By Lori Tremmel Freeman, BS, MBA
Chief Executive Officer, AMCHP
Adolescent health is often front and center for me and my family because of our teenage twins. Yet, our family is very fortunate to experience excellent health, have access to quality health insurance and medical providers, to live in a community that has exercise trails and parks readily available, to feel safe walking, biking and playing outside, to have food and housing security. We all know that many families and the adolescents living in those households do not have these same things we so often take for granted. Let's face it, being an adolescent is hard enough without these additional burdens.
Whenever I'm curious about something and need a rather unbiased answer, I always turn to my kids. I find they are usually refreshingly honest when I ask their opinions about something – in fact, almost to a fault! When I asked my kids about adolescent health in general, their responses were surprising. They don't see the point of routine doctor visits at all. My son says the doctor treats him 'like I'm five years old.' He added that it's just as easy to go to the grocery store to have his blood pressure taken anytime he wants or even to do an eye test. The thing that was most impressionable to my daughter about the adolescent doctor visit was the reflex test of all things. She says, "the only thing the doctor does is the same exact thing every year…she whops me on the knee and gets the identical result she did last year. What is the point of that?"
Admittedly, I was taken aback both by their candor and their disregard for the well visit. Obviously, given the field I'm in, I took their responses seriously as a teachable moment. Explaining and educating why it's important to see the doctor, why and how we need to keep up with our vaccination boosters, what the HPV vaccine is meant to do for them now and later in their lives, and that monitoring one's health now is a great prevention strategy for staying healthy as an adult was news to them at the age of 16. I felt a bit disappointed that my husband and I were left to our own devices to advocate for the doctor visit. I mean, shouldn't there be some shared responsibility here with the medical providers also?
If adolescent health is a priority, which we know it is as evidenced by #10 of the national performance measures – Adolescent well-visit (percent of adolescents, ages 12 through 17, with a preventive medical visit in the past year) – then we truly need to respect their perspectives and perceptions about these visit. My kids honestly could not describe the value of going to the doctor every year. They are not treated like adults and they don't really receive even a cursory attempt at providing information about the well visit or why it's even necessary. I've a feeling they are not in the minority opinion here.
Fortunately, you'll learn more through this issue of Pulse about the number of ways we are working actively in adolescent health and teen pregnancy to improve our systems for this important population. For example, the Adolescent and Young Adult Health National Resource Center (AYAH-NRC) provides the opportunity for state MCH programs to participate with key partners in a new Adolescent and Young Adult Health Collaborative Improvement and Innovation Network (AYAH CoIIN). This past summer, I had a chance to visit with the five states participating in the CoIIN including Iowa, Mississippi, New Mexico, Texas and Vermont. I was particularly fascinated with the inclusion of young adult representatives from each of the state teams. Their maturity and ability to articulate the needs of their population was really refreshing and I'm excited to see how their continued participation drives the process and outcomes for this CoIIN. These young adults want most of all to be taken seriously, for their thoughts and opinions to be sought, to have a chance to influence their own outcomes, and through their experience with leadership roles to help their peers to have better experiences. They were absolutely amazing to watch and interact with – fully present at the meeting and participatory. I was proud to think of them as future leaders of their communities!
So, as I learned from the dinner conversation about adolescent health with my kids AND from the young adults from Iowa, Mississippi, New Mexico, Texas, and Vermont, let this be an important and sobering reminder for us all. We must continually engage with the people we are trying to help. We must listen – and hear – their needs. We need to better understand their opinions and perspectives and what MATTERS to them most. And, we need to be open, willing and flexible enough to allow this feedback to inform our search for solutions and improvements moving forward.