In each 5-year grant cycle, all PRCs conduct prevention research in community settings. Our current core research project aims to support rural primary care clinics and clinicians in providing high-quality adolescent preventive care related to psychosocial and sexual health. Central to this project is the development of a clinic-level program, called TALK: Toolkit for Adolescent Care. This project builds on a CDC-funded special interest research project that was completed during the previous PRC cycle, the Confidential Adolescent Sexual Health Services study.
Foundational Research | Confidential Adolescent Sexual Health Services: CASH study
The CASH study included a nationally representative survey of adolescents (11-17 years) and their parents (n=1005 pairs) and in-depth interviews with 25 primary care clinicians and 36 parent-youth dyads across the state of Minnesota. Through the CASH study, researchers learned that parents and teens want to talk with their primary care clinicians about a wide range of psychosocial and sexual health topics, but that many have not had this opportunity. Research showed that the majority of parents are comfortable with one-on-one time between an adolescent and their clinician, especially when it is framed as an opportunity to teach adolescents to take more responsibility for their own healthcare. Clinicians also indicated that resources related to sensitive or psychosocial health topics would help them deliver the high-quality preventive care they strive to provide.
Current Research | TALK: Toolkit for Adolescent Care
Primary care is a critical support system for adolescents. The leading causes of adolescent morbidity and mortality are related to high-risk and unhealthy behaviors, and are preventable. Adolescents and parents want to talk about topics like sexual health, substance use, and mental health, but many want clinics and clinicians to help facilitate opportunities for these conversations. Therefore, TALK includes three components to support and facilitate these conversations:
- Training clinicians to talk about sensitive topics using a communication framework called SUPPORT & GUIDE. Whether talking about time alone or a specific health topic, how something is said often matters more than what is said. This is particularly true for sensitive issues, when trying to facilitate behavior change, or with patients or their families who are resistant to making healthy choices.
- Supporting clinicians to engage in conversations that use the SUPPORT & GUIDE framework, and one-page talking sheets, called TALK Tools. These tools provide information, resources, and talking points that clinicians and parents can use to have effective conversations with adolescents on psychosocial or sexual health topics.
- Standardizing practices that clinics can use to support clinicians and families in conversations about psychosocial and sexual health topics. A set of basic adolescent-friendly practices for clinics to implement as part of the TALK program have been developed. Two key practices include standardizing time alone between an adolescent and their clinician, and sending a “welcome to adolescent care” letter to adolescents and parents before preventive visits to help them know what to expect during adolescent preventive visits as well as things they can do to prepare for these visits.
The TALK program will be implemented and tested in primary care clinics in greater Minnesota.
Christopher Mehus, PhD