What's involved with teen disease prevention?

The teen years are a time of growth that involves experimentation and risk taking. For some teens, the social pressures of trying to fit in can be too much. These years can be even more troubling for teens who are confronted with teenage pregnancy, substance abuse, violence, delinquency, suicide, depression, unintentional injuries and school failure. Parents often walk a tightrope between allowing their teenager to gain some independence and helping them to deal with their feelings during this difficult and challenging time in their lives.

Teenagers recognize that they are developmentally between child and adult. Emerging cognitive abilities and social experiences lead teens to question adult values and experiment with health-risk behaviors. Some behaviors threaten current health, while other behaviors may have long-term health consequences. The changes in cognitive abilities offer an opportunity to help teenagers develop attitudes and lifestyles that can enhance their health and well-being. Teen disease prevention includes maintaining a healthy diet, exercising regularly, preventing injuries, and screening annually for potential health conditions that could adversely affect teenage health.

Health checkups

Annual checkups for teenagers provide an opportunity to

• promote healthy lifestyle choices which include nutrition, exercise;



• screen sexually active teenagers for sexually transmitted diseases (STDs);



• screen sexually active teens at risk for HIV infection;



• assess whether teen has an eating disorder such as anorexia nervosa, bulimia, or obesity. This assessment is reached by determining weight and stature, and asking about body image and dieting patterns;



• discover if teenager is experiencing emotional problems such as depression or anxiety;


• screening for depression or suicide risk for teens who have declining grades, chronic melancholy, family dysfunction, physical or sexual abuse , alcohol or drug abuse or previous suicide attempt;




• ask teenager if they have a history of emotional, physical, and sexual abuse;



• discuss health risks of smoking, alcohol abuse, and other drug abuses;



• ask teens about learning or school problems to determine if they need special counseling;



• screen teenagers who have a history of absences or declining school performance for dyslexia, learning disabilities, or attention deficit hyperactivity disorder;



• identify signs and symptoms of disease, illness and health conditions;



• screen for high blood pressure;



• test teenagers cholesterol level if their parents have a serum cholesterol level greater than 240 mg/dl;



• screen teenagers who have multiple risk factors for future cardiovascular disease (for example, smoking, high blood pressure, obesity, diabetes mellitus, excessive consumption of dietary saturated fats and cholesterol) for total serum cholesterol level;



• assess health-risk factors for overweight teenagers to determine their risk for future cardiovascular disease.

Immunizations

This is the immunization schedule as recommended by the federally convened Advisory Committee on Immunization Practices and Centers for Disease Control and Prevention (CDC).

• Teens should receive a trivalent Tdap vaccine booster at the 11-12 year visit if not previously vaccinated within five years. With the exception of the Tdap booster at 11-12 years, routine boosters should be administered every 10 years.



• Teenagers should receive a second dose of MMR at 11-12 years of age, unless there is documentation of two vaccinations earlier during childhood. The first vaccination is generally given at 1 year of age. MMR should not be administered to pregnant teens.



• Teens, 11-12 years of age, who have not received their second Varivax vaccination as part of a routine childhood schedule and who do not have a reliable history of chickenpox should receive this booster vaccination. The first dose is generally given at 1 year of age.

Most infants complete their immunization series against hepatitis B by their first birthday. If not completed, this should be accomplished by teens 11-12 years of age. Hepatitis A should be given to teens who are traveling or living in countries with high or intermediate hepatitis A virus (HAV), live in communities with high rates of HAV, have chronic liver disease, are injecting drug users, or are males who have sex with males. Complete immunization requires two vaccinations separated by a minimum of six months.

Meningococcal vaccine—All teens 11-12 years of age should receive a onetime only vaccination to prevent meningococcal diseases (meningitis, general body sepsis, etc). Of note, this has become a mandatory vaccination for college.

Female teens should be immunized against human papillomavirus (HPV). HPV is the leading cause of cervical cancer and genital warts. Three vaccinations over a six-month period are necessary for maximum protection.

Annual vaccination against influenza is recommended for all teens.

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