTIVES
The major goal is to train interdisciplinary leaders in adolescent health who will be capable of assuming roles as faculty in health professional schools, clinician/educators, administrators, researchers and health policymakers at the community, university, state/regional and national levels. Specific Objectives include: 1. To provide interdisciplinary leadership training for the 5 core MCH disciplines including Medicine, Nursing, Nutrition, Psychology and Social Work which focuses on the primary target areas of the Healthy People 2000 objectives. 2. To implement and evaluate culturally sensitive, family-centered exemplary models of accessible, coordinated comprehensive longitudinal health care services for youth that reflect the Goals of Healthy People 2000 and Bright Futures. 3. To assist community, state regional and national health care and policy organizations in developing and addressing the core public health functions for adolescent health. 4. To continue to develop a knowledge base in adolescent health through the pursuit and dissemination of research and evaluation. 5. To prepare adolescent health specialists to play key roles in the development of policies shaping the system of care for adolescents at local, state, regional and national levels.

METHODOLOGY
The following methods are used to implement the Project’s major goal and five specific objectives: I. Training A. Long term trainees at UCB and UCSF in five disciplines (Medicine, Nursing, Nutrition, Psychology and Social Work) are trained using 33 major inter-disciplinary components developed around four Core Areas: (1) A Biopsychosocial and Environmental Context Core, (2) Leadership Development Seminars, (3) Research/Evaluation/ Health Policy and (4) Clinical Services at a University and Community. B. Short term trainees in MCH-affiliated programs at UCB and UCSF receive additional training in adolescent health to supplement their discipline-specific public health training. II. Services: A full complement of primary, secondary, tertiary and community-based clinical programs has been developed to meet the needs of the adolescent population and the training project. The major focus is to develop services that maximize resources of public and private partnerships through a coordinated strategy to decrease duplication of services and increase integration and access of care for adolescents in our Region. III. Consultation, Continuing Education and Technical Assistance: The project provides consultation, continuing education and technical assistance to MCH-related projects at the community, state, regional and national level. At the community level, we are developing CE programs to train health professionals to provide clinical services to adolescents within primary care settings. At the state level, we are leading the Adolescent Task Force, which is developing a coordinated State Plan to utilize existing resources for improving the health status of California youth through using the public and private sectors. We are developing a formal traineeship for advanced level trainees based within the California MCH branch. At the national level we have outlined a plan to utilize the existing relationships between the Office of Adolescent Health, MCHB and the Partners in Program Planning in Adolescent Health to develop CE consulting programs that maximize the resources of MCHB and professional organizations. IV. Research: We continue the development of a knowledge base in adolescent health through research/ evaluation that focuses on a number of the health damaging and promoting behaviors unique to adolescence. Beyond this we continue to develop mechanisms to utilize extant databases in California for research and policy development. In an effort to increase research productivity within adolescent health, we have developed a plan to develop “user friendly” modules for research training. V. Policy Development: To facilitate the development of adolescent health specialists in adolescent health policy, we are in the first year of developing an adolescent health policy seminar series for advanced level trainees in existing LEAHs Following the development, a formal National Summer Institute would be developed for adolescent health specialists.

COORDINATION
The faculty have developed collaborative relationships with the community, state, regional and national organizations focused on MCH populations in the development of this project including such professional organizations as AAP, ABA, AMA, APA, NASW and NCYL. These organizations continue to play an advisory role in the ongoing operation of the project through the Professional Advisory Committee.

EVALUATION
The most important outcome of this training project is the success of our past trainees in providing leadership in Adolescent Health. To measure this outcome, we conduct an annual survey of all former trainees assessing current job, professional activities in the field, publications, etc. We also measure the intermediate outcomes of our Training Project through a carefully designed self-assessment instrument that measures the success at meeting the eleven Core Objectives of our Training Project. This evaluation instrument is used three times during the course of their training. In the area of clinical services, we monitor the volume and number of patients seen including the number of agency referrals and the number of consolidated service programs that develop during the course of the project. Health outcomes are monitored in the clinical settings where preventive service guidelines continue to be implemented through HEDIS measurement tools. In the area of consultation, continuing education and technical assistance, we evaluate the effectiveness of our educational programs through pre and post measurement instruments. In the area of research, we measure the outcomes through publication and dissemination of findings and new extramural awards.

ANNOTATION
Adolescents and young adults remain our nation’s greatest resource and our critical link to the second millennium. The demography of adolescents is changing: California leads the nation in numbers and diversity of its adolescents, 1 of 8 U.S. adolescents now live in California, most of minority origin. These adolescents continue to have major unmet health needs with decreased access to the new managed health care system reducing their chances to establish themselves as a healthy integral part of our society. Major adolescent health problems require an integration of the biological, psychological, social, environmental and policy areas for effective health intervention and disease prevention. Adolescents with problems of substance use, injury/ violence, poor nutrition, consequences of sexual activity and the increased prevalence of chronic conditions and mental health disorders present themselves to all health professional disciplines requiring unifying approaches to treatment and prevention. In contrast to the increasing scope of problems projected for U.S. youth in the new millennium, over the past decade, the preparation of health professionals to meet these challenges has remained static with little improvement in the content and skills incorporated into the curricula of most professionals schools. The complexity of adolescent health problems requires interdisciplinary leaders trained in settings with sound clinical, public health, research skills and breadth of knowledge about the issues of adolescence. Because California is already experiencing the enormous increase in number of adolescents, diversity and economic challenges projected for the country as a whole in the new millennium, our project is uniquely situated to take a major leadership role in professional organizations and MCH to prepare to meet these challenges in the future. Our project is uniquely situated to prepare trainees in health professions, MCHB and other professional organizations to meet these challenges. This project based within our UCSF Division of Adolescent Medicine will build on its track record of bringing together faculty in education, medicine, nursing, psychology, social work, nutrition and health policy to be responsive to the changing nature of the population and extend into new areas of leadership.

KEYWORDS
Adolescent Health, Nutrition, Adolescent Medicine, Pediatrics Interdisciplinary Training Project, Psychology, Maternal and Child Health, Public Health, Nursing, Social Work