HRSA/MCHB 2005 FEDERAL/STATE PARTNERSHIP MEETING

PUBLIC HEALTH ACROSS THE LIFESPAN

Title V and Adolescent Health

KRISTIN TEIPEL: My name is Kristin Teipel. I work as the project coordinator at the State Adolescent Health Resource Center, at the Kinapse Institute for Best Practices in Adolescent Health at the University of Minnesota. And I just advanced my slides. That was cute. Hang on here.

My role here today is to talk to you about this adolescent health system capacity assessment that Nan and Judy have talked about. It's a wonderful resource tool available to you. It's recently released. We'll talk a little bit more about that.

How many of you have heard of the Cast Five Assessment? Pretty familiar with that? This is in the same vein. It's just looking at adolescent health specifically. So I'm going to tell you a little bit about it where it came from, what the benefit of it is and how you might go about doing it if you're so interested.

So the goal is to look at capacity, do we have the capacity to help young people? We're responsible for their health. We're there working with them and for them, but do we have what it takes to do this good work? And so this assessment process and it's actually a quality improvement process, is one way of figuring out where you are, what you want to do and where you want to be going.

And as part of that, you need a strong public health MCH system to address adolescent health. We need things like commitment. We need those partnerships to get the work done. We know about partnerships, collaborations. None of us does it alone. Adolescent health doesn't lie in one particular partner agency. It's kind of everywhere.

We need to do good programs. That means we have to plan and evaluate in ways that are comprehensive and coordinated. And we have to know what's what, what's happening, where we are, how well we're doing, and that requires a strong data and surveillance system.

We also need to help the people that are doing the good work at the local level. And that's providing technical assistance, providing education of work force, that kind of thing.

And lastly, policy is a part of this. We need strong policies. We need to be able to develop policy, have the capacity for that, and the capacity to advocate, get the word out, let the needs of adolescents and their families be heard.

So that's what this tool is based on, is those six areas, they're called capacity areas.

It is a quality improvement process. It's a way of a state sitting down bringing in their partners to say how are we doing in these areas, not only what are we doing but how good is it? Is it what we need? Is it the kind of thing that really helps us move forward? So we look at our tools and resources. It's a way of saying wow, great, we've got great things at hand there are some strong places we need to celebrate and make sure we keep. It's also a way of looking to decide where do you need to shore things up? What are you maybe missing? Maybe something you need to do more of or to do it better or in collaboration with somebody, so it's a way of identifying those areas of improvement. And lastly like any good planning process you develop a plan. And if done right, just like Cast Five, it should be a plan that's doable and reasonable, because it's based on you looking at what you've got, what the needs are, where you are, what's feasible so you can identify actions that really can make a difference and that you can follow through on.

So the tool and the process really is a framework. There's a lot of discussion. There's a lot of review, a lot of analysis, and the nice thing about the tool is it really assumes that everybody is a little bit different. It's not a gold standard that says you must have these 25 things in this particular way and this set up in this direction. It lays out the framework for what's important to have and gives you the opportunity to really think about how well you're doing. It can be really tailored. It's very flexible.

And it really recognizes a range of infrastructure. So I think it's a really neat tool and one that can be useful to lots of folks.

What's the benefit? Nan actually has gotten into this a little bit. So you find out where you are, what's your baseline, what a great way. Especially in times when we're going through a lot of reorganization to know where you are and to think about where you want to be going. It's a great baseline.

Involvement of your partners. We're forever doing it. It takes a lot of time. But this is a great opportunity to bring those partners in and get them engaged and find out what they think about the world and how well you're doing. And it's also a way of identifying new partners and resources. It's amazing, with the states I've worked with that have done the assessment, people make these connections. Like any time you get a group of people in the room to network, they go I didn't know you were doing that. I didn't know you were doing that. They start building some bridges. It provides that natural opportunity for that connection.

It's also a great way to really define or refine what your role is in the MCH world and adolescent health. It's a little fuzzy because adolescent health happens in so many different places, so many issues. It's a great way to say what's our role? It's like any kind of action planning, it provides you a sense of where to go, some very doable action steps.

And lastly, if this is all done right and we really are committed and follow through, theoretically we're going to be improving the health of youth. So that's our bottom line.

As you've heard, the architects of this tool are two organizations, AMCHP and the National Network of State Adolescent Health Coordinators ‑‑ can I call you NSAHC? It's a little bit easier. AMCHP and NSAHC. The Annie E. Casey Foundation thought this was priority enough. They really felt strongly in the interest in investing in the infrastructure of public health in the field of youth health. So they funded this project and really were an active part of this. So I think it was a really neat partnership. Both public and private. And then there was a really good pool of experts and national organizations and individuals that helped in the development of the tool. So it's a really well‑thought out initiative. And although this was done in the partnership between two specific organizations, it's under the rubric of the National Initiative to Improve the Health of Adolescents and Young Adults by the Year 2010. So for those who are familiar with this initiative, that's great. For those, this may be a new name or concept, this National Adolescent Health Initiative, we call it short, NAHI, stems from Healthy People 2010. How many are familiar with Healthy People 2010 when it was first coming out, had subgroups and subcampaigns that came out. I think college health. I can't remember all the specific groups that came out and said we want to take our focus on our issue out of the Healthy People 2010 give it some added extra focus. That was done with adolescents and young adults. And out of all of the gazillion Healthy People 2010 objectives, 21 were identified as critical for adolescents and young adults. And a national initiative evolved around this.

So this process, this tool, the moving forward with this, is part of that initiative. It's a very exciting thing. You have some information in handouts on your table about the national initiative. I really do encourage you to look at it. There's a guide for improving the health of youth ‑‑ I have to say I don't remember the exact name of the guide. Trina, can you help me? Thank you.

"Improving the Health of Adolescents and Young Adults, a Guide for States and Communities." This is a resource available to you from the national initiative. You have a handout that can get you to the website that you can actually download this or get CDs of this. It's a wonderful guide. It's another tool. It's primarily focused on helping local communities really come together and collaboratively figure out what their issues are and what they want to do about it. But there are great resources for you at the state level too. So I encourage you to look at that.

So the development of the tool, real quickly, took two years. There was a lot of review of literature and experts and it was refined and streamlined. It was piloted in three states in 2004. As you heard Nan speak, Utah had a experience, Tennessee and Wisconsin. In Oregon, Bob is going to talk about that, I consider you a pilot state because you got in there took the tool and revised it a bit for your own local needs which I thought was really interesting so I consider you a pilot state. It was released in March of 2005. So it is a really new tool.

There have been some early adopters, this has been on the radar screen of the state adolescent health coordinators for a long time because they were part of this process. So California and West Virginia have picked it up and conducted assessments since it was already relieved I'll be going out to Maine in a week and a half to help them conduct their assessment. But there are many other states that are considering this. So if you want to be at the front end of a wave or you want to see if you're part of those early adopters I'd encourage you to talk to your adolescent health folks if you are not them yourselves.

So what's the impact? What have these states gained? Many of them have grown their adolescent health program. They've taken where they are and sort of moved forward to refine and define who they are in adolescent health. They've clarified staff roles, streamlined their partnerships with advisory committees and task forces, increased collaboration, assessed the need of their work force, responded with trainings and technical assistance developed data reports. Tennessee is in the process of developing their data report, and I'm going to be going out there in about three weeks to work with them on so what are next steps beyond the data report. Moving toward a strategic plan.

And then looking at changes in data and surveillance systems to strengthen and shore those up. So what does it take? It's like any assessment process. You plan it. You start there. You figure out who needs to be at the table. You look at the many variety of different ways that you can conduct this assessment. It can be done as a one‑day meeting, two‑day meeting, a meeting spread out over many months it's like Cast Five it has a variety of different ways of conducting the assessment. When you hold your assessment it's basically a qualitative assessment process. You take your group of people. You run through some discussion questions. You really and look and see what's what? How are we doing in this area? What do we have at hand? How well are we doing? Is it meeting our needs? Doing our strengths, weaknesses, opportunities, threats analysis, identifying top issues and ranking and rating. One thing I have to say about this assessment process, it's not one where we can compare a state to a state to a state to a territory. It's really an assessment of your own self. So it's not something that we're going to be going out then and saying, well, California did this and West Virginia did that and this is the apples. It's really your own internal rating system. And then developing and implementing your action plan and moving forward and actually doing something with it. So my advice: Just do it. It's not hard. It's really simple, actually. And it doesn't cost much. And there are a lot of resources out there. It's a wonderful place to start if you're starting. It's a great place to check in if you've had an existing adolescent health program. In this time of change, it's just a wonderful opportunity.

There are a number of resources. You can down load the tool from AMCHP's website. You can get all sorts of different support guidance instructions from their website. And my center is also a resource to you. We are funded through the Maternal Child Health Bureau Office of Adolescent Health and we are funded to provide technical assistance to you and the states in regards to adolescent health. So whatever you're looking at sort of at a systems level, we're a resource for you. And one of our focal areas is the system capacity assessment. So we can help you think it through, plan it. We can help guide you and link you to other people that have done it to see what they've experienced. We can come out and facilitate assessments with you. We can help you identify your action plans. This is at no charge to you. So my encouragement to you is just call or e‑mail me if you're interested.

Thank you.