Primary care
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The purpose of the preparticipation physical evaluation (PPE) is to promote safe participation in sport and to restrict participation only when necessary for the safety of the athlete. Based on expert opinion, this tool is considered standard of care. Six stakeholder professional societies collaboratively published the Preparticipation Physical Evaluation Monograph to guide a more useful experience for both examiners and athletes. The PPE uses systems-based history-taking and physical examinations to determine medical eligibility for participation in sport.
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Trauma-informed care (TIC) is a patient-centered, strength-based approach to caring for and empowering patients. The adolescent well visit is an opportune moment to assess and address the impact of trauma. Given the well-documented impact of trauma exposure on adolescent health, and the relationship present between social determinants of health and trauma, physicians and advanced practice practitioners are well positioned to utilize TIC in the medical visit. This article will explore tools to incorporate trauma-informed practices in adolescent well visits in the context of medical care, mental health screening, and in promoting health equity.
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Review
The Role of Ethnicity and Culture in Adolescent Health in Latine, Hispanic, and Spanish Populations.
Caring for Latina/o/e/x, Hispanic, and/or Spanish (LHS) adolescents' health involves challenges and strengths unique to this fast-growing ethnic minority. Through the exploration of self and ethnic identity, LHS adolescents may find themselves represented in core values to protect against the negative effects of discrimination and internalizing symptoms. In order to provide equitable health care to LHS adolescents, health care systems, educational organizations, and government agencies must educate themselves on cultural humility and the role that social determinants of health have on perpetuating poor health care outcomes for this population.
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This article discusses the use of substances among adolescents, the unacceptable overdose death rates they bear, and the relevant evidence-based harm reduction strategies available in primary care, including medications for opioid use disorder. Access to these medications, as well as to harm reduction strategies generally, is insufficient for adolescents. Many adolescents who use substances and who are most at risk for overdose regularly visit primary care, which is an appropriate setting for treatment and harm reduction delivery.
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Adolescent relationship violence (ARV) is the use of coercive, controlling, and violent behavior within romantic adolescent relationships. It presents with patterned behaviors that occur in a cyclic fashion. ⋯ Exposure increases risk for serious acute and chronic physical and mental health consequences, including death. In the first article of this 2-part series, the authors describe the social, psychological, and medical context of ARV; in part two, the author's focus on practical aspects for approaching ARV in clinical encounters.