The final panel focused on reflecting on individual takeaways from the workshop. Terri Ann Parnell moderated the discussion, which opened with three presenters offering prepared remarks (see Boxes 6-1, 6-2, and 6-3). The presenters were Trina Anglin, former chief of the Adolescent Health Branch, Maternal and Child Health Bureau, Health Resources and Services Administration; Vanessa Simonds, associate professor of community health, Montana State University; and Earnestine Willis, Kellner Professor of Pediatrics, Medical College of Wisconsin.
Parnell asked Willis what common thread is necessary throughout all of the sectors to truly enhance health literacy among youth. Willis replied that the health professionals do not know the health education standards in schools well enough to reinforce them, and pediatricians do not always work closely with early childhood education and school systems to advocate for brain and cognitive development. She added that she would teach her pediatric residents about how to help parents make decisions about quality early childhood education environments—to help with bridging across sectors for families that otherwise may not occur.
Anglin agreed, adding that although there is wonderful evidence of early childhood education program effectiveness, it has not been translated
into policy across the country. “Programs and policy can relate back and forth between each other. To me, that is a common thread.”
Willis noted that because she works in both the medical and early childhood education (ECE) communities, she knows that the ECE community does a thorough assessment of social determinants of health for each family, but they do not share that information with pediatricians. She added, “Families shouldn’t have to repeat that information.”
Jennifer Manganello from the University at Albany School of Public Health noted that policy issues regarding the online environment are enormous. She also added that in her focus groups, young adults often said that they were not taught how to understand health information, with the occasional exception prefaced by “one of my parents is a medical professional.” “Maybe we should do a better job of working with parents to let them know they should be working on developing these skills with their kids,” she said.
Cindy Brach from the Agency for Healthcare Research and Quality noted that crucial developmental moments in children’s lives are often overlooked in a child health context, especially if they are healthy. But those early moments are the perfect time for interventions to develop health literacy skills. She wondered how institutions can serve both parents and adolescents and navigate tension as adolescents assume more self-management responsibilities but are not yet fully independent.
Willis noted that, as a physician, she encourages a collective approach to serving patients.
Winston Wong from Kaiser Permanente wondered if any speakers could talk about how health literacy could have played a more proactive role in anticipating the phenomenon of e-cigarette use among adolescents.
Willis replied that youth were active in tobacco control campaigns. When she served as the chair for the Tobacco Control Board in Wisconsin, they had a modest initiative to have 100 municipalities adopt a nonsmoking policy, and it caught on rapidly because young people were active participants in the initiative. She added that more research should be married with interventions.
Closing out the discussion, H. Shonna Yin from New York University noted that parents often play the role of the trusted and knowing other actor who will help the child build health literacy skills. In that sense, health care providers can play an important role in guiding parents on how to engage their children in their illness, be it minor or chronic. She added that more thought should go toward developing frameworks that can specifically help health care providers know how to engage children every step of the way, starting in early childhood.
IOM (Institute of Medicine). 2015. Investing in the health and wellbeing of young adults. Washington, DC: The National Academies Press.
Rosenbaum, J., C. Ahearn, K. Becker, and J. Rosenbaum. 2015. The new forgotten half and research directions to support them. New York: William T. Grant Foundation. http://wtgrantfoundation.org/resource/the-new-forgotten-half-and-research-directions-to-support-them (accessed May 5, 2020).
William T. Grant Foundation Commission on Work, Family, and Citizenship. 1988. The forgotten half: Pathways to success for America’s youth and young families. New York: William T. Grant Foundation. http://wtgrantfoundation.org/library/uploads/2018/08/The-Forgotten-Half-Optimized.pdf (accessed May 5, 2020).