Physicians as Advocates for Adolescent Reproductive and Sexual
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Transcript Physicians as Advocates for Adolescent Reproductive and Sexual
Adolescent
Reproductive &
Sexual
Health
Education
Project
Physicians as Advocates
for Adolescent Reproductive
Health
Physicians as Advocates for Adolescent Reproductive and Sexual Health
Adolescents Need Physicians
to Advocate on Their Behalf
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Adolescents Need Physicians
to Advocate on Their Behalf
Adolescence is a unique time in life requiring
special attention
Characterized by:
Physical, emotional, and developmental
changes
Emerging sexuality
Awareness of gender identification and
sexual orientation
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Factors Shaping
Adolescence
Race
Religion
Ethnicity
Peers
Socioeconomic
status
Family
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Advocacy Can Improve
Adolescent Health
The major causes of adolescent morbidity
and mortality are preventable
Physician advocacy can address the
factors that contribute to negative health
outcomes
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
What Is Advocacy?
Definition:
Application of information and resources
The action of advocating, pleading for, or
supporting a cause or proposal
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Examples of Advocacy
Placing educational literature in your office
space to educate and inform patients
Developing a community health behavior
change program that addresses STIs
among youth
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Examples of Advocacy
Giving expert testimony to the local school
board regarding comprehensive sex education
Writing a letter to a national or local newspaper
regarding risk factors for teen pregnancy
Testifying before Congress to
advocate for expanded Medicaid
coverage for contraception
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Why Should Providers
Become Advocates?
1. Physicians are leaders in the community
2. It is a residency requirement
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Steps to Advocating for
Adolescents
Identify a need
Assess Community Resources
Choose a level of advocacy
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Identify a Healthcare Need
A healthcare need may be a:
Risk factor
Screening finding
Disease symptom
Condition or disease diagnosis
Consequence of a disease
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Example: Teen
Pregnancy
Unintended teen pregnancy is a public
health concern
Healthy People 2010 goal: “Reduce
pregnancies among adolescent females”
Teen pregnancy isn’t an isolated
problem and should be viewed in the
context of
Poverty
Barriers to health care and education
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Teen Pregnancy Rates
Worldwide, 2000
Per 1000
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Reevaluating Risks of Teen
Pregnancy and Parenting
Teen Pregnancy: Cause for Concern?
Unintended pregnancies can prove
challenging regardless of age
Research indicates poor outcomes for teen
parents and their children
Health of teen mothers and infants
Educational outcomes
Highlights complexity with multiple factors contributing to
outcomes
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Outcomes for Teen Mothers
Less likely to
Receive adequate prenatal care
Graduate from high school
More likely to
Die in childbirth
Be poor as adults
Have symptoms of depression
Lack resources to foster their
children’s development
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Challenges for Teen Fathers
Poor academic performance
Higher school dropout rates
Limited financial resources
Decreased income capacity
Difficulties staying involved
in children’s lives
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Educational Achievement
And Poverty
Unintended pregnancy can disrupt education
Poverty may be a stronger factor in
educational disparities than early pregnancy
Low-income women have poor educational
outcomes
Low-income teen mothers no different than
counterparts who delay parenting until > 20
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Addressing Teen Pregnancy
Teen Pregnancy Can Be Addressed on
Several Levels
Condition
antecedents
•Providing
access to
contraceptives
and condoms
•Educating
patients on
prevention
Symptomatic
condition
Complication
•Ensuring
improved
prenatal care
•Reduction in
substance use
and risk
behaviors
•Providing
parenting skills
training
•Enabling
continued
maternal
education
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Choosing an Area of Focus
Sexually Education
•Do local schools provide comprehensive sexuality education?
After-school programs
•Are there programs in your community to keep teens active
and involved after school?
Condom and contraceptive accessibility
• Are condoms and contraceptives available confidentially?
If not, how can you play a role in filling
these voids?
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
On which level will you
choose to advocate?
Practice
Community
Media
Legislative and Policy
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Choosing a Level of
Advocacy
Practice
Identify your office as a safe space
Conduct a comprehensive patient interview,
assessing risk behavior and providing
medically factual information to counter myths
Have resources available to help patients
navigate insurance, Medicaid, and billing
process
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
What Do You Need to
Know?
Practice
Be aware of state laws regarding minors’
legal rights to comprehensive care
Be knowledgeable about local resources for
referrals to provide services beyond the
scope of your practice
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Choosing a Level of
Advocacy
Community
Steps to providing community oriented
primary care
Assessing community capacity
Identifying health priorities
Assessing population readiness
Develop Intervention
Evaluation
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Why Is Defining the
Community Vital?
Community
Adolescent reproductive health indicators
differ by region, state, city, and community
It is crucial to tailor interventions to the
needs of community members
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Assessing Community
Resources
Community
Identify programs and local, faith based,
and/or national organizations that have the
potential to improve reproductive health
Directly or indirectly:
Reduce risk factors
Enhance protective factors
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Assessing Capacity
Community
Community capacity is a comprehensive set of
data that can be used to set objectives
Assessment may include:
Compilation of demographic data from census records
Results of surveys conducted by others
Responses by partnership members to questions about
the community they serve
Focus group discussions, interviews with stakeholders
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Community-Oriented
Intervention
Community
Develop intervention based on:
Community Assessment
Community Partners and Resources
Personal and Organization Resources and
Abilities
Even the simplest intervention can
make a difference!
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Evaluation
Community
Decide specific measures of success
based on community assessment and
intervention initiative
Baseline
Measures
Targets
Outcomes
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Choosing a Level of
Advocacy
Media
The media can:
Get the attention of community/laypersons,
colleagues/institutions, and policymakers
Offer opportunities to provide scientifically
sound and accurate information
Disseminate research
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Print Media
Media
Journals
Letters to the Editor
Editorial
Web-Based
Magazines
Health column
Letters
Opinion pieces
Newspapers
Op-Ed (700–800 words)
Letters to the Editor (250–
300 words)
Newsletters
Agencies,
nonprofit organizations
professional associations
hospitals
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Broadcast Media
Media
Television
Radio
Internet
Niche Media
Spanish-Language Stations
LGBT Media
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Planning the Message
Media
Clearly highlight a discrete problem
Provide a narrow solution
Prepare sound bites
Prepare a brief summary of information that
you want to convey
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Disseminating the
Message
Media
Contact the media
Call the newsroom at your local paper and
find out how to submit a letter or Op-Ed
Join a national advocacy organization,
such as Physicians for Reproductive
Choice and Health, and identify yourself
as able and willing to talk to the media
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Choosing a Level of
Advocacy
Legislation and Policy
Your knowledge and expertise can be used in
a number of ways, including:
Providing oral or written testimony at hearings or
other public forums
Educating legislators and their staff members
Following up when information is requested from
you
Thanking legislators who vote in a manner with
which you agree
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Approaching
Policymakers
Legislation and Policy
Introduce yourself as a healthcare provider
Explain the overall purpose of your
communication and why specifically you are
bringing this issue to their attention
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
The Realities of Politics
Legislation and Policy
No decision by a legislator is straightforward
Legislators need to balance competing interests
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Meeting With
Legislators’ Staff
Legislation and Policy
Know the details of the issue the best
Significant influence on the legislator
More likely to give helpful information
Deserve equal respect
Don’t be disappointed
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Share Personal
Experiences
Legislation and Policy
Highlight how this legislation would affect:
Your work as a healthcare provider
The lives of your patients
Public health in general
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Communicating with
Legislators
Legislation and Policy
Know what you want to accomplish
Prior to the meeting
With your testimony
From your letter
Develop talking points
Stick to them
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Communicating with
Legislators
Legislation and Policy
Keep it simple
Implications of the bill
Reasons for your views
Avoid technical medical explanations
Be patient, positive, and flexible
Be clear and concise
Follow up
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Your Legislator’s Stance
Legislation and Policy
Solidly in support of your issue
Mixed on your issue
Entirely opposed to your issue
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Supportive Legislators
Legislation and Policy
Thank the legislator
Mention recent votes or comments the
legislator made about your issue and
how much you (and your patients)
appreciate this support
Express the importance of the legislation
Reaffirm the importance of vocal
legislators
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Mixed Level of Support
Legislation and Policy
Focus on a specific piece of legislation
Remember your goal: passage or
elimination of one bill
Stress the medical necessity and benefits
to the medical community and patients
Reaffirm the importance of vocal legislators
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Opposition Stance
Legislation and Policy
Acknowledge the legislator’s point of view
Highlight aspects of the legislation that would
best influence the legislator’s vote
Highlight the medical and scientific facts
Emphasize how the bill would secure the
health of your patients
Use logic to combat any emotionally charged
language or reasoning
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
How Can Physicians
Advocate?
Ask questions and get involved
Organize and speak out when necessary
Push for stronger standards of care for
reproductive health services in your practice
and institution
Contact the media; write a letter to the
editor for the local newspaper
Write to or visit your public officials
Get involved with your medical association
and Physicians for Reproductive Choice
and Health!
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Please Complete Your
Evaluations Now
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Physicians as Advocates for Adolescent Reproductive and Sexual Health
Provider Resources:
Resources:
www.prch.org - Physicians for Reproductive Choice and Health
www.aap.org - The American Academy of Pediatrics
www.acog.org - The American College of Obstetricians and Gynecologists
www.adolescenthealth.org - The Society for Adolescent Health and Medicine
www.aclu.org/reproductiverights/ - The Reproductive Freedom Project of the
American Civil Liberties Union
www.advocatesforyouth.org – Advocates for Youth
www.guttmacher.org – Guttmacher Institute
www.cahl.org/ - Center for Adolescent Health and the Law
www.gynob.emory.edu - The Jane Fonda Center of Emory University
www.siecus.org - The Sexuality Information and Education Council of the
United States
www.arhp.org - The Association of Reproductive Health Professionals
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Provider Resources:
PRCH’s Minors’ Access to Confidential Reproductive
Healthcare Cards and Emergency Contraception: A
Practitioner’s Guide
ARHP Reproductive Health Model Curriculum
AMA Guidelines for Adolescent Preventive Services
(GAPS)
The American College of Obstetricians and
Gynecologists:
Confidentiality in Adolescent Health Care
Primary and Preventive Health Care for Female
Adolescents
Tool Kit for Teen Care—available at:
http://www.acog.org/bookstore/Tool_Kit_for_Teen
_Care_P348C84.cfm
Info on emergency contraception, www.not-2-late.org
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Provider Resources
Centers for Disease Control and Prevention. Sexually Transmitted
Diseases Treatment Guidelines 2002:
www.cdc.gov/std/treatment/rr5106.pdf
Building Emergency Contraception Awareness Among Adolescents,
A ToolKit, Academy for Educational Development:
http://www.aed.org/Publications/upload/ECtoolkit3283.pdf
Henry J. Kaiser Family Foundation: public health policy, broken
down by area (e.g., reproductive, state-specific, Medicaid,
HIV/AIDS): www.kff.org.
The Young Men’s Clinic of Columbia University:
http://www.cumc.columbia.edu/dept/sph/popfam/
Mount Sinai Adolescent Health Center:
http://www.mountsinai.org/msh/msh_program.jsp?url=clinical_servic
es/ahc.htm
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