The Line Between Enabling and Supporting

To be healthy teens need to assume responsibility for their lives gradually, as they are emotionally ready for it, but hopefully before they need the skills to live independently. Some of the basic skills they will need include getting up on time, feeding themselves, driving, managing money, cleaning their space, basic work skills, and manners.

I spend a lot of time encouraging parents to be supportive of their teens and hear many stories about how hard it is to stick to being supportive without enabling our teens to be too dependent on us.

For example, if we wake our teen up every day, and one day we wake him or her up late, whose fault is it - theirs for not using an alarm clock, or ours for waking them up late - or maybe for waking them up everyday?

How about screaming bloody murder about the mess in the house - is it their fault for leaving their stuff wherever they drop it, or ours for not teaching (and requiring) them to pick up after themselves every day?

Same goes for coming home after a long day to hungry teens who chose to wait for you rather than feed themselves - who takes the responsibility?

I am not meaning to sound the "it is always the parents fault" siren, really, I am not! I think it is important though to be conscious about how our behavior as parents is impacting our teen. If what we do is comfortable for us and helps them be independent, then great - we are good. If however, we are doing too much for them, it might be worth readjusting everyone's expectations and being clear about or expectations in relation to skills they need to develop!

Just a thought this morning!



Photo credit: freeparking

Permalink | 0 Comments| Email Post

Post your comment

Obesity - Trying to Slow the Growth

The Centers for Disease Control (CDC) reports that in 2007 the percentage of adults that were considered obese (based on their BMI score) had grown to 26 percent, compared to about 15 percent in 1978. It is estimated that more than 17% of teens are obese, as well!

Given the increase in obesity, and the increasing amount of screen time teens are experiencing, San Mateo County in California has developed a Web site dedicated to engaging youth in the effort to combat obesity. You can see it at Get Healthy SMC. On the site parents, community members and youth will find links to facts, exercise and eating tips, as well as plenty of encouragement to get fit!

I found several very interesting resources, including a page for parents that includes several great resources including information for African American families, material in Spanish, and a five-page document about how to avoid using food rewards in classrooms.

Let's get active!

Photo credit: hobbs_luton

Permalink | 1 Comments| Email Post

Post your comment

Youth Risk Behavior Survey - United States 2007

Every other year the Centers for Disease Control and Prevention (CDC) collects Youth Risk Behavior Survey (YRBS) data from a scientifically sound sample of public and private schools. In 2007 that sample included more than 14,000 questionnaires from 39 states and 22 large urban school districts.

Here is a summary of the 2007 results. High school students today are less likely to engage in many health risk behaviors than high school students in the early 1990s, unless those students are Hispanic.

Let's start with the good news:

• There are have been significant decreases in the percentage of black students who have had sexual intercourse (down from 82% in 1991 to 66% in 2007);
• There are have been significant decreases in the percentage of black students who have had four or more sexual partners during their lifetime (down from 43% in 1991 to 28% in 2007);
• There are have been significant decreases in the percentage of white students who have had sexual intercourse (down from 50% in 1991 to 40% in 2007);
• Compared with Hispanic high school students in the 1990s, Hispanic students in 2007 were more likely to wear a seat belt at least some of the time and to use condoms during their most recent sexual intercourse;
• Compared with Hispanic high school students in the 1990s, Hispanic students in 2007 were less likely to smoke cigarettes, drink alcohol, use drugs such as marijuana and methamphetamines, or ride with a driver who had been drinking alcohol.

The bad news for Hispanic youth:

• There has been no significant decreases in the percentage of Hispanic students who have had sexual intercourse (53% in 1991 and 52% in 2007);
• Overall, Hispanic students were more likely than either black students or white students to attempt suicide, use cocaine, heroin, ecstasy, ride with a driver who had been drinking alcohol, or go 24 hours or more without eating in an effort to lose weight;

Other not so good news:
In the United States, 72% of all deaths among people 10 to 24 years old result from four causes - motor vehicle crashes, unintentional injuries, homicide and suicide. The 2007 data indicated that during the 30 days preceding the survey, many high school students engaged in behaviors that increased their likelihood of death from these four causes:

• 11% had never or rarely worn a seatbelt when riding in a car driven by someone else;
• 29% had ridden in a car driven by someone who had been drinking alcohol; and
  
• 18% had carried a weapon.

In addition, in the 12 months preceding the survey:

• 7% had attempted suicide (down from 8.4% in 2005);
  
• 48% reported ever having sexual intercourse; and
• 39% had not used a condom at last sexual intercourse.

Among adults over 25 years old, 59% of all deaths result from cardiovascular disease and cancer, and we know that many habits that contribute to those causes of death start during adolescence. In particular, results show that in 2007 a total of 20% of high school students had smoked cigarettes during the 30 days preceding the survey and 79% had not eaten at least five servings of fruits or vegetables during the previous week, 65% were not getting enough exercise, and 13% were obese.

Photo credit: anarchosyn

Permalink | 0 Comments| Email Post

Post your comment

Defending The Health Care Rights of Adolescents

There is some very dangerous stuff happening at the Department of Health and Human Services (HHS) in Washington D.C. There is a"Proposed Rule Ensuring that HHS Funds Do Not Support Coercive or Discriminatory Policies or Practices in Violation of Federal Law" (Fed Reg 73, No 166, August 26, 2008) that, if implemented would broaden the scope of the existing federal refusal laaws by allowing healthcare providers to withhold medical information based on their religious or moral beliefs. It would open the door for hospitals and physicians to deny access to or information about contraception.

Currently healthcare practitioners are not required to perform abortions or sterilizations if personal beliefs conflict with those procedures, however they are ethically bound to inform patients about all of their options and refer them to someone who will do those procedures. This new regulation would allow practitioners to not mention the options they did not agree with and a teen would never know what options she was not offered.

In addition, it widens the law by extending the right to refuse health services to a broad range of healthcare workers who are not directly involved in patient care. Receptionists could refuse to schedule appointments; health insurance agents could refuse to process payments; and operating room staff could refuse to clean equipment used for procedures they disagreed with.

In addition, the proposed regulation does not make explicit that healthcare providers cannot deny women contraceptives by claiming they are tantamount to abortion.

PLEASE!! The new regulations would affect 580,000 hospitals, clinics, and other entities and cost $44 million to enforce - give me a break!

The proposed regulation is unnecessary, would damage the integrity of the relationship between healthcare providers and patients, and would undermine the ability of women and families to make informed reproductive healthcare choices. Please join me and the organizations listed below in urging the HHS to withdraw this proposed regulations.

American Academy of Pediatrics
American Nurses Association
American Psychiatric Association
Association of Women's Health, Obstetric and Neonatal Nurses
Physicians for Reproductive Choice and Health
Society for Adolescent Medicine

Photo credit: ema

Permalink | 0 Comments| Email Post

Post your comment

Thank You - Grand Rounds 5.1

Thanks to Val Jones, MD at Dr Val and the Voice of Reason (and her hosts Kevin and Kim) for hosting Grand Rounds this week and including the Teen Health 411 post about family dinners.

This week was really fun to read, and I loved the quotes from the wonderful bloggers! Here's to more energy for medical blogging and Grand Rounds!

Photo credit: Ed Bierman

Permalink | 0 Comments| Email Post

Post your comment

The Importance Of Family Dinners

If you could reduce the chances that your child would smoke, drink, use illegal drugs, misuse prescription drugs, and have friends that did those risky things - all in less than an hour a day - would you do it?

Of course you would but the research suggests that less than 60% of families are doing it - and you actually only have to do it five times a week to enjoy the benefits. I am talking about family dinners - at least five times a week - how easy is that?

Start today! Plan to start having dinner together on September 22, 2008 - Family Day - sponsored by Casa to remind parents that what kids really want at the dinner table is you! Your children and teens want to be engaged and need your attention.

According to the Family Day web site there are seven secrets to successful family dinners:

• Start the pattern of family dinners when children are young
• Encourage your children to createmenu ideas and participate in meal preparation
• Turn off the TV and let your answering machine take all calls during dinner
• Talk about what happened in everyone's day: school, work, extracurricular activities or current events, including headlines from the newspaper (which are frequently including as extra credit on tests in school, I might add)
• Establish a routine to start and end each meal, light candles, tell a story, say a blessing
• After dinner play a board game or postpone the clean up to encourage conversation
• Keep the conversation positive and make sure everyone has a chance to speak

And I want to add another couple suggestions:

• Mix it up - let the younger ones makes a "rule" for each dinner - no drinking until done with food, only butter knives to eat with, only hands, in the dark with a candle, fresh flowers from the yard, on the front porch, dessert first ...
• Do not shy away from sensitive or difficult topics - drugs, alcohol, friends, sex
• Answer every question and listen to what kids are saying - be "present" - nothing is more important than the time you spend with your children
  
• If you cannot answer the question, go to a teen health web site you trust and look for the answer together.
• Make extra, you'll attract other teens, who almost never prefer eating alone!
  

Most importantly, have fun!

Photo credit: griffhome

Permalink | 2 Comments| Email Post

Post your comment

Top 50 Health 2.0 Blogs

I would like to thank RN Central for including Healthline’s Health Matters as one of the top 50 health blogs! I am honored to be a part of a team that was included with the other wonderful groups on this list.

As many of you may know, using technology, like blogs and texting, to bring bring health care into the community for patients, parents, doctors and other health care professionals is part of Health 2.0 and a much larger effort to provide the best possible health care, to everyone. Together, we can inform and empower people to improve their health, trust themselves and make our world a better place! How cool is that?

Photo credit: sprigley

Permalink | 0 Comments| Email Post

Post your comment

Emergency Preparedness

Yesterday was the second annual observance of "Get Ready Day," designed to raise awareness about community preparedness. The goals of the campaign are to help Americans prepare themselves, their families, and their communities for pandemic flu, emergencies like natural disasters and other health threats (read terrorism).

The campaign suggests that every family have three days worth of emergency food and water, batteries, flashlights, blankets, a radio, and extra medications, as well as an emergency plan that you will follow if there is a natural disaster and you and your loved ones are separated.

You can get some great tips for making this plan at Ready.gov, and I suggest you do talk to your kids about this. Just remember when they were little and you told them about 10,000 times "if you ever get lost, stand still. I will come back to find you" only to lose them in Toys R Us and hear them running as fast as they could up and down the aisles looking for you. Some things are worth discussing again and again!

The American Public Health Association suggests that you "Set your clocks and check you stocks" as a way to remember and be prepared. When daylight savings time ends on Sunday, November 2, 2008 you should change the batteries in your smoke detectors, check all your emergency supplies, and briefly review your emergency plan with your family.

Photo credit: jr conlin

Permalink | 0 Comments| Email Post

Post your comment

Thank You - Grand Rounds 4.52

Thank you Mother Jones, RN at Nurse Ratched's Place for hosting Grand Rounds 4.52 this week and including a post about Preventing Rape from Teen Health 411.

This week was really interesting. I loved the variety, theme, pictures, and especially your sense of humor.

Photo credit: Ed Bierman

Permalink | 0 Comments| Email Post

Post your comment

Friends & Healthy Relationships

One of the most important things in our lives is knowing we have family and friends who will love us no matter what happens. Being able to recognize who our true friends are, and knowing how to avoid unhealthy relationships are important skills.

Transitions from elementary to middle school, from middle school to high school, and from high school to college, are stressful. Teens are vulnerable to creating bad relationships when they feel awkward or are lonely, homesick, bored, or struggling academically or financially. These transitions also usually include exposure to a wider variety of people and differences, which can be exhilarating to teens trying to find their own path in the world.

Parents can help them make good decisions about friends by talking about what makes true friends versus false friends. Here are some tips for evaluating friends that you can share with your teens.

True Friends

• Tend to get closer over time, getting to know each other slowly. Instant friendships can end just as quickly as they started.
• Make us feel safe, welcome, and secure. They do not bend rules or disrespect your values or trivialize your concerns.
• Support your goals, encourage you to do your best, and want you to be successful.
• Take time for you, listen to you, disagree with you gently and point out differences of opinion gently. They never make fun of you!
• Are never jealous or possessive - they encourage time spent with family and new or old other friends.
• Are able to work through conflict - explain their feelings, own their part in the problem, apologize, and talk the problem through.
  

False Friends

• Demand all of your attention and are jealous of other friends or family.
• Only appreciate your opinions when they are similar to their own beliefs or opinions.
• Expect you to do what they want to do all of the time - the relationship is pretty much "all about them."
• Never take responsibility for problems and hurt feelings - nothing is ever their fault.
• Demand proof of your devotion - more time spent with them, more attention - and there is never enough.
• Do not respect your values, limits or boundaries and may encourage you to do things you are not comfortable doing.
• Want too much, too soon!

Relationships are built on love and history - they take time and effort. It cannot hurt to talk about these things and let your teens know you are always willing to talk about how to get out of uncomfortable situations - true friends (and conscious parents) never say "I told you so!"

Photo Credit: Shahram Sharif

Permalink | 0 Comments| Email Post

Post your comment

Making Community College Important

Sometimes young adults are not ready for a 4-year university right out of high school, but the transition from high school to college still includes many changes for the teen, the parent, and the family. It is important that the transition get acknowledged and that families go through many of the same processes experienced by families with university-bound teens.

The habits that get established the first semester of college, including community college, are important and are related to the attitude of the teen and family. You can help your student do a better a job in school by taking college seriously, acknowledging how hard your child is working and giving them as much emotional and financial support as possible.

There are a few things you can do to help your student get a good start:

• Attend the parent orientation
• Encourage the student to join campus social groups
• Encourage your student to stay on campus to do homework, meet with professors and meet other students
  
• Encourage your student to talk about what s/he is learning, the professors, and any challenges
• Find any needed tutoring groups with your student (math, writing)
  
• Discuss how much housework they are expected to do
• Discuss any problems they are having turning off their computer, getting enough sleep, keeping a schedule
  
• Discuss financial expectations - is their room and board free, who pays for gas, car washes, and insurance, will you provide money for lunches or social activities?

College students carrying 15 units should be in class and doing homework for 45 hours a week - that is more than a full time job. If they also have to commute and work they will have very little free time. Help them treat community college just like living away at college- their focus should become college and their own growth. They need our support to make the most of it!

Photo credit: Pat Hawks

Permalink | 0 Comments| Email Post

Post your comment

Rape Is A Reality: What College Students Should Know

It is sad but true that on every campus, sexual assault exists and is the most common during the first few weeks of school, when everyone is a stranger and students are moving in and out, there are parties, and defenses are down. Talk to your college student about sexual assault and know what you can do if it ever happens to them.

Every college student needs to know how to avoid sexual assault.
To avoid being a victim

• Always have enough cash to pay for your meal or movie or get yourself home, and carry a cell phone or calling card.
• If you are going to a party or a bar, have a buddy who keeps an eye on you and notices anything unusual.
• If a friend seems unusually sleepy or intoxicated after only one drink - take her home and stay with her.
  
• Trust your instincts - if it feels weird - it is - change the situation, even if you have known the person for a while.
  
• Do not allow yourself to become isolated from other people.
• Never leave a drink unattended or drink something you did not watch be poured or open yourself.
• Take a self-defense course and be assertive, not passive if things feel "funny."
• Drink responsibly - most sexual assault on campus includes drinking.
  
• If you are ever sexually assaulted go to the doctor immediately and then call the Rape Crisis Support on campus or the Rape, Abuse & Incest National Network (RAINN), 1-800-656-HOPE, or visit RAINN on the Internet.
  

To avoid being a rapist

• Be respectful. Ask if your partner is OK with your advances and know that "no," and "I don't know" both mean NO!!
• Recognize that your sexual needs or desires do not give you the right to do whatever you want. If the other person is not capable of making a decision - stop.
• Understand that what you "meant" does not matter - it is how a person takes your comments or gestures that matter - never touch someone without their explicit permission.
• Drink responsibly - most sexual assault on campus includes drinking.
• If you know a roommate or friend is sexually assaulting someone, you must stop it, or are just as guilty!

If your child is ever sexually assaulted, never doubt that it happened and listen as long as she or he wants to talk. First, make sure they are safe and not still in an unsafe situation then encourage them to seek medical care immediately. Second, let them stay in control - they have just experienced something that took away their control - having you swoop in and fix it will not help them deal with things - have them find a friend who will go with them to the doctor and then call RAINN yourself or the campus rape crisis unit. You may feel powerless, but they know you support them and love them - and that is what matters.

Photo credit: fabbio

Permalink | 1 Comments| Email Post

Post your comment

Thank You - Grand Rounds 4.51

Thanks to Cris Cuthbertson at AppleQuack for hosting Grand Rounds 4.51 this week and including a link to the 2nd Anniversary post at Teen Health 411 .

This week was really interesting and including some great posts. I also appreciate the Sound of Music theme, which I am sure will play in my head all morning!

Photo Credit: Ed Bierman

Permalink | 0 Comments| Email Post

Post your comment

Book Review: You're On Your Own (but I'm here if you need me)

Marjorie Savage wrote You're On Your Own (but I'm here if you need me) to help parents mentor their children during the college years, and I definitely suggest that parents of high school seniors read it! I believe that having a good sense of what might be coming your way will help you sleep better and not overreact when things do happen.

Whether your child is going to a local community college or an ivy league campus across the country, the transition from high school to college is huge for your child, your family, and you as a parent. In many communities the amount of support that exists for families of young children just does not exist for parents of teens and young adults, so read this book and reach out to those of us experiencing this transition - it sounds like the road is going to get bumpy.

I loved the practical advice and great stories provided by Ms.Savage about how parenting a college student is different, requires a different approach to finances, health, wellness, academics, work, emergencies, and most importantly mentoring. There are down-to-earth examples of how families handled different challenges, and not everyone is perfect.

At the end of the book is a great summary about what the major issues are during each of the four years at college, and I found it comforting to feel like I could start doing things now to help my teens learn how to manage their time, make decisions about risky behavior, balance responsibilities with social goals, make use of opportunities available, set reasonable goals about money, think long term, and not fear uncertainty.

Ms. Savage not only spoke to me as a parent of a high school junior but she has some great advice for teens and college students at the end of every chapter. There is also a great chapter about learning outside the classroom and how to chose a career, not a job.

This book made me feel much more secure about the types of challenges our family will face soon and did not shy away from some difficult subjects including sex, alcohol, drugs, sexual assault, emotional health, how to prepare for visits with your college student, and even body art. A must read for parents and it would not hurt students either!

Photo Credit: tonystl

Permalink | 0 Comments| Email Post

Post your comment

Parenting To Prevent Sexual Risk

Parents can help prevent early sexual behavior and risk. Between the ages of 9 and 12 preteens care what their parents think and are listening to what parents have to say. I think this is the best time to develop a positive relationship with your (almost) teen and set up the communication patterns that will prevent early sexual debut.

Here are some concrete things parents of preteens can do to set up habits and patterns that protect youth from early sexuality and other risk behavior:

• Accept your role as the primary sexuality educator of your child;
• Learn everything you can so you feel confident and provide books for your child to learn from;
• Monitor your preteen - as children spend time away from parents and school, always know where they are and require them to call if leaving school or home;
• Structure "free time" to avoid long periods of unsupervised time;
• Encourage hobbies, sports & music;
• Encourage children to set long term goals that include college and careers;
• Talk about difficult subjects - sexuality, drugs, alcohol, and abuse, making your values clear as well as your behavioral expectations for your children;
• Share facts about how FEW teens actually participate in risk behaviors to challenge their social norm that may be that "everyone is doing it;"
• Be a healthy role model in relationships; and finally,
• Whatever you do, please do not over react to the stories you will start to hear about what "other" kids are doing.
  

That is if you want to be a parent your kids can talk to! If these patterns start early, they are likely to continue through high school and be applied to romantic and sexual relationships your children will think about or start later on in their lives.

Photo credit: gcoldironjr2003

Permalink | 0 Comments| Email Post

Post your comment

Beauty At Any Cost

YWCA USA has produced a new report called "Beauty at Any Cost" and is teaming up with filmmaker Darryl Roberts to distribute his documentary film called "America the Beautiful" to raise awareness about the costs of our culture's obsession with beauty.

This new report portrays our obsession with beauty as a lifelong burden taking a terrible toll on young girls and women in this country. The report shows an alarming increase in toxic cosmetic use, cosmetic surgery, as well as more perceived appearance-based job discrimination, and decreases in self-esteem and healthy interpersonal relationships.

The report and discussion guide can be accessed at the YWCA web site.

Photo credit: nosha

Labels: Beauty, Healthline

Permalink | 0 Comments| Email Post

Post your comment

Thank You - Grand Rounds 4.50

Thanks to Laurie Edwards at A Chronic Dose for hosting Grand Rounds 4.50 this week and including the post about the Importance of Education from Teen Health 411.

This week was really interesting. I read by favorites first but then had to read some new ones! Great theme!

Photo Credit: Ed Bierman

Labels: Education, Grand Rounds, Healthline

Permalink | 0 Comments| Email Post

Post your comment