Hennepin County Medical Center earned a 2014 Gage Award honorable mention in the population health category.

More than other teens, Latino youth struggle to overcome mental health, sexual health, and educational achievement issues. Hennepin County Medical Center, in Minneapolis, created Aquí Para Ti (APT)/Here for You, an outpatient clinic that takes a holistic approach to teen health care. APT aims to reduce health disparities for this specific population using an integrated, bilingual, culturally competent approach. Since 2002, APT has provided comprehensive youth development and primary health care services to more than 1,200 Latino teens and their families.

Innovative strategies address health disparities

Latino teens struggle with disparities related to mental health, substance abuse, and physical activity. They are more likely to become pregnant than other teens. Their rate of contracting sexually transmitted diseases (STDs) is two to three times higher than white teens. And suicide attempts among Latina teens is the highest among adolescents—one in seven will attempt suicide in her lifetime.

To tackle these challenges, APT uses the following methods:

  • the developmental-ecological model, which emphasizes the role of the individual, family, or group and sociocultural and historical context to shape the development experiences and health practices of youth
  • the positive youth development paradigm, which promotes internal assets such as self-esteem, self-efficacy, and hopefulness and external supports to promote positive behavior
  • family parallel care, an approach that addresses the needs of both parents and youth and integrates the strong Latino sense of family and unity
  • the health care home model, in which primary care providers, families, and patients work together to improve health outcomes and quality of life for individuals with chronic health conditions and disabilities

Helping parents help their kids

APT pays special attention to the role parents play in teens’ mental and physical health. At the clinic, both youth and parents can receive medical care, connections to resources, and case management. Parents receive additional parenting skills coaching, while teens receive health skills coaching and a school/college connector.

APT also actively responds to changing needs and suggestions. When program staff realized that parents’ mental health also needed to be addressed, they collected data and developed programs and protocols to focus on this area. APT also has an advisory board made up of youth patients and their parents. The advisory board meets bimonthly at the clinic to discuss the program and offer suggestions for improvement.

Measuring and replicating

APT regularly evaluates its effectiveness using pre and postsurveys, chart reviews, and qualitative approaches. In particular, evaluations focus on mental health outcomes, coordination of services with partner agencies, parent efficacy, developing positive connections between families and the community, school needs assessments, and providing holistic services to families.

Results suggest that APT enhances the overall health status of its patients, improves parents’ ability to interact with their children, and increases their comfort with accessing health care providers and other resources for youth development.

Having been recognized as an evidence-based, innovative, promising practice at the state and national level, APT is involved in initiatives to change state policy and create health equity across Minnesota. It has been included in the Agency for Healthcare Research and Quality’s Innovations Exchange, and Hennepin staff are working under a grant from the National Institutes of Health to assist with replication and evaluation. Within the Hennepin system, APT has led to the creation of Henne-Teen, which establishes adolescent care and youth-friendly practices across the organization.

For more information about Aquí Para Ti/Here for You, please contact:

Maria Veronica Svetaz, MD
Director
Aquí Para Ti
Hennepin County Medical Center
maria.veronicasvetaz@hcmed.org