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• W2589192866 abstract "In this issue of the Journal of Adolescent Health, we are fortunate to publish the first three review articles originating from the Adolescent and Young Adult Health Research Network, a collaborative transdisciplinary research network recently established by the Maternal and Child Health Bureau (MCHB). Dating back to the early 1960s, the MCHB has a long history of advancing the field of adolescent health and medicine with support for training programs for physicians. By 1977, these efforts had led to the interdisciplinary training program now known as Leadership in Adolescent Health Training. Originally focused on training health professionals to provide better clinical care to adolescents in academic and community-based settings, the Leadership in Adolescent Health Training Program has recently expanded to include program evaluation and research training. In 1987, the MCHB built upon its initial investment in training by supporting the Healthy Futures I state-of-the-art conference; Healthy Futures II followed in 2002. Proceedings of these meetings were published in New Directions for Child Development [[1]Irwin Jr., C.E. Adolescent Social Behavior and Health. New Directions for Child Development, No 37. Jossey-Base, San Francisco1987Google Scholar] and Journal of Adolescent Health [2Journal of Adolescent HealthHealth futures of youth.J Adolesc Health. 1988; 9: 1S-69SGoogle Scholar, 3Irwin Jr., C.E. Duncan P.M. Health futures of youth II: Pathways to adolescent Health: Executive summary and overview.J Adolesc. 2002; 31: 82-89Scopus (6) Google Scholar]. The Healthy Futures conferences identified priorities for improving clinical services, training health professionals, and informing state and federal policies, as well as opportunities for interdisciplinary research based on biopsychosocial development, including positive youth development. In the early 1990s, based on recommendations from the Office of Technology Assessment's Report on Adolescent Health [[4]U.S. Congress, Office of Technology AssessmentAdolescent health Volume I: Summary and policy Options. (OTA-H-468). U.S. Government Printing Office, Washington, D.C.1991Google Scholar], the MCHB established a series of Adolescent Health Resource Centers. The primary purpose of these resource centers was to improve adolescent and young adult health by supporting analysis and technical assistance that would improve the integration of public health and clinical delivery systems; the first, the National Adolescent Health Information Center (NAHIC), was started in 1994. NAHIC began with an exclusive focus on adolescent health, later growing to include the health of young adults. One of NAHIC's early reports documented the necessity of collaborative research networks to advance meaningful outcomes of clinical interventions [[5]Millstein S.G. Ozer E.J. Ozer E.M. et al.Research priorities in adolescent Health: Analysis and Synthesis of research recommendations. University of California, San Francisco, National Adolescent Health Information Center, San Francisco, CA1999Google Scholar]. Since then, the MCHB has supported two national studies from the Institute of Medicine (now known as the National Academy of Medicine) that led to two landmark reports: Adolescent Health Services: Missing Opportunities [[6]Institute of Medicine and National Research CouncilAdolescent health Services: Missing opportunities. National Academies Press, Washington, D.C.2008Google Scholar] and Investing in the Health, Well-being and safety of Young Adults [[7]Institute of Medicine and National Research CouncilInvesting in the health and well-being of young adults. National Academies Press, Washington, D.C.2015Google Scholar]. Both identified key research needs in the field of adolescent and young adult health. In 2014, the MCHB took another major step forward in its commitment to advancing research by establishing the Adolescent and Young Adult Health Research Network (AYAH-RN). AYAH-RN is based at the University of California, San Francisco with Dr. Elizabeth Ozer as the principal investigator and has collaborators at the Center for the Developing Adolescent at the University of California, Berkeley; Boston Children's Hospital/Harvard University; Indiana University; Johns Hopkins University; University of Alabama; University of Minnesota; University of Washington; and the Society for Adolescent Health and Medicine. Its primary mission is to establish a research agenda for the field of adolescent and young adult health, with an emphasis on developing collaborative transdisciplinary research that utilizes developmental science to improve the lives of young people. In pursuit of that mission, AYAH-RN has contributed the three review articles appearing in this issue of the journal. The first, “Leveraging Neuroscience to Inform Adolescent Health: The Need for an Innovative Transdisciplinary Development Science of Adolescence,” outlines the role that developmental neuroscience might play in informing prevention and intervention efforts to improve adolescent health [[8]Suleiman A.B. Dahl R.E. Leveraging neuroscience to inform adolescent health: The need for an innovative transdisciplinary developmental science of adolescence.J Adolesc Health. 2017; 60: 240-248Abstract Full Text Full Text PDF PubMed Scopus (26) Google Scholar]. The authors Suleiman and Dahl propose that the period of brain development beginning with puberty and extending through adolescence offers unique opportunities for learning and experiences. Comparing adolescent brain development to that of early infancy, when the brain anticipates and learns from visual stimuli, the authors describe the unique learning periods of early adolescence. Unlike brain development during infancy, which has been studied in great detail, the utility of the relationship between brain development and puberty has not been fully explored. Suleiman and Dahl identify two critical health issues of adolescence: pubertal changes in sleep/circadian regulation and social and affective changes at puberty relevant to anxiety and depression. The focused discussion of these two issues demonstrates how advancing integrative developmental science can help to identify leverage points and modifiable factors that can be targeted as key inflection points along the developmental trajectories of health problems.See Related Articles on pps. 240, 249 and 261 See Related Articles on pps. 240, 249 and 261 The second article, “Research on clinical preventive services for adolescents and young adults: where are we and where do we need to go?” provides a comprehensive review of our understanding of clinical preventive services for adolescents and young adults [[9]Harris S.K. Aalsma M.C. Weitzman E.R. et al.Research on clinical preventive services for adolescents and young adults: Where are we and where do we need to go?.J Adolesc Health. 2017; 60: 249-260Abstract Full Text Full Text PDF PubMed Scopus (60) Google Scholar]. Harris and her coauthors identify system-, clinician-, and visit-level strategies to optimize the clinical encounter and the efficacy of preventive interventions. Parents, too, have a critical role to play, and technology offers unprecedented ways to expand the clinician's reach. The article explores not just the distinct issues associated with preventive services for adolescents but also of those for young adults, a group that is not often addressed in prevention science. An overview of the critical role that the Patient Protection and Affordable Care Act has played in providing coverage for evidence-based services for adolescents, young adults, and young women offers readers a useful perspective on policy. The article provides an important roadmap for future research on adolescent and young adult clinical preventive services, recommending research to optimize system-level clinical strategies, enhance parent engagement, expand the evidence base for preventive interventions, and continue to develop innovative uses for technology. The third and final review article in this issue, “Research in the Integration of Behavioral Health for Adolescents and Young Adults in Primary Care Settings: A Systematic Review,” explores what our clinical delivery systems are doing to improve health outcomes for young people with behavioral health issues [[10]Richardson L.P. McCarty C.A. Radovic A. Suleiman A.B. Research in the integration of behavioral health for adolescents and young adults in primary care settings: A systematic review.J Adolesc Health. 2017; 60: 261-269Abstract Full Text Full Text PDF PubMed Scopus (48) Google Scholar]. Richardson et al. conducted an elegant systematic review to identify the efficacy of three types of well-established delivery systems for adults: coordinated care, co-located care, and integrated care. Most of the randomized clinical trials were based on the coordinated care and integrated care systems. The paucity of research in this area is surprising given the prevalence of behavioral disorders among adolescents and young adults and the large number of studies of adult populations documenting evidence in support of integrated delivery systems. These three articles from the Adolescent and Young Adult Health Research Network provide us with new opportunities to improve our understanding of adolescence and young adulthood; optimize the utility of the clinical preventive visit; expand delivery systems that provide or coordinate a full range of physical and behavioral health care; and educate investigators and providers. The next step is for researchers to consider how the innovative research directions outlined in this issue of the journal might inform our efforts to improve adolescent and young adult health. Research in the Integration of Behavioral Health for Adolescents and Young Adults in Primary Care Settings: A Systematic ReviewJournal of Adolescent HealthVol. 60Issue 3PreviewDespite the recognition that behavioral and medical health conditions are frequently intertwined, the existing health care system divides management for these issues into separate settings. This separation results in increased barriers to receipt of care and contributes to problems of underdetection, inappropriate diagnosis, and lack of treatment engagement. Adolescents and young adults with mental health conditions have some of the lowest rates of treatment for their conditions of all age groups. Full-Text PDF Open AccessLeveraging Neuroscience to Inform Adolescent Health: The Need for an Innovative Transdisciplinary Developmental Science of AdolescenceJournal of Adolescent HealthVol. 60Issue 3PreviewIn this article, we consider how to leverage some of the rapid advances in developmental neuroscience in ways that can improve adolescent health. We provide a brief overview of several key areas of scientific progress relevant to these issues. We then focus on two examples of important health problems that increase sharply during adolescence: sleep problems and affective disorders. These examples illustrate how an integrative, developmental science approach provides new insights into treatment and intervention. Full-Text PDF Open AccessResearch on Clinical Preventive Services for Adolescents and Young Adults: Where Are We and Where Do We Need to Go?Journal of Adolescent HealthVol. 60Issue 3PreviewWe reviewed research regarding system- and visit-level strategies to enhance clinical preventive service delivery and quality for adolescents and young adults. Despite professional consensus on recommended services for adolescents, a strong evidence base for services for young adults, and improved financial access to services with the Affordable Care Act's provisions, receipt of preventive services remains suboptimal. Further research that builds off successful models of linking traditional and community clinics is needed to improve access to care for all youth. Full-Text PDF Open Access" @default.
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