Beyond the Data Update — Adolescence: Preparing for Lifelong Health and Wellness

MUSIC [Thorpe] Welcome to Beyond
the Data, I’m Dr. Phoebe Thorpe here to talk about Adolescent Health and with me today is Dr.
Stephanie Zaza, the Director of the Division
of Adolescent and School Health. Stephanie, thank you so
much for joining us. [Zaza] Thanks
for having me. [Thorpe] This is a very
exciting session of public health grand rounds about
adolescents…teenagers. Everybody knows that
teenagers are at adolescence, change, evolve, it
can be day-to-day. It seems like forever and
then they get through it. What is it about that time
period in people’s lives that is so important for
us to focus on from a public health
point of view? [Zaza] Well, I’m
glad you asked. It’s a really profound
time of change. Lots going on for these
young people and there’s natural risk-taking that
has to happen for them to grow and mature and that’s
why it’s so important that we pay attention. This is the time when all
kinds of new behaviors are being tried out,
tested if you will, and they’re learning from those. And so if we can really
encourage healthy habits and try to as much as
possible, reduce the risky habits that they could be
forming it does two things first, it prevents
problems right now when they’re kids. So for example, reducing
risk behaviors right now. But that it also sets up
new habits for a lifetime so that they’ll have
healthy nutrition for example, throughout their
whole life if they’re learning how
to do that now. It’s a very important time
because they’re learning so much so fast. [Thorpe] And it’s the
habits now that they form, that they carry through
into adulthood and the rest of their life. [Zaza] Exactly. [Thorpe] Sure. So can you tell me some
about the risks that we’re concerned about that
adolescents take and everybody knows the ones
about like texting and things, but what are
some of the other ones? [Zaza] Well I think you
raise a really important one, you know, ten years
ago we didn’t have to even ask the question,
have you ever texted while you were driving? We ask that question now
and a very disturbing number of young people
admit that they text while they’re driving
or use the phone. And so that’s a really
important new risk. We’re also seeing some
emerging things like the use of e-cigarettes or
other vapor products which we didn’t really have
as a risk before. So the things that are
ongoing though, I think, injury risks are huge so,
bicycle helmets, learning safe driving habits for
example, those are really important during
this time. And then the other side of
habits, there are several, using substances: alcohol,
tobacco and other drugs, very important. If young people don’t
start in this time of life they often won’t ever. So really trying to avoid
some of these very risky behaviors in adolescence
can be very important. And then the third area
that I think I’d focus on is sexual risk. This is a normal time,
this is puberty, sexual maturation, it’s unique
to adolescence, and again, this is how young people
have to learn how to manage these new feelings
and new bodies that they’re inhabiting and so
helping them through that time to understand how to be safe with their sexual habits, how to hopefully
delay sexual initiation until they’re really ready
and then once they do, to be safe in their habits with a smaller number of partners, with using condoms, using contraception. Really helping them learn
what those things are for a lifetime. [Thorpe] Yeah, and that
sounds really kind of like the interventions that
you’re talking about are both looking at risks that
they’re taking but also addressing or looking at
the good behaviors that they have either we’re
wanting them to take or that they’re
already doing. I have through working
with the session with you, I have heard more about
how the focus is also not only kind of, “don’t do
that”, but also, “hey, you’re doing this well”. Can you tell us some about
that, that shift in the in the concept of
adolescence? [Zaza] Really, really
important area. So we call it, you know,
we often talk about risk factors, but what we want
to also focus on, and maybe want to focus on
even more are what we call protective factors. Things that really help young people. Things like youth
development, parent engagement. There’s almost nothing
more important than the parent relationship
with the young person. Constant conversations and
knowing that the parent is there.
These are important. Connectedness to the
school can be very important for
young people. So that sense of belonging
and having safe places within that school. So, for kids who feel like
they’re maybe excluded from some things or
bullied, to find allies and to find places where
they know teachers and to know that the school
supports them. So these kind of
protective factors are really important for
young people as well. Not just focusing on the,
you know, sort of the scolding,
“don’t do that” kind of… But providing that
nurturing and that youth development. Giving young people responsibility for their health and for setting that expectation, but giving them the
tools to do it. The skills and the
knowledge to do that. [Thorpe] That’s a very
good example of it because what I was, when you were
saying, I was thinking of you had mentioned that
as children go into adolescence that one of the things as clinicians that we can do is try to encourage them
to have alone time with the physician while they’re there for their visits. That’s an example of what a clinician or an individual could do. There’s also more about
what communities can do and, can you tell us a
little bit about how the interventions run that
whole gamut of individual or clinician to community
and where that’s going? [Zaza] So, you know, we’ve
talked a lot about young people and working
with them individually. We also look at things
like health education and physical education
in school. So schools can do
lots of things. Clinicians have a
very important role. So they provide a lot of
anticipatory guidance. They’re actually providing
some of that health education, if you
will, in that setting. They’re also teaching in the nature of that relationship a young person how to be
a good healthcare consumer. How to take care, how to
seek information and services when they need them,
very, very important. And it’s important for
parents to understand why that needs to happen so
that they will either absent themselves from the
visit or allow that to happen so that the young
person can learn how to engage with their physician. And then, in the
community, it’s very important that we think
about the whole community as supporting adolescents,
their families, making sure all those pieces
are fitting together. So we think about
for example the school can’t do everything, but the school can have good connections to clinical
services or other health services in the community
and help the adolescent actually activate those
services and get to those services.
That’s important. Having good transportation
to those services. And then once the young
person arrives there, that those services are teen
friendly, that they understand how teenagers
think and work and feel and what they need so that
the, when the teenager gets to that place they
feel comfortable and confident and able
to use that service. [Thorpe] So, we talk
about a lot of different interventions
in the session. And they’re like here and
there and they’re great examples but I would
really like to know what’s the next step? How can we go from here
and there to beyond to what can we do to
make it bigger? And also like the whole
child, you know, it sounds like it’s like everywhere
we need to kind of work… [Zaza] I think the most
important thing we need to do first is to set
adolescence, the stage of adolescence
as a priority. That we do a really good
job with early childhood. For example lots of
energy, lots of attention to early childhood
development, early childhood education,
vaccines in childhood and then we sort of expect
our adolescents to kind of go it on their own. [Thorpe] (speaking over
Zaza) They’re almost there… [Zaza] They’re almost
there, almost adults, but they’re not mini adults. They are in a very unique
developmental stage and so first I think, as
communities, we have to prioritize acting during this time to help nurture that development. That very specific
developmental stage. I think that’s the first
thing we have to do. Because you can’t scale
up these interventions to create a community unless
you’re actually setting that as a priority.
So that’s the first thing. Not that you want to take
anything away from the early childhood piece at
all, but we also have to not ignore the
adolescent time. And then we have to have
at a community level, policies in place
that support the kind of interventions
that need to happen. So you have to have
policies that support health education
in the school so a school district policy
for example. And you have to have
policies in the community that can create a
safe environment. Policies like bike trails
and crosswalks and, you know, so it’s sort of,
again, it’s a whole community
that is, you know, the school is
part of the community, the families are
part of the community. So really bringing that
all together is important. [Thorpe] Thank you so much
for coming today and for putting on this session. It’s very, very important. [Zaza] Thank you. [Thorpe] Very important to
our adolescents and to all their futures. [Zaza] Thank you. [Thorpe] And thank
you for joining us. See you next time
for Beyond the Data. MUSIC

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