Birth outcomes of individuals who have experienced incarceration during pregnancy.

Objectives: Describe the prevalence, health, and birth outcomes of incarcerated pregnant individuals in California between 2011 and 2015.

Study Design: A population-based cohort study was performed using linked birth certificate and hospital discharge data. Associations between incarceration and birth outcomes were examined, including multivariable logistic regression to estimate odds ratios and 95% confidence intervals.

Providing Online Portal Access to Families of Adolescents and Young Adults with Diminished Capacity at an Academic Children's Hospital: A Case Report.

Background: For caregivers of adolescents and young adults with severe cognitive deficits, or "diminished capacity," access to the medical record can be critical. However, this can be a challenge when utilizing the electronic health record (EHR) as information is often restricted in order to protect adolescent confidentiality. Having enhanced access for these proxies would be expected to improve engagement with the health system for the families of these medically complex adolescents and young adults.

Providers' Perspectives on Adolescent Confidentiality and the Electronic Health Record: A State of Transition.

Purpose: Electronic health records (EHRs) have led to more transparency and improvements in patient safety, yet electronic access to personal health information can pose significant threats to maintaining confidentiality for adolescents. To date, no studies have explored clinicians' perspectives on EHR functionality and institutional policies related to confidentiality and health information sharing for adolescents aged <18 years.

Methods: A Web-based survey was sent out via the national listserv of the Society for Adolescent Health and Medicine.

Commercial Sexual Exploitation and Sex Trafficking of Children and Adolescents: A Narrative Review.

Commercial sexual exploitation and sex trafficking of children and adolescents represent a severe form of child abuse and an important pediatric health concern. Youth who are commercially sexually exploited have a constellation of clinical risk factors and high rates of unmet physical and mental health needs, including conditions that directly result from their victimization. Common physical health needs among commercially sexually exploited children and adolescents include violence-related injuries, pregnancy, sexually transmitted infections, and other acute infections.

Understanding Parent Perspectives Concerning Adolescents' Online Access to Personal Health Information.

Background: Although today's youth are interested in using the internet to access and manage information related to their health, little information exists about parental attitudes towards the release of health information to adolescents.

Methods: Structured interviews were conducted with the parents of 83 adolescents detained at a large Northern California juvenile detention facility to examine parental perceptions toward allowing their children online access to their own health information.

Results: The majority of parents interviewed (70%) wanted their children to have online access to their own health information.

In Their Own Voices: The Reproductive Health Care Experiences of Detained Adolescent Girls.

Background: Adolescent girls involved with the juvenile justice system have higher rates of sexually transmitted infections and pregnancy than their nondetained peers. Although they may receive reproductive health care while detained, following clinician recommendations and accessing services in the community can be challenging.

Objectives: This study aimed to determine the barriers this population faces 1) accessing reproductive health care and 2)following the recommendations they receive when they are in the community.

Mental Illness Drives Hospitalizations for Detained California Youth.

Purpose: The purpose of the study was to describe inpatient hospitalization patterns among detained and nondetained youth in a large, total population of hospitalized adolescents in California.

Methods: We examined the unmasked California Office of Statewide Health Planning and Development Patient Discharge Dataset from 1997 to 2011. We considered hospitalized youth aged 11-18 years "detained" if admitted to California hospitals from detention, transferred from hospital to detention, or both.

Immunization Coverage Among Juvenile Justice Detainees.

This study sought to (1) quantify the baseline immunization coverage of adolescents entering the juvenile justice system and (2) assess the effect of detention-based care on immunization coverage in youth. A cross-sectional retrospective chart review was performed of 279 adolescents detained at a large juvenile detention facility. Only 3% of adolescents had received all study immunizations prior to detention.

Internet access and attitudes toward online personal health information among detained youth.

Objective: To assess Internet access and usage patterns among high-risk youth involved in the juvenile justice system, and to determine if health information technology tools might play a useful role in more actively engaging this population in their health care.

Methods: A sample of 79 youth between the ages of 13 and 18 years old underwent a structured interview while detained in a large, Northern California juvenile detention facility. After an institutional review board-approved assent/consent process, youth discussed their typical Internet use when not detained, as well as their attitudes toward online access to their personal health information (PHI).

Special requirements for electronic medical records in adolescent medicine.

Adolescents are a group likely to seek and, perhaps, most likely to benefit from electronic access to health information. Despite significant advances in technical capabilities over the past decade, to date neither electronic medical record vendors nor many health care systems have adequately addressed the functionality and process design considerations needed to protect the confidentiality of adolescent patients in an electronic world. We propose a shared responsibility for creating the necessary tools and processes to maintain the adolescent confidentiality required by most states: (1) system vendors must provide key functionality in their products (adolescent privacy default settings, customizable privacy controls, proxy access, and health information exchange compatibility), and (2) health care institutions must systematically address relevant adolescent confidentiality policies and process design issues.

Implementing an Interoperable Personal Health Record in Pediatrics: Lessons Learned at an Academic Children's Hospital.

This paper describes the development of an innovative health information technology creating a bidirectional link between the electronic medical record (EMR) of an academic children's hospital and a commercially available, interoperable personal health record (PHR). The goal of the PHR project has been to empower pediatric patients and their families to play a more active role in understanding, accessing, maintaining, and sharing their personal health information to ultimately improve health outcomes. The most notable challenges proved more operational and cultural than technological.

The health status of youth in juvenile detention facilities.

Youth exiting detention facilities have particularly high rates of co-occurring health-risk behaviors, while lacking access to the health care system. Not surprisingly, these youth suffer a disproportionate share of adolescent morbidity and mortality. Their time of incarceration often represents their only significant contact with a health care provider outside of an emergency setting.