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Setting priorities in adolescent medicine research

Secondary-school-BangladeshToday, the world has more than a billion young people aged 10 to 19. Most of them live in low- and middle-income countries, and of the 1.3 million annual deaths that occur in this age group each year, 97 percent happen outside the world's wealthiest countries.

Those numbers hint at the need for better adolescent medicine research focused on the developing world. But, given that relatively few research dollars are directed at teens in these locations, how should scientists prioritize what problems they tackle?

That was the question posed by a team of adolescent medicine experts led by Stanford's Jason Nagata, MD, in a study published this week in the Journal of Adolescent Health. Nagata and his co-authors polled 142 adolescent medicine experts on six continents for their research ideas, and used a previously established ranking system for getting those same experts to figure out which research questions are most pressing. The questions were divided into eight subject areas and scored in a variety of domains: clarity, ability to generate important new knowledge and usable interventions, ability to be translated into strategies that could be implemented in the real world, and ability to address inequities such as unequal disease burdens in different groups of teens. Each question then got a total score to determine its overall research priority.

It's interesting to see what bubbled to the top. Here are some of the top-ranked questions in some of the different categories of adolescent health:

  • Communicable diseases prevention and management: What are the key barriers faced by adolescents to access TB and TB/HIV diagnostic and treatment services in high- and low-income countries, and how can these be overcome?
  • Injuries and violence: What are the barriers and facilitators to increasing compliance with motorcycle helmet legislation?
  • Mental health: What would be the most cost-effective, affordable and feasible package of interventions for promotion of mental health and prevention of mental health disorders among adolescents?
  • Noncommunicable disease management: Can a low-cost rapid antigen test for diagnosis of streptococcal pharyngitis (which can lead to rheumatic heart disease) be developed that is suitable for use in low-resource settings?
  • Substance use: What prevention and treatment services related to substance use are acceptable to adolescents?

"Improving the health of adolescents in low- and middle-income countries will be essential for the world to achieve the United Nations Sustainable Development Goals," the researchers wrote. "Although there has been an increased call for research on the health and well-being of adolescents... research from [these countries] is still limited." The team hopes their work will guide donors, scientists and others interested in global health to the most important scientific questions.

Previously: Adolescent Health Van wins community award for aiming to "help kids turn their lives around", A team approach to international health and A journalist's experience with tuberculosis, the "greatest infectious killer in human history"
Photo by Asian Development Bank

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