Evaluating the Efficacy of Medical-Legal Partnerships that Address Social Determinants of Health.

Background: Medical-legal partnerships (MLPs) are health system-community partnerships composed of multi-disciplinary teams designed to improve patient and community health. MLPs provide legal services to address health-harming legal needs that contribute to health inequities.

Methods: A grant provided by the Association of American Medical Colleges (AAMC) and the Centers for Disease Control and Prevention established the Accelerating Health Equity, Advancing through Discovery (AHEAD) Initiative to identify, evaluate, and disseminate community-based interventions that improve health equity.

How can healthcare professionals provide guidance and support to parents of adolescents? Results from a primary care-based study.

Background: This study explored the rewards and difficulties of raising an adolescent and investigated parents' level of interest in receiving guidance from healthcare providers on parenting and adolescent health topics. Additionally, this study investigated whether parents were interested in parenting programs in primary care and explored methods in which parents want to receive guidance.

Methods: Parents of adolescents (ages 12-18) who attended an outpatient pediatric clinic with their adolescent were contacted by telephone and completed a short telephone survey.

Indiana's Section 1115 Medicaid Waiver And Interagency Coordination Improve Enrollment For Justice-Involved Adults.

Timely access to Medicaid coverage offers many potential benefits to justice-involved adults reentering the community. In 2015 Indiana's Section 1115 Medicaid waiver (the Healthy Indiana Plan [HIP]) expanded eligibility for low-income adults. To expedite coverage for justice-involved adults, Indiana subsequently improved interagency coordination in two ways.

Caregiver Comfort in Adolescents Independently Completing Screening Tablet-Based Questionnaires at Primary Care Visits.

Purpose: The objective of this study was to assess caregiver comfort regarding adolescent completion of computerized health screening questionnaires created for adolescents.

Methods: We conducted a mixed-method, cross-sectional survey of caregivers of adolescent patients (n = 104) aged 12-18 years who had a medical visit between June 2017 and August 2017. Topics assessed included who completed the questionnaire, caregiver comfort and concern regarding questionnaire data, and caregiver reasons for involvement in completing the questionnaire.

Physician Intervention to Positive Depression Screens Among Adolescents in Primary Care.

Purpose: The objective of this study was to determine the effectiveness of computer-based screening and physician feedback to guide adolescent depression management within primary care.

Methods: We conducted a prospective cohort study within two clinics of the computer-based depression screening and physician feedback algorithm among youth aged 12-20 years between October 2014 and October 2015 in Marion County (Indianapolis), Indiana.

Results: Our sample included 2,038 youth (51% female; 60% black; mean age = 14.

Making the Legal and Ethical Case for Universal Screening for Postpartum Mood and Anxiety Disorders in Pediatric Primary Care.

Postpartum depression (PPD), part of a larger spectrum of perinatal mood and anxiety disorders, affects up to 15% of women following the birth of an infant. Fathers may also be affected. PPD not only affects caregivers, but also impacts infants through mechanisms such as inadequate caregiver-infant interactions and non-adherence to safety practices.

Perspectives of family medicine physicians on the importance of adolescent preventive care: a multivariate analysis.

Background: The study objective was to identify commonalities amongst family medicine physicians who endorse annual adolescent visits.

Methods: A nationally weighted representative on-line survey was used to explore pediatrician (N = 204) and family medicine physicians (N = 221) beliefs and behaviors surrounding adolescent wellness. Our primary outcome was endorsement that adolescents should receive annual preventive care visits.

Parent and Adolescent Views on Barriers to Adolescent Preventive Health Care Utilization.

Objectives: To determine adolescent and parent views of barriers to annual adolescent preventive care.

Study Design: A nationally recruited cross-sectional study of adolescents between ages 13 and 18 years, and parents of adolescents from different families, were recruited. The primary outcome was self-report of preventive care in the last 12 months.

Medical legal partnership and health informatics impacting child health: Interprofessional innovations.

Dramatic differences in health are closely related to degrees of social and economic disadvantage. Poverty-induced hardships such as food insecurity, utility shut-offs, and substandard housing, all have the potential to negatively impact the health of families. In an effort to better address social determinants of health in pediatric primary health care settings using the Medical Legal Partnership (MLP) model of health care delivery, an interprofessional team of investigators came together to design an innovative process for using computerized clinical decision support to identify health-harming legal and social needs, improve the delivery of appropriate physician counseling, and streamline access to legal and social service professionals when non-medical remedies are required.

Adolescent Self-Consent for Biomedical Human Immunodeficiency Virus Prevention Research.

Purpose: The Adolescent Medicine Trials Network Protocol 113 (ATN113) is an open-label, multisite demonstration project and Phase II safety study of human immunodeficiency virus (HIV) preexposure prophylaxis with 15- to 17-year-old young men who have sex with men that requires adolescent consent for participation. The purpose of this study was to examine factors related to the process by which Institutional Review Boards (IRBs) and researchers made decisions regarding whether to approve and implement ATN113 so as to inform future biomedical HIV prevention research with high-risk adolescent populations.

Methods: Participants included 17 researchers at 13 sites in 12 states considering ATN113 implementation.

Screening Incarcerated Juveniles Using the MAYSI-2.

The high prevalence of mental health disorders among incarcerated juveniles is a matter of national and global concern. Juvenile justice personnel need accurate screening measures that identify youth requiring immediate mental health services. The purpose of this study was threefold: (a) to examine the utility of the Massachusetts Youth Screening Instrument, Version 2 (MAYSI-2) in identifying juveniles with mental health concerns in a large sample of juveniles (N = 4,009), (b) to provide data regarding rates of identified mental health needs in incarcerated youth, and (c) to provide descriptive comparisons to other studies using the MAYSI-2.

Clinical conversations about health: the impact of confidentiality in preventive adolescent care.

Purpose: To better understand how confidentiality impacts the delivery of preventive adolescent health care by examining adolescent and parent beliefs and the relationship between confidentiality and the number and subject matter of health topics discussed at the last visit.

Methods: This study represents a secondary analysis of nationally representative online survey data collected from adolescents aged 13-17 years (N = 504) and parents of adolescents aged 13-17 years (N = 500). Descriptive statistics were conducted on confidentiality variables of interest.

Proactive parents are assets to the health and well-being of teens.

Objectives: To analyze parents who self-identified themselves as being proactive parents (PPs) compared with non-PPs who were queried about their teen's health to understand common adolescent health concerns, parenting practices/behaviors around health, and whether their adolescent had received a preventive care visit in the last year

Study Design: Secondary analyses of parents (n = 504) from a nationally representative online panel were surveyed to assess health beliefs/attitudes, perceived adolescent health concerns, frequency of health discussions, topics that pediatricians should discuss, and their teen's last annual visit. Demographics, parental beliefs, frequency of health conversations, and topics that physicians should discuss were compared. Logistic regression determined the likelihood of PPs compared with non-PPs reporting a teen annual health visit within the last year.

Child exposure to parental violence and psychological distress associated with delayed milestones.

Objective: To examine the association between parental report of intimate partner violence (IPV) and parental psychological distress (PPD) with child attainment of developmental milestones.

Methods: By using data collected from a large cohort of primary care patients, this cross-sectional study examined the relationship between parental report of IPV and/or PPD and the attainment of developmental milestones within the first 72 months of a child's life. Multivariate logistic regression analyses were used to adjust for parental report of child abuse concern and sociodemographic characteristics.

Associations of early exposure to intimate partner violence and parental depression with subsequent mental health outcomes.

Importance: Children with known exposure to intimate partner violence (IPV) or maternal depression are at risk for negative mental health outcomes as early as preschool age. Active ongoing surveillance for these risk factors can lead to earlier mental health intervention for children.

Objective: To examine the association between parent reports of IPV and depressive symptoms within the first 3 years of a child's life with subsequent mental health conditions and psychotropic drug treatment.