282 ABSTRACTS JOURNAL CF ADOLESCEXT HEALTH CARE Vd. 11, No. 3

WX,4TI&NSiilP WlWl2N MOLESCENT IffXCta*S PHYSICIARS AND KENTAL HSALIII imillms. Susan I.. BcironLhsl. Ph.D. and PCulk II. Biro, 1.D.. Div. uf Adoleacmt tlcdisine, Childrex’s Hospite.likdiul Cenrer, Cinsinnatl, Ohio.

Phvaician members of sM vere surveyed regarding the rela- tioe~bip, cb,y hnv. with ment.l health (NNH) vurkers, and vare requested LO list rbe HH cervices they vould like for their Patients. TO data, 413 revponres wan rctuxvd end 392 could be analyzed. Eighty-ei8ht PeKellt Of those v‘th patient contact reported working with one ur more hH vorkers, and 70% of those reported uorking virb three or mre ICi professionals. PsycheI- ogtsto constituted 36% of Ml vorkers, social mrkars 312, and psychiatrists 281. Tvo-thirds of KR providers vere on-site and 66X of an-site workers ycr* full-CiQe. Patient rave~ves accounted for 43% of funding for MI vorkess. and institutional support an additional 42X. Distribution of funding ~6 differeat betveen the hospital-based 9rovpa (university and craunicy) sod tire HO/private practice group (p<.OOl). uirh a predominance of institutioeal and petienc revmoes, respectively. There was P signifi- cant diEfsrencs in distribution when l naly;inS type of interaction .monB the thrva major hH discxplinrr (p=.OOl). ti Si#,ifiCN,Cc UPS accounted by peychistry being more likely to provide both ass+s,ment and trs.tment or assemmnt alone and less likely to provide ll~iaonieo-onnagemenr, and social work more Ilksly tu provide Iiaiaonlcu-manageaunt and lean likely to provide ase...Mnt and tra.tmmt, rhen rurvayed reSardin9 interdisciplinary twa conc@pcl, 81Y of SAN phymiclrr,$ !ned an interdioeipllnary team approach at leeat nonthly, and 51% st losvr wrkly. Team conferences vera held at loerr monthly by 73X, and at least veekly by 40%.

One-fourth volunteered they uere oatlrfiad with HH mrvltao; unaolleited NH ~ervlce concern. includnd affordability (17X), on-a‘te acsenaibiliry (13X), and Imprdinunt to urlll~rrion of servicer (11%). Fewer (6%) requested BpeCifiC services for ae!Wr~~ or perticulsr populsfionl or are.s. Our study sugelstl that there is a uide r&e of Ml services available to health care provlderr, w‘tk d‘ffarencer in type of servicea by KK disc,- Pll”% There reraln, however, society-ulde l~,uas regardi” acceasiblllty,

Scree”ing ‘311e9e Studwlb for NyeercholesterOlemia lhrria c. Feigel. M.D., university Health servicea Brandais Univeraicy, Waltham. Eu. Selected wxeeniw for children eaes 2 throwh 19 and ma81

acras”in9 fur adult6 arm the ‘z.6 SErateBieS ree&eedd for detectinS hwsrcbelcstarol~k awd identifyinK isdiv'duals .t risk for early heart aiwka. However, the interval 6&&K tbc end .of adolescence an& the be9innis9 of sdultboud, the ye.rs betsees the a-es of 18 and 22, is a time of maray trarditiona and a hard :ine of dermrcetion may not be usefsl for many of rhcm. Ose such ia cholesterol.

We beBan mdatory mp@v cbuleeterol ecteeaiag for all “nder8raduate rind 8raduPCe eCudents nwly eniolled in a small research vniveree81ty with the class wtriculating in September 1977. % student re8ardleSa of laak of family hiscory to the contrary has bee” permitted to enroll a8 either B full-time or Part-tlw Student since then without rePOrtin hia or her cholesterol level Becvee” September I, 1977,and Juno 30. 1989. 12.743 individuals provided data. The mean cholesterol Level fell frum 176 r&d1 in 1977 co 170 q Sfd1 in 1987. The 97th percentile w.8 205 for the men and 212 for the -en and all those exceeding these limits have had further eva1uatiaw.

ELuore than NO dozen 111 and 19 year old freslmeo and their famLliea vith unknowa hypercholesterolemia have hem detected each year. A cm- parable number Iran families in which the disorder ww kncu” in ocher me&era but had nut been fomd In eheae students wee also found. We conclude that (RIII SCEeeni,,~ of i)tudenta esteri,, CO11CSe CM, identify atudcntr -ho have hiah levels of cholelterol and vbo would benefit free, a cot’mary eiak rcductlo” pruKr,,&

SOCIAL SKILLS TRAINING FOR REDUCING AIDS-RELATED RISK BEHAVIORS IN ADOLESCENTS. Melbourne Hovell, Ph.D., M.P.H.. Elrrrianne Felice, M.D., Richard Hofstettea, Ph.D., Catherine atkins. Ph.D., Carol Sipan, R.N.. U.P.H., Elaine Blumberg, M.A.. Janet Stanley, M.A.

Dept. of Pediatrics, University of California, San Diego. and Graduate School of Public Health, San Diego State University.

Pro]ect STARRT (Skills Training for 'LIDS Risk Reduction in Tsenst is one of five projects fu”+d by NICHHD to test innova- live approaches to AIDS prevention in adolescents. Project STARRT’s approach is based on Operant and Social Learning Theories. 150 Wispanlc and 150 Anglo youth 14 to 16 years of ege are being recruited from San Diego community medical clinics and randomly assigned to experimental training, usual-training Eontroi 2nd no-training conditions. The experimental traini” COnsistS of behavioral skills training designed to establish specific social and decisron-making skrlls considered .lecessary for the avoidance of AIDS-related risk benaviors. The usual tralnlng ConsiStS of didactic S.PX education without social skills traL%ng. Subjwts are pwtested and foLlowed for 18 months followng treLning,using Interview and bzhavloral lvrdeotapedl formats to measure possible determinant, of so;ial skills and Sexual behaviors. and dependent variables (knowledge, attitudes, condom use. high risk sexual behaviors, self-PEficacy, and tar- geted social skills). One friend of each subject will be measured to e+tlmete tbe diffusion of the training effects on peer pres- sure/SuPPOrt for responsible sexual behavior. reliability measures and Factor A”al~e~~ Frequencies,

results based on data from the Pil;lt teSC of the measures fN=40) completed in July, 1989 ~111 be presentsd. Phase 1 pre-test and post-test results to be completed in December. 1989 tN=69) will provide preliminary l”dlcatlo”s of the Pfiects of treatment an dependent variables through A~alyeas of Variance procedures.

!3ncIIaiGBsmRBs,iximmssI~.~-IlG- NEss:AREMBWOPAmlIssI(EISmaN-unIT. Is16 J. Seltzer, I.A., and James Pitzgib?xm, !4.D., Adolescent Services, Children's Hospital Medical Center of Akron, Akron, OH.

The objective of the study was to compare two populations of adolescents admitted to the adolescent unit of a regional Hi- atric hospital, one before the establishment of a sh.ort to intermsdiate term looked psychiatric unit, and one after. Xz was anticipated that there would be a reduction in the number a&acuity of adolescent patients after the unit opened in

U&g discharge diagnoses for case findings, retrospective chart revi- of adolescent cx.azs discharged from the Adoles- cent Unit from Jan. 1 through Dec. 31, 1980, and Jan. 1 through Dee. 31, 1987, were completed. An extensive chart review of admissions for self-destructive behavior, psychiatric Dr psychosocial diagnoses. accidents, and those msdical diagnoses indicative of psychosomatic illnesses such as abdominal pain, headache, and syncope WBB undertaken. Three hundred sixty-one 1980 charts were reviewed and 375 1987 charts were reviewed. Aspects of the medical records analyeed included demographics (marital and employment status of parents), documentation of depression, utilieation of in-hospital resources, discharge diagnosis, discharge planning, and recidivism rate.

The results of the study lend support to the position that psychosocial disturbances can be appropriately cared for on a general adolescent unit. In addition, it provides information useful for developing a hospital-based model of care as well as post-hospital coordination.

behwiom &b&g !nmcy, sexual &omis& a”d cbenWdq&de”cy). 2 of the 34 swdy population baamo HIV antibody positive #aMduy to blood a~afosioos (hmqbilia); I sdolwxnl becane HIV antibody posit& as the n%ub of sexual abw by 8” IV drug abusing cantin; anolhcradolcscent sczoconv&ddoc to (pmmiscuous) hetwscxuaI conma; all oahas became HlV antibedy posit& sxadary to volunwy panicipatio” in high risk bebaviwrs, such as lVDA md pmsdtodon.

11 is well afocpred ti pudcipadca in owain high risk eaivities @ispow to HlV infkaia Sexual abuse mny be tbc ssnrincl event in dz liver of HIV wibcdy positive adolcsccnts ad young adults. In this population. a thorough pursuit of a biimry of sexual abuse is erswtial. Discway of this ondezrqowd vicdmiratio” CM allow tic poeess of inlavendon to&in.

Tk 1nvcl1vmt?nt of Fanily Practitioners in pdo1escent i&.lth Care - A survey UX Society for Molesoat Wicine Mtnbers Kwk E. liolwitz, M.D. Y.uthera” Meaieal center, Brc&ly” , NY 11220

Fanily Physicians (We) provide mxs-c of ttrs ti&went health care in thio CCu”try. liwaver. little krfon'iwtian is available a&M thr involvrmst of m’s in varicus aspxts of aMoscent -Seine. Active rrrnbere of th Society forAdolcwmt%xlicine fswwholisted f.anL1ylredicichsss Uv?irsPecialty (n-44) were surveyad atit the nahus of their involvsnwit in tlvz health - of aloLescents. nirrtysixrespYlsesv~rrooived. inciuding hwltyssvsn ma7tezsfrantheVnitad States, thtwfmnCaMdsandsixfranothsr ccuntr~s. ?uentyons hu13~-rrrplstedatleastmeysarof fellmsNptmSnisg in Adolsacont &diciw. Eighteen respznder.ts said

Yean; in practice range Era zero to n~rn thrm forty. thpl w;:9 pramdnate1y involved in the private

practim of Fanily &Caine, nearly all of these rssponaents stated my a190 sngagad in the private prectko c. TC Mole.w2nt Medicine to 94118 dsgrsa. A mjority of LLOSB surveyed were involve: Fn teaching tredical e.Ments and resMe”W. Ten P’S wxkod ti student health at tbs cQllC+! or university level and l&a were involved In BchDol !wlth program. Several respondents volunteer their CeAvim part tina in doleacent hwlth fsemties ir.clulingskltars,detentlan~tenBdclinics. lwlsaidtlmy u?rsconductingaollgoriginsl had used a significant portiw

research. Nearly all reamto stated they

AWescant Medicine topics. oE their W tin2 with&” tlm past year for

Alttmighm- .'4 SW represent a self-selected g-with regard to ndolesoentYlealthcare.thiss~~revsdsthevariednatureof ET's involverent in adolsscznt medicine.