Funded Projects

Grant Status: Active

Training Category: Healthy Tomorrows

Grant Title: Building the Capacity for Adolescent-Centered Health Care in Rural Communities in HHS Region V

Project Director(s):

Ellen Wagner, MPH, MS
Assistant Director
Adolescent Health Initiative
The Regents of the University of Michigan
2025 Traverwood Dr, Suite A6
Ann Arbor, MI  48105
Phone: 734-998-5805
Email: ellwagne@med.umich.edu

Problem:

Adolescent patients access primary care services at lower rates than any other age group despite increased risk for morbidity and mortality due to high-risk behaviors such as substance use, sexual activity, interpersonal violence, and suicide. While these high-risk behaviors are common among adolescents, less than 20% receive recommended screening and counseling on them from their healthcare providers. In addition to the general healthcare disparities for adolescents described above, rural living is associated with a number of increased risks for adolescents. The AAP has noted that the current distribution of primary care pediatricians is inadequate to meet the needs of children living in rural areas. It is critical that the pediatrics practices that are located in rural areas are providing evidence-based, high quality, youth-friendly care to the adolescents they serve.

Goals and Objectives:

Goal 1: Collaborate with Region V MCH Directors, AAP Chapters and other key stakeholders to ensure project is meeting the needs of communities where interventions will be in place. - Objective 1a: Establish interdisciplinary Advisory Board to further hone goals and objectives of project. - Objective 1b: Connect with other key stakeholders to tailor intervention to state specific needs. Goal 2: Build capacity of youth-serving primary care services in rural and underserved communities in HHS Region V (Illinois, Indiana, Ohio, Michigan, Minnesota, and Wisconsin) to provide youth-friendly health care services for adolescents through engagement in the Adolescent-Centered Environment Assessment Process (ACE-AP). - Objective 2a: Collaborate with State Title V MCH Director and AAP Chapter to recruit 54 pediatric clinical practices in rural or underserved areas in each HHS Region V state to participate in the 18-month ACE-AP intervention through three cohorts of mini-grant making with 2-4 clinics from each state per cohort. - Objective 2b: Complete ACE-AP process with all participating pediatric clinical practices. - Objective 2c: Certify sites who meet AHI Adolescent-Centered Environment certification criteria upon completion. Goal 3: Equip each HHS Region V state with the ability to continue to build capacity of pediatric clinics beyond the length of the project by training individuals from each HHS Region V state in facilitation and dissemination of the ACE-AP. - Objective 3a: Collaborate with state Title V MCH Director and AAP Chapter to recruit 1 person per HHS Region V state to be trained as ACE-AP coach. - Objective 3b: Train coaches through community of practice including three in-person summits in the Midwest. - Objective 3c: Train coaches by offering ongoing customized technical assistance. Goal 4: Evaluate and disseminate model findings to stakeholders including HRSA, Advisory Board, AAP, and national audience. - Objective 4a: Report project progress and outcomes to HRSA, Advisory Board, AAP, and other stakeholders. - Objective 4b: Disseminate and publish results for other key stakeholders and national audience.

Methodology:

The Adolescent Health Initiative (AHI) will collaborate with an Advisory Board and key stakeholders from each HHS Region V state to improve youth friendly services in rural and underserved communities by implementing the Adolescent-Centered Environment Assessment Process (ACE-AP) in pediatric practices. Simultaneously, AHI will train local coaches in each state to implement the model. This will build the capacity of each state beyond the scope of the project to continue to improve statewide adolescent centered services.

Coordination:

AHI will coordinate with the Advisory Board, MCH Title V Directors and state AAP chapters as well as local organizations to customize the model in order to meet community needs and to deliver the project in a sustainable and culturally sensitive manner.

Evaluation:

All goals and objectives will be systematically tracked and measured for the purpose of continuous quality improvement as well as to ensure that adolescent-level health outcomes are successfully achieved. AHI will utilize a nuanced and comprehensive evaluation plan, which combines a variety of methods to track project success.