Birth Control Management for the Primary Care Provider.

Contraceptive management is occurring more frequently in the primary care setting. Pediatricians should be familiar with the most common methods of contraception due to the fact that families are comfortable seeking care for their adolescents at the primary care office for these types of concerns. Contraceptive methods are often used for noncontraceptive benefits as well, which makes it even more important to feel comfortable prescribing contraceptives at pediatricians' offices. [Pediatr Ann. 2019;48(2):e51-e55.].

The Truth About Obesity, Exercise, and Nutrition.

There is a plethora of misinformation regarding obesity, diet, and exercise due to lack of supporting evidence on these topics. There are myths and facts about what exactly encompasses a healthy lifestyle that interfere with the ability to lose weight and stay healthy. These include topics such as the effects of small sustained increases in energy intake or expenditure, establishment of realistic goals, rapid weight loss, readiness for weight loss, physical activity, breast-feeding as well as the effects of eating breakfast daily, early childhood experiences, eating fruits and vegetables, weight that cycles up and down, snacking, and the environment. There are evidence-based approaches that can help guide people in their pursuit of a healthy lifestyle, weight loss, and physical activity. Pediatricians and health care providers should be aware of these approaches when counseling patients on a healthy lifestyle. [Pediatr Ann. 2018;47(11):e427-e430.].

Depression in Children and Adolescents: The Pediatrician at the Front Lines.

Pediatricians are the primary care providers for most children and adolescents in the United States, so they need to feel comfortable caring for children and teens with depression. This topic is an extremely important one because the top three reasons teens die or get injured are related to accidents (3.7 per 100,000 for those ages 5-14 years and 28.5 per 100,000 for those ages 15-24 years), suicide (1 per 100,000 in the younger age group, and 12.5 deaths per 100,000 in those ages 5-14 years), and homicide (0.7 per 100,000 in those age 5-14 years, and 10.8 per 100,000 in those age 15-24 years). Each year, 21% of children ages 9 to 17 years are diagnosed with a mental or addictive disorder associated with at least minimum impairment, with 11% of these children having significant functional impairment and another 5% demonstrating extreme functional impairment. We know that one-half of all lifetime cases of mental health disorders start by age 14 years. This includes serious adult psychiatric illnesses such as major depressive disorder, anxiety disorders, and substance abuse. Three-quarters are present by age 24 years; therefore, interventions aimed at prevention or early treatment need to focus on youth. [Pediatr Ann. 2018;47(7):e261-e265.].

Adolescent Sexual Health and Education: Where Does the Pediatrician's Responsibility Fall?

Adolescence is a stressful time with a considerable amount of change, not only physically, with all the changes expected throughout puberty, but also emotionally, spiritually, and psychosocially. Teens are learning how to build and sustain relationships, learning boundaries in all areas of their lives, experimenting, as well as setting values that will sustain them throughout their lives. Home, school, various social settings, and places of worship all contribute to where adolescents learn what their values are, what they want their values to be, and how they start to make choices about their personal beliefs, which may not always align with their family values. Adolescents spend most of their time in school, so the classroom is a logical place where certain discussions, such as puberty and sexuality, should happen regarding changes that are occurring with their bodies. The home environment, as well as the willingness of parents to have open, honest dialogue about sexual education, is also a vital component of ensuring that adolescents feel safe to openly discuss this topic. Pediatric clinicians also play an important role in helping to inform adolescents and their families about sexual health and development. [Pediatr Ann. 2018;47(4):e136-e139.].

Outcomes of an Adolescent School-Based Health Initiative Needs Assessment.

Adolescent School-Based Health Initiatives (ASBHIs) are designed to increase adolescent access to medical homes and services that are not otherwise available without significant barriers. ASBHIs have been proven to increase access to care for school-aged adolescents with unique needs and limited access to these much-needed medical services. For this descriptive study we conducted a needs assessment to understand and determine the needs and desires for a school-based health initiative in a middle school in the community. Survey topics included demographics, health care needs, and desired health resources. Most teachers (94%) and parents (83%) indicated that they would encourage their student/child to participate in an ASBHI program, and 57% of students reported that they would use an ASBHI program. Both parents (71%) and teachers (94%) indicated that student attendance would improve with an Adolescent School-Based Health Initiative. There is sufficient evidence for the need and utilization of an ASBHI program in this community.

Talking to Adolescents About Social Media.

I see a large number of adolescents in my clinic with issues related to their social media use. These issues range from lack of sleep, to depression, to cyberbullying, and even sex trafficking, all secondary to constant social media exposure. Pediatricians should ask about social media use when they see children and adolescents who already have access to electronic devices. They should also ask parents about controls that are set in place to monitor social media use, content, and friend connections on those sites. They should ensure that their children know personally everyone they are connected to on social media and that their accounts are always private and not public. This will help reduce many of the issues associated with the potential consequences of social media use. [Pediatr Ann. 2017;46(8):e274-e276.].

Addressing Eating Disorders and Weight Control in Children and Adolescents.

How often do we look at a patient's body mass index (BMI) and only make a comment if the BMI is above normal in the overweight or obese category? As pediatricians, we often do not give it a second thought when the BMI is normal, and we generally do not counsel on healthy eating practices in these cases. However, when people are overweight, obese, and sometimes even normal weight they are told by family, friends, as well as physicians that they need to either not gain any more weight, or that they need to lose weight. As clinicians, we should be aware that comments like that may trigger a disordered pattern of eating for some people, which can lead to an eating disorder. [Pediatr Ann. 2017;46(5):176-e179.].