Toolkit for Improving Family Planning Services in School Settings

Prioritizing Adolescent-Friendly Care

Andrea Vazzano, Zabryna Balén, Jennifer Manlove, Jenita Parekh, Katherine Cushing, Andrea Shore, & Donnie Greco

Young people deserve high-quality sexual health care that respects their unique experiences, strengths, and social and developmental contexts. When providers and programs ensure that health services are easily available, developmentally appropriate, and responsive to adolescents’ needs, youth will be more likely to access and use these services. Prioritizing adolescent-friendly care can therefore lead to more positive health outcomes for youth. It is one of the four foundational approaches to school-based sexual health services highlighted in this toolkit.

This section of the toolkit presents six strategies for ensuring adolescent-friendly sexual health services. These strategies are based on interviews with family planning service providers in school-based health centers (SBHCs) or other school settings. They also align with national and global guidance on providing tailored health services for youth. For example, the World Health Organization maintains that youth-friendly services should be accessible, acceptable, equitable, appropriate, and effective for young people. You will see many of these characteristics in the examples included under each of the six strategies.


Using This Tool

Audience

These six adolescent-friendly strategies target health providers and programs delivering sexual health services in school settings with a focus on providers and administrators in SBHCs. However, any health provider or organization working with youth will benefit by incorporating these principles and practices into their work.

Structure

Each of the following six strategies includes:

  1. A description of the strategy
  2. Case examples of SBHCs or organizations that have successfully implemented the strategy
  3. Reflection questions to guide teams and individuals on how to implement the strategy in their own context
  4. Links and resources for further reading

Adapting outreach strategies to your context

While this toolkit offers ideas and examples of ways to provide adolescent-friendly care and services, you are the expert of your own practice and program. Each strategy is flexible and will look different depending on the context of your clinic and available resources. We encourage you to use the information here as a starting point for brainstorming how you or your clinic can prioritize adolescent-friendly care.

Before getting started, we recommend that you reflect on your goals for ensuring adolescent-friendly sexual health services. To aid in this reflection, we provide some needs assessment questions to guide your thinking about existing efforts for adolescent-friendly care in your clinic setting. At the end of this section of the toolkit, we provide prompts to help you determine next steps.

Needs Assessment Questions on Current Adolescent-Friendly Strategies at Your Site

Consider what you are currently doing well in your setting to ensure that services are adolescent- friendly.
  1. What do you or your clinic currently do to provide adolescent-friendly sexual health services?
    1. Which of these strategies are most successful?
    2. Where is there room to improve?
Identify the people who interact most with youth in your clinic (e.g., front desk staff, medical providers, health educators, etc.) and consider opportunities to build skills in adolescent-friendly communication and care.
  1. Who in your clinic interacts with youth or provides sexual health services or health education?
    1. Do these staff have access to ongoing training and support in adolescent-friendly practices?
    2. What processes are in place for these staff to receive feedback from youth directly?
Consider any barriers that stand in the way of providing adolescent-friendly care in your clinic or school.
  1. What barriers exist to ensuring that all students feel safe and welcome and that their needs are respected and met in your setting?
    1. What specific challenges do you or others face in interacting with youth in an adolescent-friendly manner?
    2. What specific challenges does your clinic face in ensuring access to services?
    3. What people or policies have limited your ability to provide adolescent-friendly care?
Brainstorm possible resources or assets that could help you or your organization better ensure adolescent-friendly services and care.
  1. What resources (e.g., people, funding, partnerships) could help you or your clinic provide better or more adolescent-friendly services?
    1. Are there particular staff members with expertise or skills that could be helpful in growing clinic capacity for adolescent-friendly care?
    2. What current or potential funding mechanisms are available that could support additional staff or services?
    3. Which community partners can you engage to supplement current efforts to provide adolescent-friendly services?

You can view the Needs Assessment questions as a PDF form here.

Strategies for Ensuring Adolescent-Friendly Sexual Health Services

Facilitate access to sexual health services

It is not enough for sexual health services to be available for youth; they must be accessible and convenient. Access to comprehensive sexual health information and services is a basic and universal right for young people. When services are not provided onsite or in convenient locations or timeframes, youth can face multiple, unique barriers to accessing the care they need. For example, a student referred to an outside provider may need to ask a parent, friend, or other adult for transportation, which could force them to disclose this confidential care. The student may also feel uncomfortable going to a medical office that is new and unfamiliar. These barriers can quickly add up, ultimately preventing the student from receiving critical care.

Programs can support youth in receiving the services they need by removing key barriers to access beyond being conveniently located at school. For example, some programs make sexual health appointments easy to schedule and attend by:

  • Offering walk-in or same-day appointments to avoid turning students away
  • Extending clinic hours to include after-school hours and/or summer breaks
  • Offering telehealth visits as appropriate to help mitigate scheduling or transportation challenges
  • Using HIPAA-compliant technology to facilitate appointment requests and scheduling, such as apps to support secure messaging

Programs can also expand the number and types of sexual health services available onsite to reduce the need for students to visit outside providers or organizations. Some family planning programs and providers have had success:

  • Stocking oral contraceptives, including emergency contraception, so that a prescribing health provider can dispense directly to students
  • Training providers to offer long-acting reversible contraception (LARCs) insertion and removal
  • Partnering with outside providers or pharmacies to fill gaps in providing services

Many efforts to expand access to sexual health services require additional staffing, training, or advocacy. Meaningful change often takes time and requires long-term planning and foresight. Consequently, it may be helpful to determine short-term steps and long-term goals. For example, an SBHC that wants to offer LARC services onsite might first develop a strong referral partnership with a local community clinic. While the ultimate goal may be to reduce the need for referrals, this partnership can ensure confidentiality that services are available in some capacity while the SBHC invests in needed advocacy or provider training.

Case examples

An SBHC in Minneapolis, Minnesota explained that their program allows walk-ins and does not require patients to make an appointment to be seen. In addition, the SBHC operates a community clinic after school hours, which provides students and local youth more opportunities to access and receive care. The SBHC serves students enrolled at the school from 9 AM to 3 PM and then opens its doors to teens in the community from 3 PM to 6 PM. One provider described how some students enrolled at the school preferred visiting the facility during these community clinic hours to ensure privacy or to accommodate busy school schedules.

One SBHC in Seattle, Washington identified a creative way to dispense prescription contraceptives directly to patients at the clinic. The SBHC partners with a local pharmacy that ships contraception directly to the SBHC through a courier service. This removes the need to send students to an outside pharmacy and ensures that they leave with medicine in hand. The SBHC also facilitates access to services by using a text messaging system to remind students of upcoming appointments and encouraging use of the secure MyChart app to easily view test results and schedule appointments.

La Clínica sponsors eight SBHCs in northern California. Several years ago, only a handful of the health centers’ providers were trained to offer LARC services. This meant that any students interested in a LARC method needed to schedule appointments at a time and clinic with a trained provider. In response, a provider spearheaded developing a competency-based training program to build capacity for LARC services in the SBHCs. The program has trained eight providers to insert and remove LARCs, giving students faster and more convenient access to these services across SBHC locations.

For more information about La Clínica’s provider training program, go to this case study.

Reflection questions

Consider how your clinic can address barriers to accessing sexual health services.
  1. What barriers do youth in your clinic face in successfully scheduling and attending appointments for sexual health services?
  2. What changes could you make in your clinic policies, procedures, or offerings to help address these barriers?
  3. What sexual health services would you like to provide onsite that you are not currently able to offer?
  4. What resources or assets can you leverage to enable you to provide these services? (e.g., partnerships, funding, trainings, etc.)

Resources and Citations Referenced in this Section

Create a warm and welcoming environment

Ensuring that youth feel welcome and positive in a health care setting can make them more likely to seek and access health services. Clinics or programs providing sexual health services to youth should commit to creating an environment that welcomes adolescents. Intentionally creating this environment requires thinking critically about the physical environment (e.g., the way a clinic looks) and about social interactions (e.g., the way a clinic visit feels) in a clinic setting.

Providers and administrators serving youth in school settings can create a welcoming physical environment for sexual health care by rethinking the traditionally sterile feel of medical offices. For example, many staff from SBHCs and clinics serving youth suggest:

  • Furnishing common areas with couches, floor cushions, or communal tables
  • Decorating walls with colorful posters and art
  • Playing popular music that students can request or control

Clinics can also foster a welcoming social environment by investing in staff committed to positive and judgment-free interactions with youth. While strength in adolescent-friendly communication is critical for staff in all roles, early interactions are particularly important in setting the tone for a student’s visit for sexual health services. Many people we interviewed stressed the importance of staff practices such as:

  • Greeting patients with a smile, especially upon arrival
  • Listening to any questions or concerns without judgment
  • Communicating to youth that the clinic is their space and that they are welcome anytime
  • Developing rapport by showing interest in students’ lives

Programs serving youth in school settings must consider how school policies affect their ability to create a welcoming space. For instance, there may be limitations on how a clinic can be furnished or decorated or policies that keep students from lingering in clinic common areas. Programs should be creative when working within their unique circumstances and limitations. If changes to the physical space are not possible, ensuring positive social interactions becomes even more important.

Case examples

One SBHC in Seattle, Washington reported placing a communal table in the main clinic space for students to use at their leisure. Students gather at the table for lunch or to talk with friends, giving them a feeling of ownership over the clinic itself. As one of the nurses explained, “It is really important that it is their space. It is not that they’re going into a clinic, but we are guests in their school and their space. So, they need to feel like they can come and use that as they want to and as they choose.”

An SBHC sponsored by MedStar Georgetown University Hospital in Washington, D.C. described taking intentional steps to make students feel welcomed “from the moment they walk in the door.” For example, front-desk staff always greet students with a smiling face, and they like to have snacks and cold, filtered water available. Students know they can stop by and grab a snack even if they do not have an appointment, which allows staff to build relationships with students even before these students seek health care related services.

Reflection questions

Consider ways to improve your setting’s physical space and environment.
  1. What are some reasons that youth may feel uncomfortable seeking sexual health services in your setting?
  2. What could you add or change in your program’s space to make youth feel more comfortable visiting your SBHC or clinic?
Consider ways to support staff in creating a positive social environment in your setting.
  1. What does your SBHC or clinic staff do to make students feel comfortable coming in for sexual health services? Which of these practices are working well? Where is there room for improvement?
  2. What are some resources or strategies to help your staff grow their skills in adolescent-friendly communication, particularly around sexual health? (e.g., trainings, sample scripts, practice conversations, etc.)

Resources and Citations Referenced in this Section

Provide services and referrals to address the whole person

Providers and clinics serving youth must acknowledge and address the many contextual and systemic factors that shape adolescent’s lives and well-being. Youth who come to SBHCs and clinics for sexual health services may face multiple issues that have profound implications for their safety, security, and sense of self. Youth may be struggling with mental health, experiencing food or housing insecurity, or have important needs that are not readily apparent in a brief intake interview. For sexual health care to be truly adolescent-friendly, it must meaningfully treat the whole person. While this level of care may not always be possible, it can be cultivated through actions and investments by providers and the clinic at large.

Providers serving youth should strive to deliver holistic care that recognizes youths’ needs beyond medical and sexual health. Providers can accomplish this by:

  • Intentionally taking time during appointments to speak with youth about their overall health and well-being—not just the reason for their visit
  • Using checklists or questionnaires that include questions on social determinants of health (i.e., multiple social and environmental conditions that can impact a person’s health and well-being) administered as a screening tool before appointments or reviewed in-person during visits
  • Building personal relationships with local medical providers and service organizations to ensure that students have access to a network of community services

In addition, clinics and programs should strive to provide access to comprehensive services that address the many factors that shape youth’s lives. The following can help clinics and programs accomplish this goal:

  • Employing mental health practitioners, nutrition counselors, and social workers in the clinic building to provide key health and social services
  • Partnering with school staff—nurses, psychologists, and guidance counselors—to provide cross-referrals and warm hand-offs
  • Partnering with outside organizations to address critical needs, such as legal aid organizations or local food pantries

Providing comprehensive care and services can be difficult given demands on provider and staff time and clinic resources. Not all providers will be able to spend adequate time during an appointment exploring non-medical issues. Likewise, clinics may not be able to hire staff such as health educators or social workers. Providers and clinic staff should think about solutions specific to their context. For example, in the absence of a dedicated staff person to help with social services, school resources or community partnerships can help bridge a critical gap. Many schools often have existing partnerships or lists of community organizations that could be used for referrals.

Case examples

At an SBHC in a Cincinnati, Ohio high school, all new patients receive a comprehensive screening so that SBHC staff can identify students’ health and social needs. SBHC staff then provide referrals (and often warm hand-offs) to school counselors, nurses, and school psychologists for youth who need services. For example, if a student would benefit from mental health support, SBHC staff might walk with them over to the school psychologist’s office and introduce them to the mental health professional. This personal introduction helps ensure that students receive the help they need. This SBHC implements other promising practices in providing comprehensive services, including helping eligible youth enroll in state-sponsored health insurance and linking students to the high school’s food pantry, which provides food, cleaning supplies, clothes, and feminine hygiene products.

The SBHCs sponsored by MedStar Georgetown University Hospital in Washington, D.C., participate in a medical-legal partnership with the Georgetown University Health Justice Alliance Law Clinic. During physicals, staff screen youth for potential health-harming legal needs to determine if they would benefit from a referral for legal aid. If so, the legal team calls students within the week and offers to provide legal guidance and assistance to families. For example, if SBHC staff finds that a patient is living in a house with dangerous living conditions that have gone unaddressed by the landlord, the legal team will help the student’s family take legal action to ensure a safe living space.

Reflection questions

Consider opportunities to improve whole person care at the provider and clinic levels.
  1. What processes or practices do providers currently use to ensure that youth receive care that goes beyond their medical and sexual health needs?
    1. How could you change or improve these processes or practices to better meet the needs of the youth you serve?
  2. What medical and non-medical student needs are not currently met through the services provided at your clinic or program?
    1. What conditions or resources would be required to offer these services?
    2. What relationships or partnerships could be leveraged to make these services available to the youth that you serve?

Resources and Citations Referenced in this Section

Ensure privacy and confidentiality in care

Adolescents will be more likely to access and use sexual health services when they trust that their care is private and confidential. SBHCs and clinics serving youth may face unique challenges to maintaining privacy and confidentiality. This is particularly true when services are provided in school settings, which can feel less private to students. In addition, programs may find that school policies, insurance billing practices, or local laws on health care for minors may make sensitive information available to parents or legal guardians. For example, if a clinic bills a student’s private insurance for a LARC insertion, the student’s guardian may be able to see this procedure on the insurance claim.

SBHCs and clinics can still optimize privacy and confidentiality when providing sexual health services for adolescents. Family planning providers and administrators may use a variety of strategies depending on resources and contexts. These strategies include:

  • Giving parents or guardians limited proxy access to students’ online health records in accordance with state and local laws
  • Not requiring parental or guardian consent for sexual health services unless it is legally required
  • Not billing private insurance for sexual health services so that these services do not show up on insurance claims or explanation of benefits (EOBs)
  • Providing students with options to receive confidential sexual health information outside the clinic (e.g., through community partners or confidential sexual health hotlines)

Policies around confidentiality can be complex or confusing, such as when parents have access to some but not all information in a student’s medical record. As much as possible, ensure that patients are aware of and comfortable with your clinic’s privacy and confidentiality practices. This may require clear signage and extra time from providers or staff to explain to youth, in plain language, exactly what information will remain confidential. This communication can help promote the openness and honesty necessary for sexual health conversations. Clinics can also make explicit efforts to communicate with parents why privacy and confidentiality are part of high-quality adolescent health care and are associated with healthy adolescent growth and development.

Case examples

At a group of SBHCs sponsored by Denver Health in Colorado, parents and guardians sign a consent form for their children to be seen for medical and health education services. This consent form gives students access to all medical and health education services including sexual health services. However, in accordance with Colorado Minor Consent regulations, the SBHCs recently began allowing adolescents to self-consent for specific, confidential sexual health services as defined by the state. The SBHCs also avoid billing private insurance for sexual health services, recognizing that claims on private insurance may be viewed by parents and guardians. They accommodate this by billing Medicaid (which does not provide EOBs) when applicable and using grants to help offset costs.

Clinica Sierra Vista sponsors two SBHCs in Fresno, California, where, under state law, minors 12 and older have a legal right to health information privacy. To comply with the law, Clinica Sierra Vista must ensure that no one other than the child can see sensitive information in their electronic health records (EHR), such as notes from visits and descriptions of services received. The organization, like many community clinics in California, worked with IT personnel to automate the process of giving limited proxy access to parents and guardians when a child is eligible under the law. They also have a guide for front desk and medical assistants to use to help explain the proxy limitation to parents who ask about accessing electronic health records.

Reflection questions

Consider how clinic protocols and policies can be improved to protect privacy and confidentiality regarding sexual health services
  1. What laws and policies exist in your context related to protecting youth’s privacy and confidentiality?
  2. How can your SBHC, program, or clinic protect youth’s privacy while also meeting the requirements of local laws and policies?
  3. What steps can you take as a provider or program to ensure youth are aware of privacy and confidentiality practices?

Resources and Citations Referenced in this Section

Foster safety and comfort among adolescents around sexual health

Delivering sexual health education, counseling, and services to adolescents requires a deep appreciation for adolescents’ autonomy and comfort. Adolescents are at a unique point in their development and may find it difficult to openly discuss sexual health, particularly in a medical context. In addition, procedures such as gynecological exams and LARC insertions can be intimidating or traumatizing for many young people. Providers and programs must be thoughtful about how sexual health counseling and care is designed and delivered. This requires practices that demonstrate respect of adolescents’ autonomy and comfort when discussing sexual health and when delivering services and procedures.

Much of this comfort must be fostered during provider-youth interactions. For example, many providers serving youth recommend:

  • Avoiding assumptions, particularly around pregnancy intentions, sexual history, and gender or sexual identity
  • Using anatomically correct and gender-neutral terminology and modeling comfort using and discussing these terms
  • Acknowledging social and cultural considerations, including systemic racism, that can affect sexual and reproductive health decisions
  • Using motivational interviewing techniques or open-ended questions to ensure that conversations are youth-driven

In addition, many clinics or programs will design their program or services to intentionally cultivate adolescents’ autonomy and comfort. Clinics or programs accomplish this by:

  • Using informational and evidence-based videos or technology to introduce uncomfortable topics
  • Employing health educators to provide individualized counseling, particularly when medical providers cannot accommodate in-depth discussions because of time constraints
  • With student consent, allowing a support person to be present for difficult conversations or procedures, such as LARC insertions

Creating a culture of comfort and safety requires investments in your clinic workforce. Accomplishing the first set of bulleted points above may require offering special training for providers, such as in language best practices or motivational interviewing techniques. Accomplishing the second set of bulleted points above may require additional staffing or volunteers. Planning for efforts around this strategy will therefore hinge on a program’s or clinic’s financial capacity.

Case examples

At SBHCs sponsored by the Minneapolis Health Department, health educators describe using inclusive and respectful language when discussing topics related to sex, gender, and reproductive health. For example, when introducing themselves, they make a point to share their gender pronouns so that youth feel more comfortable sharing theirs. Health educators also use anatomically current and non-gendered language when educating on anatomy—for example, saying “people with vaginas” or “people with penises.” Using this language provides many students with a model for confidently discussing sex and sexual health.

For more information about the Minneapolis Health Department’s health educator program, see this case study.

La Clínica, a federally qualified health center sponsoring eight SBHCs in northern California, developed a LARC doula program in which health educators and medical assistants are trained to provide a safe and comfortable environment for adolescents during LARC procedures. During a LARC procedure, doulas offer patients various materials to reduce discomfort and pain (e.g., heating packs, portable fans) and engage with them according to their preference (i.e., staying silent, describing each step of the procedure, or discussing other topics as a distraction). Ultimately, LARC doulas help patients attain a sense of comfort, control, and well-being during a potentially painful or intimidating procedure.

For more information about La Clínica’s LARC doula program, see this case study.

Staten Island University Hospital/Northwell Health received a grant to implement an evidence-based interactive video activity to stimulate thinking and conversations about reproductive and sexual health in their SBHCs. Students who come in for sexual health services or education are offered a small incentive ($10 gift card) to complete the video activity before their appointment. The activity takes about 20 minutes to complete, is shown in a private exam room, and is available in English and Spanish. The video depicts real-life scenarios many youth face when navigating sexual and romantic relationships. Students serve as active participants in the video, reflecting on their own experiences and preferences and indicating how they might react in the same situations. One provider described how this exercise can make discussions and decisions about sexual health more comfortable, saying, “It’s designed to make them think about where their choices might make them lead. So kind of like a motivational interview, but you’re doing it on your own. I think that’s unique, and I think some students really like that. Not everybody is always so willing to answer your questions when you’re doing initial interviewing. So it’s more in their head, but that can be very powerful.”

Reflection questions

Consider how your SBHCs and programs can help make youth feel safe and comfortable when seeking sexual health services at your site.
  1. How can you and your staff be more intentional about the language used to discuss sexual health with youth?
  2. What interventions or practices could help make youth feel more comfortable with sexual health counseling and services in your setting?

Resources and Citations Referenced in this Section

Engage and uplift youth voices

For services to be truly youth-friendly, providers and programs must recognize youth as the experts in their own needs. Seeking input and feedback directly from youth not only improves sexual health services but communicates to youth that their voice is valid and important. By fostering authentic engagement and systems of continuous feedback, programs and providers will be better able to be truly responsive to youth wants and needs.

At the most basic level, providing access to satisfaction surveys and anonymous feedback forms can ensure that feedback is heard and incorporated. However, many programs serving youth in school settings go beyond light-touch efforts to foster more meaningful, long-term engagement. For example, some school-based programs have successfully built and maintained youth advisory councils or peer education programs. These groups often meet regularly and require staff training and facilitation, but they provide opportunities for students to be meaningfully involved in clinic decisions and designs. Youth advisors and peer educators can offer important input from themselves and their peers to strengthen a clinic or program.

Meaningful youth engagement requires an up-front and ongoing investment of time and resources. In planning, programs should consider not just how to gather youth input but also how to ensure those insights are used. Before any engagement or data collection effort, clinics should think through key questions around data use. Who will be responsible for analyzing survey data? How will a clinic incorporate feedback into its operations? Long-term planning will help ensure that youth voices are heard and utilized.

Case examples

Health educators in SBHCs sponsored by the Minneapolis Health Department developed a youth advisory council with student representatives from each school served by the SBHC program. Council members promote the SBHC program within their schools and are well-versed in topics such as safer sex, condoms, birth control, STI testing, mental health, gender identity, and sexual orientation. In addition, youth on the council provide valuable feedback to the SBHCs on ways in which the clinics can be more appealing to adolescents. Council members and their friends will conduct “secret shopping” activities in which they test services and identify opportunities for the clinic to improve. Feedback from the council has led to tangible changes in the SBHC program, sometimes led by students themselves. For example, one council member has developed and grown the program’s social media presence.

For more information about the Minneapolis Health Department’s health educator program, see this case study.

Staff at SBHCs sponsored by Heartland Health Centers in Chicago, Illinois recognized that many students felt more comfortable sharing feedback directly with their peers. In response, a group of health educators established a youth advisory council that operates across all SBHCs. Students identified as passionate about health care and motivated to make a change in their schools are invited to join the council. These students are then supported in connecting with their peers and sharing feedback with health educators about the types of information and services that students want and need.

Reflection questions

Consider how to elevate youth voice within your program.
  1. What strategies do you currently use to solicit feedback from youth at your SBHC or clinic about sexual health services?
  2. How might these strategies be changed or improved to promote more meaningful youth engagement and input?
  3. What resources does your SBHC have to make this a sustainable activity and ensure that youth investment is coupled with follow-through to make meaningful change?

Resources and Citations Referenced in this Section

Next Steps

Now think about concrete actions you can take to better ensure that you and your clinic prioritize adolescent-friendly care. The following statements can serve as prompts to help you identify potential next steps.

Reflections on Goal Setting

1. Identify at least one new adolescent-friendly strategy to implement in your school-based health setting or organization over the next three months.

Think about the six strategies described in this section of the toolkit. What strategies or examples sparked your interest? Think about how implementing this/these strategy(ies) might look in your setting. Determine and set a concrete goal and timeline.

2. Identify at least one existing adolescent-friendly strategy in your school-based health setting or organization to improve over the next three months.

Think about something you or your clinic already does to ensure that sexual health services are adolescent friendly. Consider one small change or improvement that could make this strategy more effective. Test the idea. Then consider an additional small change.

You can view the Next Steps questions as a PDF form here.


Suggested Citation

Vazzano, A., Balén, Z., Manlove, J., Parekh, J., Cushing, K., Shore, A., & Greco, D. (2022). Prioritizing Adolescent-Friendly Care. Child Trends. https://doi.org/10.56417/8169l6896o

This publication is supported by the Office of Population Affairs (OPA) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $2,036,999 with 100 percent funded by OPA/OASH/HHS. The contents reflect the views of the authors and do not necessarily represent the official views of, nor an endorsement by, OPA/OASH/HHS, or the U.S. Government. For more information, please visit https://opa.hhs.gov/.

Scroll To Top Scroll To Top Icon