Funded Projects

Problem:

Adolescents have preventable health problems; 15-18% of youth have a chronic illness. Obesity and lack of physical activity loom as critical issues. Investing in the health of youth requires trained health professionals qualified to partner with MCH to achieve 2020 Objectives.

Goals and Objectives:

Goal 1: Provide interdisciplinary leadership training of health professionals in 5 Core disciplines (medicine, psychology, nursing, nutrition, and social work) and develop health services for adolescents Objective 1: Boston LEAH will train at least 10 diverse, long-term trainees in medicine, nursing, psychology, nutrition, and social work for leadership positions in adolescent health, and 60 intermediate-term and 100 short-term trainees to expand workforce capacity to meet the needs of the MCH populations. Objective 2: Fellows will demonstrate knowledge, skills, and competency in adolescent health including expert family-centered and youth-centered clinical care, leadership, program development, quality improvement (QI), teaching, cultural competency, evaluation, legal/ethical principles, research, and advocacy. Goal 2: Improve family- and youth-centered care for adolescents, enhancing the capacity building with Title V programs, supporting a diverse interdisciplinary faculty and fellows who will provide CE and TA. Objective 1: LEAH faculty and fellows will demonstrate scholarly productivity and a commitment to enhancing population based and community care by giving at least 100 presentations and directing at least one continuing education course. Objective 2: By the end of each year, LEAH faculty and fellows will provide at least 75 TA consultations and undertake at least 3 projects that address health disparities. Goal 3: Improve family- and youth-centered care by providing faculty development, mentoring of health professionals, disseminating research and best practices, and developing community-based programs Objective 1: LEAH faculty will demonstrate faculty productivity, mentoring of trainees, and translation of research to practice, disseminating more than 15 scholarly reports and reviews and by hosting at least 3 websites for youth, families, and health professionals. Objective 2: The LEAH program will enhance family- and youth-centered, interdisciplinary clinical care to over 4000 patients at CHB and in diverse community-based sites with involvement and input on program planning and training from LEAH Parent and Youth Advisors. Goal 4: Work toward improved health status of adolescents, quality care, elimination of health disparities, and Healthy People 2010 Adolescent Objectives through partnerships Objective 1: Fellows and faculty will have demonstrated at least 10 partnerships and collaborations with Title V agencies and projects, MCH training programs, Schools of Public Health, SPRANS, professional organizations, and/or the SAHCs in Region I. Objective 2: The Boston LEAH Program will meet or exceed goals set for the LEAH Performance Measures and demonstrate progress in QI goals.

Methodology:

The Boston LEAH provides interdisciplinary leadership training in adolescent health to diverse health professionals in 5 disciplines (nursing, social work, medicine, psychology, and nutrition). Fellows participate in an innovative, learner-centered, interdisciplinary Leadership curriculum which includes a Leadership Lecture Series; didactic seminars such as: Orientation to LEAH, MCH, NIIAH, and Leadership Competencies; Cultural Competency, Diversity, and Adolescence as a Culture; Program Development, Organizational Management, and Advocacy (PDOMA); Nursing Models of Care; Mental Health Rounds; Psychopharmacology; Substance Abuse; Nutrition; Eating Disorders and Wellness (Obesity) Team Meetings; Teaching Workshops; Introduction to Epidemiology, Qualitative Research Methods, Research Design, and Biostatistics; Fellow/Faculty Research; Writing; Evidence-Based Adolescent Health; Reproductive Endocrinology and Gynecology; and Adolescent HIV Care Conference. Fellows learn skills in clinical programs and outreach experiences. Fellows participate in teaching activities, learn about systems of care, involve youth and families in planning, and conduct research. The program also trains short- and intermediate-term. The Faculty and fellows provide CE and TA, disseminate scholarship through publications and websites, and collaborate with MCH agencies. Evaluation and assessment of outcomes are a critical component of LEAH, including the MCH performance measures and the CHB QI projects.

Coordination:

Boston LEAH provide model collaborations with the MCH programs, including promoting regional activities, consulting to Title V projects and professional organizations. Examples have included an annual "Adolescents and HIV" training (AIDS Bureau; MDPH), Governor's Health Council (MDPH); MA PCC Medicaid Advisory Committee; teaching at the HSPH; substance abuse curriculum with MCH LEBP and Poison Center; serving on a taskforce on HP 2020 indicators; initiatives with LENDs, PPCs, and LEAHs.

Evaluation:

Evaluation is critical for documenting the effectiveness of the program, progress in meeting the PMs; and quality of care. Process evaluations include clinical activity, numbers of trainees, CE, presentations, publications, grants, websites, and TA. The trainees are assessed by faculty evaluation of skills, scholarship, and leadership. Long-term evaluations focus on leadership and interdisciplinary care of graduates. Curriculum is modified using a continuous improvement cycle.

Experience to Date:

From 1992-2011, the Boston LEAH has trained (or in training) 155 Long term trainees/Fellows (23% from underrepresented groups). From 1997-2011 the Boston LEAH directed or co-directed over 50 CE courses, provided over 5100 technical assistance consultations; gave over 40,000 presentations to academic institutions, schools and lay audiences; and published over 1000 articles, chapters, books, videotapes, cases and internet resources (4 websites). Boston LEAH launched a website for teen boys in 2008 and hosts an award winning teen girl website www.youngwomenshealth.org which receives over 10 million visitors each year. Boston LEAH developed a collaboration with the other LEAHs to create a new mentoring program at SAHM for interdisciplinary investigators. From 2010-2011, the LEAH Program trained 17 long term trainees, 117 intermediate term trainees, and 769 short term trainees. LEAH directed 5 CE course, gave 379 presentations to over 22,000 participants, provided over 800 consultations, and published over 400 articles, chapters, videotapes, abstracts and internet resources. Faculty served on national and regional committees in adolescent health including SAHM, NASPAG, APHA, APA, American Board of Pediatrics, MA Dietetic Association, and MA Social Work Association.