Welcome to the training on High-Risk Behaviors In Young People: Screening and Intervention provided by the Texas Health and Human Services Commission (HHSC) and the Texas Department of State Health Services (DSHS).
Goal
The goal of this module is to equip Texas Health Steps providers and others to recognize the origin, prevalence, signs, symptoms and effects of high-risk behaviors and to respond with appropriate interventions that promote protective factors and help youth make healthy decisions.
Target Audience
Texas Health Steps providers and other interested health-care professionals.
Specific Learning Objectives
After completing the activities of this module, you will be able to:
- Summarize how physical, cognitive and social development influences risk-taking behavior among adolescents and distinguish between positive risk-taking and unsafe risk-taking behaviors.
- Specify common high-risk behaviors and their impact on young people.
- Apply the Texas Health Steps Periodicity Schedule to conduct routine screenings for high-risk behaviors.
NOTE: For purposes of this module, the terms “young person,” “youth,” “teen” and “adolescent” are interchangeable. The term “parent” also refers to guardians and caregivers.
Please note this module expires on 8/3/2024.
This module was released on 8/3/2021.
Accreditation Statement
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 2.00 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 2.00 contact hour(s) of Continuing Nursing Education.
Certified Health Education Specialists
Sponsored by The Texas Department of State Health Services, Continuing Education Service, a designated provider of continuing education contact hours (CECH) in health education by the National Commission for Health Education Credentialing, Inc. This program is designated for Certified Health Education Specialists (CHES®) and/or Master Certified Health Education Specialists (MCHES®) to receive up to 2.00 total Category I contact education contact hours. Maximum advanced-level continuing education contact hours available are 2.00.
Social Workers
The Texas Department of State Health Services, Continuing Education Service, the continuing education provider, ensures that the education provided is directly related to the practice of social work; and that the individuals presenting the information have the necessary experience and knowledge in the topics presented. The Texas Department of State Health Services, Continuing Education Service has awarded 2.00 hours of credit.
Certificate of Attendance
The Texas Department of State Health Services, Continuing Education Service has designated 2.00 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 2.00 contact hour(s) of continuing education for Certified Community Health Workers and Community Health Worker Instructors.
Disclosures
One of the requirements of continuing education is disclosure of the following information to the learner:
- 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.
- Commercial Support.
The THSTEPS Web-based Continuing Education Series has received no commercial support. - Disclosure of Relevant Financial Relationships.
The THSTEPS Continuing Education Planning Committee and the authors of these modules have no relevant financial relationships to disclose. - 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. - 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).
Browser Requirements
Texas Health Steps courses are best viewed using a current browser. If you are using an out-of-date browser or a version of Internet Explorer less than 11, lesson progress and interactive features may not function properly.
Section 1: The Lure of High-Risk Behaviors for Young People
- Centers for Disease Control and Prevention. (2020). Injury Prevention and Control. WISQARS™ — Web-based Injury Statistics Query and Reporting System.
- Centers for Disease Control and Prevention. (2018). Adolescent and School Health, Protective Factors.
- FosteringResilience.com.
- National Alliance to Advance Adolescent Health. (2021). Got Transition.
- Texas Health and Human Services Commission. (2016). Texas Health Steps. Adolescent Health: A Guide for Providers.
- Texas Health Steps. Anticipatory Guidance Provider Guide.
Section 2: Communication Strategies
- American Academy of Pediatrics. Bright Futures Guidelines and Pocket Guide, 4th Edition (2017). An essential resource that provides health-care professionals with updated background and recommendations for pediatric health promotion, health supervision, screening schedules and anticipatory guidance.
- American Academy of Pediatrics. (2019). Policy Statement: Unique Needs of the Adolescent. Pediatrics, 144(6), e20193150.
- Children’s Hospital Boston. (2018). CRAFFT screening tool.
- Centers for Disease Control and Prevention. (2020). Adolescent and School Health.
- Centers for Disease Control and Prevention. (2021). Helping Your Child Cope with a Disaster.
- Centers for Disease Control and Prevention. (2020). Talking with children about Coronavirus Disease 2019.
- Contemporary Pediatrics. (2014). HEEADSSS.
- Children’s Hospital Boston. (2018). CRAFFT screening tool.
- Motivational Interviewing Network of Trainers. (2020).
- National Alliance to Advance Adolescent Health. (2021). Got Transition.
- PositivePsychology.com. (2021). 17 Motivational Interviewing Questions and Skills.
- Texas Health and Human Services Commission. (2021). Outreach, Screening, Assessment and Referral Centers (OSARs).
- The Texas Campaign. (2019). Navigating the Maze: Consent, Confidentiality, and Access to Health Care for Texas Youth.
- U.S. National Library of Medicine. MedLinePlus.
Section 3: Motor Vehicle Crashes and Violence
- American Academy of Pediatrics. (2021). Connected Kids: Safe Strong Secure.
- American Academy of Pediatrics and the Centers for Disease Control and Prevention. (n.d.). Parent-Teen Driving Agreement.
- Centers for Disease Control and Prevention. (2020). Transportation Safety. Teen Drivers: Get the Facts.
- Centers for Disease Control and Prevention. (2020). Violence Prevention: Youth Violence.
- Stopbullying.gov. (2018). Bullying and Pediatricians. Parents and Providers: Partnering with Healthcare Providers to Respond to Bullying.
- Teens in the Driver Seat. (2021). Peer-to-peer driver safety program, designed by and implemented by teens.
- Texas Department of Public Safety. (2021). How to Apply for a Texas Driver License as a Teen.
- Texas Department of Public Safety. (n.d.). Alcohol-related Laws for Minors.
- Texas Department of Transportation. (2020). Distracted Driving laws.
- Verywell Family. (2020). 7 Warning Signs Your Teen Is in an Unhealthy Relationship.
Section 4: Self-Injury and Suicide
- American Academy of Pediatrics. Bright Futures. Developmental, Behavioral, Psychosocial, Screening, and Assessment Forms.
- Centers for Disease Control and Prevention. (2020). Injury Prevention & Control Center.
- Children’s Safety Network.
- Cornell University, College of Human Ecology. (2021). Self-Injury and Recovery Research and Resources (SIRRR). Helpful self-injury handouts for people who self-injure, parents and other caring adults, friends, therapists, clinicians and youth-serving professionals.
- Counseling on Access to Lethal Means (CALM). (2018). A best practice technique recommended to assist providers to implement counseling strategies to help reduce access to lethal means by patients at risk for suicide and their families.
- David’s Law, Senate Bill 179. A Texas law governing cyberbullying.
- Mental Health America of Texas. (2015). Coming Together to Care: A Suicide Prevention Toolkit for Texas Communities.
- National Suicide Prevention Lifeline: 800-273-TALK, available 24/7. Also available is an online national chat network through Lifeline Crisis Chat, a national crisis chat network.
- Safety Planning Intervention. (2021). A brief intervention for reducing suicide risk.
- Suicide Prevention Resource Center (SPRC) website.
- Texas Council of Community Centers. (2018) Visit the group’s website for a map showing service areas and a directory of center addresses and contact information.
- Texas Health Steps Medical Checkup Periodicity Schedule for Infants, Children, and Adolescents. (2018).
- Texas Health and Human Services Commission. (2019). Find Your Local Mental Health or Local Behavioral Health Authority.
- Texas Health and Human Services Commission. Texas Suicide Prevention web page offers suicide hotlines in Texas.
- Texas Suicide Prevention Collaborative. (2021). A website providing resources and training for ASK (Ask About Suicide) and the ASK App, training for CALM (Counseling on Access to Lethal Means) and CALM First Responder.
- Texas Suicide Prevention Toolkit. (2015). Coming Together to Care. This toolkit emphasizes the importance of discussing suicide in a manner that supports prevention, rather than sensationalizing it.
- Zero Suicide in Texas (ZEST). Describes the framework and requirements for becoming a Safer Suicide Care Center.
- ZEST Toolkit for Safer Suicide Care Centers covers the main concepts of Zero Suicide, including Texas recommendations and best practices for health-care providers.
Section 5: Substance Use
- American Academy of Pediatrics website. Substance Use and Prevention: Information on Marijuana.
- American Academy of Pediatrics. (2017). Clinical Report: Counseling Parents and Teens About Marijuana Use in the Era of Legalization of Marijuana. Pediatrics, 139(3) e20164069.
- American Academy of Pediatrics. (2015). Policy Statement: The Impact of Marijuana Policies on Youth: Clinical, Research, and Legal Update. Pediatrics, 135(3), 584-587.
- National Institute on Drug Abuse. (2020). Drugs, Brains, and Behavior: The Science of Addiction.
- Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Integrated Health Solutions. SBIRT: Screening, Brief Intervention, and Referral to Treatment, a website with resources and training on SBIRT.
- Texas Department of State Health Services. Search for DSHS Funded Substance Abuse Services.
- Texas Health and Human Services Commission. (2019). Find Your Local Mental Health or Local Behavioral Health Authority.
- Texas Health and Human Services Commission. (2021). Outreach, Screening, Assessment and Referral Centers (OSARs).
- Texas Poison Center Network. (n.d.). Operates a 24/7 toll-free poison information hotline at 800-222-1222.
- U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. (2017). Screening, Brief Intervention, and Referral to Treatment (SBIRT).
Section 6: Sexual Behavior
- American Academy of Pediatrics. AAP report offers guidance on how to counsel adolescents on LARC methods.
- American Academy of Pediatrics. (2020). Clinical Report, Long-Acting Reversible Contraception: Specific Issues for Adolescents. Pediatrics, 146(2), e2020007252.
- Centers for Disease Control and Prevention. (2021). Sexually Transmitted Diseases. (STDs).
- Common Sense Media, a website from Common Sense, a nonprofit dedicated to helping kids thrive in a world of media and technology. It provides many helpful resources for parents, educators and advocates, including a booklet about sexting.
- Gay & Lesbian Medical Association. (2006). Guidelines for Care of Lesbian, Gay, Bisexual, and Transgender Patients.
- Journal of Adolescent Health. Positive Youth Development as a Strategy to Promote Adolescent Sexual and Reproductive Health.
- March of Dimes. (n.d.). One Key Question. Guidance on asking your young patients if they want to become pregnant in the next year.
- National LGBTQ+ Health Education Center website.
- RAINN (Rape, Abuse & Incest National Network), website provides safety and prevention tips for parents and students.
- Texas Abuse Hotline, 800-252-5400.
- Texas Health Steps. Adolescent Health: A Guide for Providers. Updated August 2016.
- Texas Health Steps. Anticipatory Guidance Provider Guide.
- Texas Health Steps, Periodicity Schedule. (2021).
- Texas Department of State Health Services, Disease Reporting. (2021). HIV/STD Reporting: Information to Texas Health Care Providers and Laboratories.
- Texas Department of State Health Services. (2021). Infection Disease Control. Notifiable Conditions.
- Texas Department of State Health Services, Texas Vaccines for Children Program (TVFC). (2020) Provides vaccines recommended by the CDC’s Advisory Committee on Immunization (ACIP) at no cost to enrolled providers.
- The Safe Zone Project.
- U.S. Department of Health and Human Services. (2020). HIV National Strategic Plan, 2021-2025.
Section 7: Unhealthy Eating
- Academy for Eating Disorders publishes many resources in multiple languages for health-care providers and others, including Eating Disorders: A Guide To Medical Care (2016). The guide is endorsed by the AAP, the American Psychiatric Association and the Society for Adolescent Health and Medicine, among other professional medical organizations.
- American Academy of Pediatrics. Bright Futures Guidelines and Pocket Guide. An essential resource that provides health-care professionals with updated background and recommendations for pediatric health promotion, health supervision, screening schedules and anticipatory guidance.
- National Eating Disorders Association. (2018). Information By Eating Disorder.
- Oral Health Literacy: Tool Kit offers a list (beginning on page 53) of plain language terms that can be substituted for medical terms.
- WebMD. Raising Fit Kids: Healthy Nutrition, Exercise and Weight. Interactive content for children, teenagers and parents.
Section 8: Making Referrals
- Texas Health and Human Services Commission. (2019). Find Your Local Mental Health or Local Behavioral Health Authority.
- Texas Medicaid & Healthcare Partnership (TMHP). CCP Prior Authorization Request for Non-Face-to-Face Clinician-Directed Care Coordination Services form, which can be submitted via fax or online.
- Texas Medicaid & Healthcare Partnership (TMHP). Online Provider Lookup.
- Academy for Eating Disorders. (2020).
- AccessMedicine. (2021). Anorexia Nervosa.
- Alcohol Rehab Guide. (2020). Alcohol-Related Crimes.
- American Academy of Child & Adolescent Psychiatry. (2021). TV Violence and Children.
- American Academy of Child and Adolescent Psychiatry. (2019). Self-Injury in Adolescents.
- American Academy of Pediatrics, Healthychildren.org. (2020. Contraception Explained: Options for Teens & Adolescents.
- American Academy of Pediatrics, Healthychildren.org. (2020). Liquid Nicotine Used in E-Cigarettes Can Kill Children.
- American Academy of Pediatrics. (2020). Clinical Report, Long-Acting Reversible Contraception: Specific Issues for Adolescents. Pediatrics, 146(2), e2020007252.
- American Academy of Pediatrics Policy Statement. (2019). The Impact of Racism on Child and Adolescent Health. Pediatrics, 144(2), e20191765.
- American Academy of Pediatrics. (2019). Policy Statement: Unique Needs of the Adolescent. Pediatrics, 144(6), e20193150.
- American Academy of Pediatrics. (2017). Clinical Report: Sexual and Reproductive Health Care Services in the Pediatric Setting. Pediatrics, 140(5), e20172858.
- American Academy of Pediatrics. (2017). Clinical Report: Counseling Parents and Teens About Marijuana Use in the Era of Legalization of Marijuana. Pediatrics, 139(3) e20164069.
- American Academy of Pediatrics. (2015). Policy Statement: The Impact of Marijuana Policies on Youth: Clinical, Research, and Legal Update. Pediatrics, 135(3), 584-587.
- American Dental Association. (2020). Oral Health Topics: Oral Piercings.
- Anderson, C. A., Bushman, B. J., Bartholow, B. D., Cantor, J., Christakis, D., Coyne, S. M., . . . Ybarra, M. (2017). Screen Violence and Youth Behavior. Pediatrics, 140(Supplement 2), S142-S147.
- Bell, C., Kerr, J., & Young, J. (2019). Associations between Obesity, Obesogenic Environments, and Structural Racism Vary by County-Level Racial Composition. International Journal of Environmental and Public Health, 16(5): 861.
- Centers for Disease Control and Prevention. (2021). CDC Fact Sheet: Information for Teens and Young Adults: Staying Healthy and Preventing STDs.
- Centers for Disease Control and Prevention. (2021). Genital Herpes - CDC Fact Sheet (Detailed).
- Centers for Disease Control and Prevention, National Center for Health Statistics. (2021). National Health and Nutrition Examination Study.
- Centers for Disease Control and Prevention. (2021). Sexually Transmitted Diseases, (STDs).
- Centers for Disease Control and Prevention. (2021). Changes in Suicide Rate — United States, 2018-2019. Morbidity and Mortality Weekly Report (MMWR), 70(8);261–268.
- Centers for Disease Control and Prevention. (2021). HPV fact sheet.
- Centers for Disease Control and Prevention. (2021). Births: Final Data for 2019. National Vital Statistics Reports, 70(2).
- Centers for Disease Control and Prevention. (2020). Smoking and Tobacco Use.
- Centers for Disease Control and Prevention. (2020). Preventing Child Abuse & Neglect fact sheet.
- Centers for Disease Control and Prevention. (2020). High School Youth Risk Behavior Survey: Texas 2019 and United States 2019 Results.
- Centers for Disease Control and Prevention. (2020). HIV Testing.
- Centers for Disease Control and Prevention. (2020). Human Papillomavirus. When to Get HPV Vaccine.
- Centers for Disease Control and Prevention. (2020). Injury Prevention and Control. WISQARS™ — Web-based Injury Statistics Query and Reporting System.
- Centers for Disease Control and Prevention. (2020). National Center for Health Statistics. Sexual Activity and Contraceptive Use Among Teenagers Aged 15–19 in the United States, 2015–2017.
- Centers for Disease Control and Prevention. (2020). National Vital Statistics Reports. State Suicide Rates Among Adolescents and Young Adults Aged 10–24: United States, 2000–2018.
- Centers for Disease Control and Prevention. (2020). Statistics Overview: HIV Surveillance Report.
- Centers for Disease Control and Prevention. (2020). Teen VaxView: 2008 through 2019 Adolescent Human Papillomavirus (HPV) Vaccination Coverage Trend Report.
- Centers for Disease Control and Prevention. (2020). Violence Prevention: Preventing Youth Violence.
- Centers for Disease Control and Prevention. (2020). Youth Risk Behavior Surveillance — United States, 2019. Morbidity and Mortality Weekly Report, 69(1).
- Centers for Disease Control and Prevention. (2020). Youth Risk Behavior Survey Data Summary & Trends Report: 2009-2019 Executive Summary.
- Centers for Disease Control and Prevention. (2020). COVID-19 Resources for Parents: Children and Young People’s Social, Emotional, and Mental Health.
- Centers for Disease Control and Prevention. (2020). Sexual Activity and Contraception Use Among Teenagers Aged 15-19 in the United States, 2015-2017.
- Centers for Disease Control and Prevention. (2019). Annual Surveillance Report of Drug-Related Risks and Outcomes.
- Centers for Disease Control and Prevention. (2019). National Vital Statistics Reports. Births: Final Data for 2018.
- Centers for Disease Control and Prevention. (2019). STDs in Adolescents and Young Adults.
- Centers for Disease Control and Prevention. (2019). Substance Use and Sexual Risk Behaviors Among Youth.
- Centers for Disease Control and Prevention. (2019). HPV Vaccine Safety.
- Centers for Disease Control and Prevention. (2019). Reproductive Health: Unintended Pregnancy.
- Centers for Disease Control and Prevention. (2018). Adolescent and School Health, Protective Factors.
- Centers for Disease Control and Prevention. (2016). Youth Violence, A Comprehensive Technical Package for the Prevention of Youth Violence and Associated Risk Behaviors.
- Centers for Disease Control and Prevention. (2016). Public Health Law: Graduated Driver Licensing.
- Centers for Disease Control and Prevention. (2014). Preventing Youth Violence: Opportunities for Action.
- Child Mind Institute. (n.d.). Teen Suicides: What Are the Risk Factors?
- Children’s Hospital of Philadelphia PolicyLab. (2018) “Not for Me:” Why Young People Avoid Certain Birth Control Methods.
- Cleveland Clinic. (2020). 10 Possible Reasons Why Your Child Isn’t Growing.
- Deloitte Access Economics. (2020). Social and economic cost of eating disorders in the US.
- Duell, N., & Steinberg, L. (2019). Positive Risk Taking in Adolescence. Child Development Perspectives, 13(1), 48-52. [Abstract]
- European Heart Journal. (2020). Research articles on exposure to e-cigarettes and damage to endothelial cells.
- Fetters, K. A. (2016). Could you unknowingly have an eating disorder? U.S. News & World Report, Feb. 19, 2016.
- FosteringResilience.com
- Gay & Lesbian Medical Association. (n.d.). Guidelines for Care of Lesbian, Gay, Bisexual, and Transgender Patients.
- Grossman, J. M., Jenkins, L. J., & Richer, A. M. (2018). Parents' perspectives on family sexuality communication from middle school to high school. International Journal of Environmental Research and Public Health, 15(1):107.
- Guttmacher Institute. (2020). Reducing STI Cases: Young People Deserve Better Sexual Health Information and Services.
- Healthline. (2019). 6 Common Types of Eating Disorders (and Their Symptoms).
- Holoyda, B., Landess, J., Sorrentino, R., & Friedman, S. H. (2018). Trouble at teens' fingertips: Youth sexting and the law. Behavioral Sciences & the Law, 36(2), 170-181.
- Insurance Institute for Highway Safety. (2019). Fatality Facts 2018: Teenagers.
- Johns Hopkins Medicine. (2021). Frequently Asked Questions About Eating Disorders.
- Journal of Adolescent Health. (2020). Adolescence and Gender Equality in Health. (Editorial).
- Kadivar, H., Thompson, L., Wegman, M., Chisholm, T., Khan, M., Eddleton, K., . . . Shenkman, E. (2014). Adolescent views on comprehensive health risk assessment and counseling: assessing gender differences. The Journal of Adolescent Health, 55(1), 24-32.
- Klein, D. A., Goldenring, J. M., & Adelman, W. P. (2014). HEEADSSS 3.0: The Psychosocial Interview for Adolescents Updated for a New Century Fueled by Media. Contemporary Pediatrics.
- Klonsky, E. D., May, A. M., & Glenn, C. R. (2013). The relationship between nonsuicidal self-injury and attempted suicide: converging evidence from four samples. Journal of Abnormal Psychology, 122(1):231-237.
- Krentzman, A. R., Robinson, E. A., Moore, B. C., Kelly, J. F., Laudet, A. B., White, W. L., . . . Strobbe, S. (2010). How Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) Work: Cross-Disciplinary Perspectives. Alcoholism Treatment Quarterly, 29(1), 75-84.
- Kreisel, K. M., Spicknall, I. H., Gargano, J. W., Lewis, F. M. T., Lewis, R. M. Markowitz, L. E., . . . Weinstock, H. S. (2021). Sexually Transmitted Infections Among US Women and Men Prevalence and Incidence Estimates, 2018. Sexually Transmitted Diseases, 48(4), 208-214.
- Ladegard, K., Thurstone, C., & Rylander, M. (2020). Marijuana Legalization and Youth. Pediatrics, 145(Supplement 2), S165-S174.
- March of Dimes. (n.d.). One Key Question.
- Mental Health America of Texas. (2015). Coming Together to Care: A Suicide Prevention Toolkit for Texas Communities.
- Molla-Esparza, C., Losilla, J. M., & López-González, E. (2020). Prevalence of sending, receiving and forwarding sexts among youths: A three-level meta-analysis. PLoS One, 7;15(12):e0243653.
- Moreno, M. (2018). What parents need to know about sexting. JAMA Pediatrics, 172(4):400.
- Mori, C., Temple, J., Browne, D., & Madigan, S. (2019). Association of Sexting with Sexual Behaviors and Mental Health Among Adolescents: A Systematic Review and Meta-analysis. JAMA Pediatrics, 173(8):770-779.
- National Alliance on Mental Illness. (n.d.). Eating Disorders.
- National Eating Disorders Association. (2018). Common Health Consequences of Eating Disorders.
- National Eating Disorders Association. (2018). Information By Eating Disorder.
- National Eating Disorders Association. (2018). Treatment.
- National Eating Disorders Association. (2018). What are eating disorders?
- National Eating Disorders Association. (2018). Eating Disorders in LGBTQ+ Populations.
- National Institute of Mental Health. (2021). Suicide.
- National Institute of Mental Health. (2020). The Teen Brain: 7 Things to Know.
- National Safety Council. (2021). Injury Facts: Teen Drivers.
- National Suicide Prevention Lifeline.
- PositivePsychology.com. (2021). 17 Motivational Interviewing Questions and Skills.
- Power to Decide. (2021). Teen Birth Rate Comparison, 2019.
- Raising Children Network. (2020). Brain development: teenagers.
- Raue, P. J., Ghesquiere, A. R., & Bruce, M. L. (2014). Suicide risk in primary care: identification and management in older adults. Current Psychiatry Reports, 16(9), 466.
- Rural Health Information Hub. (n.d.). Suicide in Rural Areas.
- Safety Planning Intervention. (2021). A brief intervention for reducing suicide risk.
- Texas Department of State Health Services, Texas Cancer Registry. (2020). HPV-Associated Cancers in Texas, 2013-2017.
- Texas Constitution and Statues. (n.d.). Communicable Diseases, Chapter 97, Title 25, Texas Administrative Code).
- Texas Constitution and Statues. (2017). Texas Occupations Code, Sec. 159.005.
- Texas Council of Community Centers. (n.d.).
- Texas Department of State Health Services. (2021). List of all Texas Notifiable Conditions – 2021.
- Texas Department of State Health Services. (2018). Texas HIV Epidemiologic Profile 2018.
- Texas Department of State Health Services, Texas Cancer Registry. (2020). HPV-Associated Cancers in Texas, 2013-2017.
- Texas Department of State Health Services. (n.d.). Search tool for DSHS-Funded Substance Abuse Services.
- Texas Health and Human Services Commission. (2020). Epi Profile Section 2 - Texans Living with HIV in 2018.
- Texas Health and Human Services Commission. (2020). Human Papillomavirus (HPV) Vaccination.
- Texas Health and Human Services Commission. (2020). National Immunization Survey-Teen (NIS-Teen) 2018, Texas.
- Texas Health and Human Services Commission. (2019). Find Your Local Mental Health or Local Behavioral Health Authority.
- Texas Health and Human Services Commission. Suicide Prevention.
- Texas Health and Human Services Commission. (n.d.). Youth Substance Use Treatment & Recovery Services.
- Texas Health and Human Services Commission. (2021). Outreach, Screening, Assessment and Referral Centers (OSARs).
- Texas Health Steps. (2016). Adolescent Health: A Guide for Providers.
- Texas Health Steps. Periodicity Schedule. (2021).
- Texas Medicaid & Healthcare Partnership. (n.d.). Comprehensive Care Program.
- Texas Poison Center Network. (n.d.).
- The Texas Campaign. (2019). Navigating the Maze: Consent, Confidentiality, and Access to Health Care for Texas Youth.
- University of North Carolina, Center for Wellness Promotion. (n.d.). Alcohol’s Role in Sexual Assault.
- U.S. Department of Health and Human Services. (2020). HIV National Strategic Plan, 2021-2025.
- U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. (2017). Screening, Brief Intervention, and Referral to Treatment (SBIRT).
- U.S. Department of Health and Human Services. (n.d.). Healthy People 2030: Increase the proportion of adolescents who speak privately with a provider at a preventive medical visit — AH02.
- U.S. Food and Drug Administration. (2020). Newly Signed Legislation Raises Federal Minimum Age of Sale of Tobacco Products to 21.
- U.S. Surgeon General. (2019). Surgeon General’s Advisory on E-cigarette Use Among Youth.
- Verywell Family. (2020). 7 Warning Signs Your Teen Is in an Unhealthy Relationship.
- Verywell Mind. (2020). Cutting and Self-Harm Behaviors in Teens.
- Verywell Mind. (2020). Self-Mutilation and Borderline Personality Disorder.
- Western Governors University. (2019). Impact of technology on kids today (and tomorrow).
- Widman, L., Nesi, J., Kamke, K., Choukas-Bradley, S., & Stewart, J. L. (2018). Technology-Based Interventions to Reduce Sexually Transmitted Infections and Unintended Pregnancy Among Youth. The Journal of Adolescent Health, 62(6), 651-660.
- Winkelman, T. N. A., Caldwell, M. T., Bertram, B., & Davis, M. M. (2016). Promoting Health Literacy for Children and Adolescents. Pediatrics, 138(6), e20161937.
- Youth.gov. (n.d.). Positive Youth Development.
- Youth.gov. (n.d.). Risks and Protective Factors.
- Zero Suicide. (n.d.). Suicide Prevention in Primary Care: A Toolkit for Primary Care Clinicians and Leaders
- Zsamboky, M., Haskell, B., Vice, R., & Schroer, M. (2021). Treating Child and Adolescent Depression and Anxiety in Primary Care. Journal for Nurse Practitioners, 17(1), 54-59.
The medical definitions in this module were obtained or adapted from the American Academy of Pediatrics, Anxiety and Depression Association of America, Mayo Clinic, Megan Meier Foundation, Merriam-Webster, Montana Department of Public Health and Human Services, National Institute on Alcohol Abuse and Alcoholism, National Institute of Diabetes and Digestive and Kidney Diseases, Orthorexia.com, Oxford University Press, ScienceDirect, Texas Department of Family and Protective Services and The Nemours Foundation.
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