Elizabeth Ozer is Professor of Pediatrics at the University of California, SF (UCSF), Co-Director of Research Training in Adolescent & Young Adult Medicine, and Director of Research & Evaluation for the Office of Diversity and Outreach at UCSF. Dr. Ozer is a psychologist whose research has focused primarily on the health of adolescents, young adults, and women. She has served as either Principal Investigator or Co-Investigator of multiple U.S. federally funded grants focused on decreasing adolescent risky behavior through improving the care provided by the health care system and the primary care provider. This research has tested models for increasing the screening and counseling of adolescents in primary care as well as evaluated the effect of provider screening and counseling on adolescent behavior across multiple health risk areas. She is currently PI on Agency for Healthcare and Quality (AHRQ) funded research to explore ways that technology can be incorporated into successful models of preventive care and a National Science Foundation grant to develop an on-line graphic novel for teens to facilitate navigating difficult social situations and decrease risky health behavior.
In addition to intervention research, Dr. Ozer and colleagues have conducted studies to enhance knowledge of preventive services delivery to adolescents, including examining ethnic/racial disparities in the delivery of preventive services, rates of screening for depression in primary care, and trends in depression, nutrition, and physical activity screening. Extending beyond the adolescent age-group, recent work has emphasized the need for guidelines for young adult preventive health care.
Dr. Ozer earned her M.A. and Ph.D. at Stanford University, completed a Clinical Psychology Internship in the Dept. of Child Psychiatry at Stanford, and a National Institute of Mental Health (NIMH) post-doctoral fellowship in Psychology & Medicine - Health Psychology with a traineeship in Adolescent Medicine at the University of California, S.F. In 2007, she served as a visiting professor at the University of Melbourne, and she is currently the Faculty Chair of the Chancellor’s Advisory Committee on the Status of Women at UCSF
Dr. Ozer has published in journals such as Journal of Personality and Social Psychology, Psychology of Women Quarterly, Women’s Health: Research on Gender, Behavior, and Policy, Archives of Pediatrics and Adolescent Medicine, Pediatrics, Journal of Adolescent Health, Health Services Research, and The Lancet.
Questions & Answers
Many of the components of the program can be adapted to best meet the needs of the primary care system or clinics where it is being implemented. The development/implementation of this intervention was a collaborative process. For example, our screening and charting forms were based on already developed forms within the health care system and were adapted for streamlined integration into the delivery system. Likewise, our training covered a wide range of risk areas and could potentially be limited to fewer risk areas and/or include some other areas that we did not address in this intervention. An important component of our training was the opportunity for providers to observe and engage in role-plays with adolescents (we utilized actors but this is not the only way to do) as a way to enhance their competence and skill to screen and counsel adolescents. While aspects of the content of the training might change, the opportunity for learning through demonstration and interactive role-plays is an important component to maintain. I also believe (and research supports) that the combination of provider training, along with tools to facilitate screening and counseling, is important.
The intervention was developed for a primary care setting. In this particular health care setting, the primary care providers were Pediatricians and Nurse Practitioners. The program could be adapted for other types of primary care providers who deliver care to both adolescents and young adults.
A major facilitator to implementation was collaborating closely with the health care system and involving clinic representatives (e.g. Chief of Service, providers, managers, reception staff…) in all aspects of the intervention including the training, screening and charting tool development, and integration of the intervention into the clinic flow. It was important to have “champions” within the system and within each of our intervention sites. Shortly after we began this work, the health plan disseminated their own preventive care guidelines (based on national guidelines) for the care of adolescent patients. This was also helpful as clinicians were interested in learning more about screening and counseling adolescents and integrating tools that would be helpful to them.
Our “Adolescent Report of the Visit (AROV)” is a useful tool for evaluating rates of screening and counseling across risk areas. It is completed by the adolescent immediately following their well visit and includes items such as, “Did your doctor ask if you smoke or use tobacco?” We have used it as an outcome measure in assessing change pre- and post-implementation.
Since the time we began developing our primary care interventions, health information technology has transformed healthcare systems. I am motivated to think about ways that technology can be incorporated into successful models of preventive care, both to provide information for prompts and cues to providers, but also to enhance opportunities for adolescent behavior change. I am currently PI on a grant funded by The Agency for Healthcare Research & Quality (AHRQ), to expand my research into this area. I also recently received a grant from the National Science Foundation focused on adolescents learning through technology with the plan of developing an on-line graphic novel to help adolescents navigate difficult interpersonal situations. Since 2006, I have also been collaborating with a colleague at the University of Melbourne conducting research on integrating primary care screening into general practice in Australia.