Screening Tools

• Centers for Disease Control and Prevention. A Guide to Taking a Sexual History. 
• Centers for Disease Control and Prevention, National Center for Health Statistics. Clinical growth charts.  
• CRAFFT 2.0. 
• Bright Futures. Developmental, Behavioral, Psychosocial, Screening, and Assessment Forms. 
• Bright Futures. Medical Screening Reference Table for Adolescents. 
• HEADDSSS questionnaire.
• PSC-35, PSC-17, Y-PSC, and PHQ-9. Bright Future’s Developmental, Behavioral, Psychosocial, Screening, and Assessment Forms.
• Tanner Sexual Maturity Rating (SMR) system.

Guidelines and Reporting

• American Academy of Pediatrics, Bright Futures. (2017). Guidelines for Health Supervision of Infants, Children, and Adolescents, Fourth Edition. 
• American Academy of Pediatrics and Bright Futures. (2017). Recommendations for Pediatric Preventive Health Care.
• American Academy of Pediatrics. (2016). Technical Report: Children and Adolescents and Digital Media.
• American Academy of Pediatrics. (2014). Screening for Nonviral Sexually Transmitted Infections in Adolescents and Young Adults.
• American Academy of Pediatrics. (2014). Policy Statement: Contraceptives for Adolescents.
• American Academy of Pediatrics. (2013). Children, Adolescents, and the Media.
• American Academy of Pediatrics. (2013). Policy Statement: Office-based care for Lesbian, Gay, Bisexual, Transgender, and Questioning Youth.
• American Academy of Pediatrics. (2008, reaffirmed 2013). Achieving Quality Health Services for Adolescents. Pediatrics, 121(6): 1263-1270.
• American Academy of Pediatrics. (2006). Clinical Guide: Connected Kids.
• American Academy of Pediatric Dentistry. (2010). Guideline on Adolescent Oral Health Care.
• American Diabetes Association, Position Statement: Screening for Type 2 Diabetes. 
• Centers for Disease Control and Prevention. (2020). Vaccine Recommendations of the Advisory Committee for Immunization Practices (ACIP).
• Centers for Disease Control and Prevention. (2020). Vaccine and immunizations web page for health-care providers.
• Centers for Disease Control and Prevention. (2016). Use of a 2-Dose Schedule for Human Papillomavirus Vaccination — Updated Recommendations of the Advisory Committee on Immunization Practices. Morbidity and Mortality Weekly Report (MMWR), 65(49); 1405–1408.
• Centers for Disease Control and Prevention. (2015). STD Treatment Guidelines.
• HealthIT.gov offers guidance and resources for providers about privacy and security laws that protect patient health-care information. 
• National Heart, Lung and Blood Institute’s Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents (2013).
• Texas Department of State Health Services. Adolescent Health: A Guide for Providers.
• Texas Department of State Health Services. Disease Reporting.
• Texas Department of State Health Services. HIV and Texas Law fact sheet.
• Texas Department of State Health Services. (2019). Immunization web page and the Texas Minimum State Vaccine Requirements for College Entry web page.
• Texas Department of State Health Services. ImmTrac2, Texas immunization registry.
• Texas Health Steps Risk Based Guidance Tool for laboratory screening.
• Texas Health Steps Medical Checkup Periodicity Schedule for Infants, Children, and Adolescents.
• Texas Medicaid Provider Procedures Manual (TMPPM).
• U.S. Department of Health and Human Services. Healthy People 2020.

General

• American Academy of Pediatrics. (2020). Lesbian, Gay, Bisexual, Transgender and Questioning (LGBTQ) Youth. 
• American Academy of Pediatrics and HealthyChildren.org. (2018). Coming Out: Information for Parents of LGBT Teens.
• American Academy of Pediatrics. (2016). Technical Report: Children and Adolescents and Digital Media. Pediatrics, Oct. 2016, e20162593.
• American Academy of Pediatrics. (2010, reaffirmed 2014). Child Abuse, Confidentiality, and the Health Insurance Portability and Accountability Act. Pediatrics, 125(1): 197-201. 
• American Academy of Pediatrics. (2010). Role of the Pediatrician in Youth Violence Prevention.
• American Academy of Pediatrics. (2006, reaffirmed 2010). The Teen Driver.
• American Academy of Pediatrics. Family Media Plan (bilingual).
• American College of Obstetricians and Gynecologists. Adolescent Health Care.
• Attorney General of Texas. Human Trafficking and “Be the One” video.
• Centers for Disease Control and Prevention. (2017). Youth Risk Behavior Surveillance (YRBS) report.
• Centers for Disease Control and Prevention. (2011). Grand Rounds: Chlamydia Prevention: Challenges and Strategies for Reducing Disease Burden and Sequelae  
• Centers for Disease Control and Prevention. National Network STD Clinical Prevention Training Centers.
• Centers for Disease Control and Prevention. WISQARS (Web-based Injury Statistics Query and Reporting System).
• JAMA Pediatrics. (2005). Brief Interventions and Motivational Interviewing With Children, Adolescents, and Their Parents in Pediatric Health Care Settings.
• Journal of Dental Hygiene. (2011). Oral Health Literacy.
• National Heart, Lung, and Blood Institute’s Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. 
• Safe Kids Worldwide 
• Star Health managed care organization. Health Passport for children in foster care.
• Texas Department of Family and Protective Services. Report Abuse, Neglect, or Exploitation.
• Texas Department of Family and Protective Services. Human Trafficking Resources. 
• Texas Department of Family and Protective Services. Texas Youth Connection.
• Texas Department of State Health Services. Texas Health Steps Child Health Clinical Record Forms.
• Texas Department of State Health Services. Texas Youth Risk Behavior Surveillance System (YRBSS) web page. 
• Texas Department of State Health Services. TB Questionnaire.
• Texas Medical Association. (2016). Integrating Child and Adolescent Mental Health into Primary Care.
• Texas Department of State Health Services. Texas Vaccines for Children Program, Immunizations Unit.
• Texas Department of State Health Services. Texas Local Public Health Organizations.
• The Nemours Foundation. Kidshealth.org 
• University Interscholastic League’s Pre-participation Physical Evaluation and Previous Athletic Participation Form.

Helpful Resources

• American Academy of Family Physicians. Familydoctor.org
• American Academy of Pediatrics. Healthychildren.org
• Boston Children’s Hospital. Youngmenshealthsite.org
• Boston Children’s Hospital. Youngwomenshealth.org
• Centers for Disease Control and Prevention. Before Pregnancy, Women.
• Centers for Disease Control and Prevention. Before Pregnancy, Information for Men.
• College Board. Big Future website, which offers resources to help prepare for college.
• The Nemours Foundation. Kidshealth.org 
• Texas Department of State Health Services. Texas Health Steps, information about finding a health-care provider and getting a ride to a checkup. 
• Texas Health and Human Services Commission. My Children’s Medicaid website, information for families about Medicaid benefits and pediatric health-care services.
• Texas Health and Human Services Commission. Say What! (Students, Adults, and Youth Working Hard Against Tobacco!) website, with events, videos, and other tobacco prevention resources.
• University of Florida. Health Care Transitions Workbook: Ages 18 and Older 
• U.S. Department of Health and Human Services. Smokefree Teen.

Featured

• American Academy of Pediatrics. (2020). The Resilience Project. Anxiety Fact Sheet.
• American Academy of Pediatrics. (2017). National Center for Medical Home Implementation.
• American Academy of Pediatrics. (2016). Clinical Report: Substance Use Screening, Brief Intervention, and Referral to Treatment. Pediatrics, 138(1):e20161211.
• American Academy of Pediatrics. (2016). Policy Statement: Achieving Quality Health Services for Adolescents. Pediatrics, 138(2):e20161347.
• American Academy of Pediatrics. (2016). Technical Report: The lifelong effects of early childhood adversity and toxic stress. Pediatrics, 129(1):e232–e246.
• American Academy of Pediatrics. (2015). Consent for Emergency Medical Services for Children and Adolescents. Pediatrics, 128(2): 427-433.
• American Academy of Pediatrics. (2014). Policy Statement: Contraception for Adolescents. Pediatrics, 134(4): e1244-e1256.
• American Academy of Pediatrics. (2013). Policy Statement: Children, Adolescents, and the Media. Pediatrics, 132(5); 958-961.
• American Academy of Pediatrics. (2013). Policy Statement: Office-based care for Lesbian, Gay, Bisexual, Transgender, and Questioning Youth.
• American Academy of Pediatrics. (2011). Adolescents and HIV Infection: The Pediatrician’s Role in Promoting Routine Testing. Pediatrics, 28(5), doi: 10.1542/peds.2011-1761.
• American Academy of Pediatrics. (2010, reaffirmed 2014). Policy Statement: Child Abuse, Confidentiality, and the Health Insurance Portability and Accountability Act. Pediatrics, 125(1): 197-201. 
• American Academy of Pediatrics. (2010). Screening Adolescents for High Risk Behaviors: A National Survey.
• American Academy of Pediatrics. (2006). Clinical Guide: Connected Kids.
• American Academy of Pediatrics. (2002, reaffirmed 2008). Policy Statement: The Medical Home. Pediatrics, 110(1): 184-186.
• American Academy of Pediatrics, American College of Emergency Physicians. (n.d.). Emergency Information Form for Children with Special Health Care Needs. 
• American Academy of Pediatrics, Bright Futures. (2019). Adolescence Visits.
• American Academy of Pediatrics, Bright Futures. (2019). Bright Futures Health Supervision Visits.
• American Academy of Pediatrics, Bright Futures. (2019). Guidelines for Health Supervision of Infants, Children, and Adolescents, Fourth Edition.
• American Academy of Pediatrics, Bright Futures. (2019). Implementation Tip Sheet. Integrating Adolescent Health Screening Into Health Supervision Visits.
• American Academy of Pediatrics, Bright Futures. (n.d.). Bright Futures Tool and Resource Kit. 
• American Academy of Pediatrics, Committee on Injury, Violence, and Poison Prevention. (2009; reaffirmed 2019). Role of the Pediatrician in Youth Violence Prevention. Pediatrics, 124(1); 393-402.
• American Academy of Pediatric Dentistry, American Dental Association. (2007). The Dental Home: It’s Never Too Early to Start.
• American College of Obstetricians and Gynecologists. (2018). Committee Opinion Number 735: Adolescents and Long-Acting Reversible Contraception: Implants and Intrauterine Devices.
• American College of Obstetricians and Gynecologists. (2017). Practice Bulletin: Long-Acting Reversible Contraception: Implants and Intrauterine Devices.
• Arain, M., Haque, M., Johal, L., Mathur, P., Nel, W., Rais, A., Sandhu, R., & Sharma, S. (2013). Maturation of the adolescent brain. Neuropsychiatric disease and treatment, 9, 449–461.
• Biro, F. M., Greenspan, L. C., Galvez, M. P., Pinney, S., Teitelbaum, S., Windham, G. C., . . . Wolff, M. S. (2013). Onset of Breast Development in a Longitudinal Cohort. Pediatrics, 132(6) pp1019-1027.
• Boyle, C. A., Boulet, S., Schieve, C. A., Cohen, R. A., Blumberg, S. J., Yeargin-Allsopp, M., . . . Kogan, M. D. (2011). Trends in the prevalence of developmental disabilities in US children, 1997-2008. Pediatrics, 127(6): 1034-1042.
• Centers for Disease Control and Prevention. (2019). Facts about Developmental Disabilities.
• Centers for Disease Control and Prevention. (2019). Ten Leading Causes of Death and Injury.
• Centers for Disease Control and Prevention. (2019). Transgender Identity and Experiences of Violence Victimization, Substance Use, Suicide Risk, and Sexual Risk Behaviors Among High School Students—19 States and Large Urban School Districts, 2017. MMWR Morbidity and Mortality Weekly Report, 68:67-71.
• Centers for Disease Control and Prevention. (2018). Fact Sheet: Reported STDs in the United States, 2018.
• Centers for Disease Control and Prevention. (2017). Healthy People. 
• Centers for Disease Control and Prevention. (2017). High School Youth Risk Behavior Survey Data, Texas Results. 
• Centers for Disease Control and Prevention. (2017). Teen Birth Rate by State.
• Centers for Disease Control and Prevention. (2017). 10 Leading Causes of Death
• By Age Group, United States—2017.
• Centers for Disease Control and Prevention. (2016). Access and Utilization of Selected Preventive Health Services Among Adolescents Aged 10–17.
• Centers for Disease Control and Prevention. (2015). Adolescent and School Health. 
• Centers for Disease Control and Prevention. (2014). Diabetes Report Card.
• Centers for Disease Control and Prevention. (2012). Prepregnancy contraceptive use among teens with unintended pregnancies resulting in live births—Pregnancy risk assessment monitoring system (PRAMS), 2004-2008. Morbidity and Mortality Weekly Report (MMWR), 61(02); 25-29.
• Centers for Disease Control and Prevention. (2006). Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings.
• Centers for Disease Control and Prevention, National Center for Health Statistics. (2015). 
• Prevalence of Obesity Among Adults and Youth: United States, 2011–2014. NCHS Data Brief No. 219.
• Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health (NIOSH). (2013). Productive Aging and Work: A Supportive Work Culture for Multi-Generational Issues.
• Columbia Lighthouse Project, Columbia University. Columbia-Suicide Severity Rating Scale (C-SSRS).
• Contemporary Pediatrics. (2014). HEEADSSS 3.0: The psychosocial interview for adolescents updated for a new century fueled by media.
• Defoe, I. N., Semon Dubas, J., & Romer, D. (2019). Heightened Adolescent Risk-Taking? Insights From Lab Studies on Age Differences in Decision-Making. Policy Insights from the Behavioral and Brain Sciences, 6(1), 56–63. 
• Dellinger, A., & Gilchrist, J. (2018). Leading Causes of Fatal and Nonfatal Unintentional Injury for Children and Teens and the Role of Lifestyle Clinicians. American Journal of Lifestyle Medicine, 13(1): 7-21.
• Gallup. (2017). In US, More Adults Identifying as LGBT.
• Gold, M. A., & Kokotailo, P. K. (2007). Motivational Interviewing Strategies to Facilitate Adolescent Behavior Change.
• Guttmacher Institute. (2015). Fact Sheet: Unintended Pregnancy in the United States.
• Johnson, S. B., Blum, R. W. & Giedd, J. N. (2009). Adolescent Maturity and the Brain: The Promise and Pitfalls of Neuroscience Research in Adolescent Health. Journal of Adolescent Health, 45(3): 216-221.
• Johnston, L. D., O’Malley, P. M., Miech, R. A., Bachman, J. G., & Schulenberg, J. E. (2014). Monitoring the Future national results on drug use: 1975–2013: Overview, Key Findings on Adolescent Drug Use. Ann Arbor: Institute for Social Research, The University of Michigan. 
• Lebrun-Harris, L. S., McManus, M. A., Ilango, S. M., Cyr, M., McLellan, S. B., Mann, M. Y., & White, P. H. (2018). Transition Planning Among US Youth With and Without Special Health Care Needs. Pediatrics, 142(4):e20180194.
• Liang, L., Meyerhoefer, C., & Wang, J. (2012). Obesity counseling by pediatric health professionals: An assessment using nationally represented data. Pediatrics, 130(1): 67-77.
• Mayo Clinic News Network. (2019). Mayo Clinic Q and A: Increasing incidence of throat cancer related to HPV.
• McManus, M., Fox, H., O’Connor, K., Chapman, T., & MacKinnon, J. (2008). Pediatric Perspectives and Practices on Transitioning Adolescents with Special Needs to Adult Health Care. The National Alliance to Advance Adolescent Health. Washington, D.C.
• National Campaign to Prevent Teen and Unplanned Pregnancy. (2016). Fast Facts: Teen Childbearing in the United States, 2014-2015 Birth Data.
• National Center for Children in Poverty (NCCP). (2018). Texas Demographics of Low-Income Children.
• National Organization for Rare Disorders. (2019). Rare Disease Database: Testicular Cancer.
• Neinstein, L., & Johnson, H. (2012). The Healthy Student: A Parent’s Guide to Preparing Teens for the College Years. Society for Adolescent and Health Medicine. 
• Palfrey, J. S., Tonniges, T. F., Green, M., & Richmond, J. (2005). Introduction: Addressing the Millennial Morbidity—The Context of Community Pediatrics. Pediatrics, 115 (Supplement 3): 1121-1123.
• Pew Research Center (2019). Reflecting a demographic shift, 109 U.S. counties have become majority nonwhite since 2000.
• Poland, S. (2009). Youth Suicide Prevention: Physicians Can Make the Difference. Medscape Psychiatry. (Free Medscape password required.)
• Power to Decide. (2020). One Key Question.
• Substance Abuse and Mental Health Services Administration. (2019). Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug Use and Health (HHS Publication No. PEP19-5068, NSDUH Series H-54). 
• Suicide.org. (n.d.). Depression and Suicide.
• Texas Department of State Health Services. (2017). STD and HIV Reports.
• Texas Department of State Health Services. (2016). Expedited Partner Therapy (EPT).
• Texas Department of State Health Services. (2019). Texas Youth Risk Behavior Surveillance System (YRBSS) Summary Tables.
• University of Rochester Medical Center, Health Encyclopedia. (2020). Understanding the Teen Brain.
• U.S. Census Bureau. (2015). Millennials Outnumber Baby Boomers and Are Far More Diverse, Census Bureau Reports.
• U.S. Department of Health and Human Services, Children’s Bureau. (2018). The Risk and Prevention of Maltreatment of Children With Disabilities. Bulletin for Professionals, Child Welfare Information Gateway.
• U.S. Department of Health and Human Services, Office of Adolescent Health. (2017). Reproductive Health: Teen Pregnancy and Childbearing.
• U.S. Preventive Services Task Force. (2019). Chlamydial and Gonococcal Infections: Screening.
• Weitzman, C. C., & Bridgemohan, C. (2019). Up to 30% of youths will develop anxiety disorders; how you can help. American Academy of Pediatrics, news article. January 15, 2019.
• White, P. H., & Cooley, W. C. (2018). Clinical Report: Supporting the Health Care Transition From Adolescence to Adulthood in the Medical Home. Pediatrics, 142(5): e20182587.
• Zablotsky, B., Black, L. I., Maenner, M. J., Schieve, L. A., Danielson, M. L., Bitsko, R. H., Blumberg,  S. J. Kogan, M. D., & Boyle, C. J. Prevalence and Trends of Developmental Disabilities among Children in the United States: 2009–2017. Pediatrics, 144 (4): e20190811.

Additional

• American Academy of Pediatrics, Committee on Pediatric Emergency Medicine and Committee on Bioethics. (2011). Policy Statement: Consent for emergency medical services for children and adolescents. Pediatrics, 128(2): 427-433.
• Alderman, E. M., & Johnston, B. D. American Academy of Pediatrics, Committee on Injury, Violence, and Poison Prevention, Committee on Adolescence. (2018). The Teen Driver. Pediatrics, 142 (4): e20182163.
• Association of Maternal & Child Health Programs. (2005). A Conceptual Framework for Adolescent Health. National Network of State Adolescent Health Coordinators.
• Centers for Disease Control and Prevention. (2018). Stats of the State of Texas, Texas Birth Data 2017.
• Centers for Disease Control and Prevention. (2018). Youth Risk Behavior Surveillance—United States 2017. 
• Centers for Disease Control and Prevention. (2017). Youth Risk Behavior Surveillance (YRBS) report. Trends in the Prevalence of Sexual Behaviors and HIV Testing National YRBS: 1991—2017. 
• Centers for Disease Control and Prevention. (2015). STD Treatment Guidelines.
• Centers for Disease Control and Prevention. (2017). Youth Risk Behavior Surveillance (YRBS) report.
• De Ferranti, S., & Washington, R. L. (2012). “NHLBI guidelines on cholesterol in kids: What’s new and how does this change practice?” AAP News, 33(2): p. 1.
• Engender Health. (2002). Youth Friendly Services: A Manual for Service Providers. 
• Hassink, S. G. (2018). Childhood Obesity: How to Battle the Unrelenting Epidemic. AAP Voices. 
• Ludwig, D. S. (2018). Epidemic Childhood Obesity: Not Yet the End of the Beginning. Pediatrics,  141(3):e20174078.
• Morreale, M. C., Kappahahn, C. J., Elster, A. B., Juszczak, L. & Klein, J. D. (2004). Access to health care for adolescents and young adults: Position paper. Journal of Adolescent Health, 35:334–42.
• National Institute of Mental Health. (2005). Mental Illness Exacts Health Toll, Beginning in Youth.
• Skinner, A. C., Ravanbakht, S. N., Skelton, J. A., Perrin, E. M., & Armstrong, S. C. (2018). Prevalence of Obesity and Severe Obesity in US Children, 1999–2016. Pediatrics, 141(3): e20173459.
• Texas Department of State Health Services. (2020). Texas Minimum State Vaccine Requirements for Students Grades K-12.
• Texas Department of State Health Services. (2019). Texas Minimum State Vaccine Requirements for College Entry.
• Texas Medical Association. (2008). Integrating Child and Adolescent Mental Health into Primary Care: A Resource Guide for Physicians.
• U.S. Department of Health and Human Services, Office of Population Affairs. (2019). Teen Pregnancy and Childbearing.

Definitions

The medical definitions provided in this module were adapted or obtained from the Texas Family Code, MayoClinic.org, and Medscape.

Continuing Medical Education

The Texas Department of State Health Services, Continuing Education Service is accredited by the Texas Medical Association to provide continuing medical education for physicians. 

The Texas Department of State Health Services, Continuing Education Service designates this enduring material for a maximum of  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Continuing Nursing Education

The Texas Department of State Health Services, Continuing Education Service is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. The Texas Department of State Health Services, Continuing Education Service has awarded contact hour(s) of Continuing Nursing Education.

Social Workers

The Texas Department of State Health Services, Continuing Education Service under sponsor number CS3065 has been approved by the Texas State Board of Social Worker Examiners to offer continuing education contact hours to social workers. The approved status of The Texas Department of State Health Services, Continuing Education Service expires annually on December 31. The Texas Department of State Health Services, Continuing Education Service has awarded contact hour(s) of Continuing Social Work Education.

Certificate of Attendance

The Texas Department of State Health Services, Continuing Education Service has designated hour(s) for attendance.

Certified Community Health Worker

The Texas Department of State Health Services, Promotor(a)/Community Health Worker Training and Certification Program has certified this course for contact hour(s) of continuing education for Certified Community Health Workers and Community Health Worker Instructors.

General Disclosure

One of the requirements of continuing education is disclosure of the following information to the learner:

1. Notice of requirements for successful completion of continuing education activity. To receive continuing education credit the learner must successfully complete the following activities:
   • Create a Texas Health Steps account.
   • Complete on-line registration process.
   • Thoroughly read the content of the module.
   • Complete the on-line examination.
   • Complete the evaluation.
2. Commercial Support.
   The THSTEPS Web-based Continuing Education Series has received no commercial support.
3. Disclosure of Relevant Financial Relationships.
   The THSTEPS Continuing Education Planning Committee and the authors of these modules have no relevant financial relationships to disclose.
4. Non-Endorsement Statement.
   Accredited status does not imply endorsement of any commercial products or services by the Department of State Health Services, Continuing Education Service; Texas Medical Association; or American Nurse Credentialing Center.
5. Off-Label Use.
   Using a disclosure review process, the THSTEPS Continuing Education Planning Committee has examined documents and has concluded that the authors of these modules have not included content that discusses off-label use (use of products for a purpose other than that for which they were approved by the Food and Drug Administration).

The following are policies and definitions of terms related to continuing education disclosure:

The intent of disclosure is to allow Department of State Health Services (DSHS) Continuing Education Service the opportunity to resolve any potential conflicts of interest to assure balance, independence, objectivity and scientific rigor in all of its Continuing Education activities.

All faculty, planners, speakers and authors of Department of State Health Services (DSHS) Continuing Education Service sponsored activities are expected to disclose to the Department of State Health Services (DSHS) Continuing Education Service any relevant financial, relationships with any commercial or personal interest that produces health care goods or services concerned with the content of an educational presentation. Faculty, planners, speakers and authors must also disclose where there are any other potentially biasing relationships of a professional or personal nature.

Glossary of Terms

Conflict of Interest: Circumstances create a conflict of interest when an individual has an opportunity to affect Continuing Education content about products or services of a commercial interest with which she/he has a financial relationship or where there are any other potentially biasing relationships of a professional or personal nature.

Commercial Interest: Any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.

Financial Relationships: Those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, teaching, membership on advisory committees or review panels, board membership, and other activities for which remuneration is received or expected. Relevant financial relationships would include those within the past 12 months of the person involved in the activity and a spouse or partner. Relevant financial relationships of your spouse or partner are those of which you are aware at the time of this disclosure.

Off Label: Using products for a purpose other that that for which it was approved by the Food and Drug Administration (FDA).

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