Are you my provider?

Danielle Lepar

Danielle Lepar

Fall is upon us and, for second year public health students, this likely means that they have completed their internship and are busy analyzing data sets and/or making posters. Students will be presenting these posters to peers, faculty, field experience preceptors, and others at an upcoming session at SPH.  While I too am trying to assemble my presentation amidst the other academic workload October brings, I’ve also had the opportunity to continue working on my field experience project.

My project has certainly evolved, but its main goal remains to design a web-based self regulation intervention for women with inflammatory bowel disease (IBD).  Initially, the priority population for this program included women roughly between the ages of 40 and 55.  These inclusion criteria were based on the results of a previous project, which involved an Internet survey that addressed multiple chronic conditions.  Respondents were mostly women, had digestive diseases, and fell within the age group mentioned above.

Prioritizing this age group seems to align well with these survey results and the fact that, in 2005, the CDC estimated that 1 in every 2 adults in the US had at least one chronic condition.  Moreover, when stratified by age, these data indicate that older adults are more likely to have a chronic illness than younger ones. While such statistics are attention-grabbing, they don’t highlight the particular challenges experienced by adolescents and young adults who are coping with chronic illness.  These challenges have caused us to reconsider who to include in this program.

IBD is typically diagnosed at a younger age: during the second and third decades of life.  This is a time when many individuals are attending school, establishing their economic viability, in addition to experiencing intense social, psychological, and identity development.   These changes are compounded by the fact that it isn’t always clear with whom this age group should seek care.  I remember my own discomfort with deciding who to see as a teenager- I felt like I’d outgrown a pediatrician, yet an internal medicine doctor wasn’t right either.  In many clinical settings, providers are only specified to serve children or adults. Yet, the transition between these two groups is quite drastic.  My involvement with this IBD-related project and a class I took on adolescent health have demonstrated the relative dearth of services tailored to meet the unique needs of young people.  Hopefully, public health efforts will continue to improve the knowledge base regarding the distinct needs of this age group, so adolescents and young adults don’t fall through the cracks of receiving care.

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