Minnesota Chapter of the American Academy of Pediatrics Hot Topics in Pediatrics May 1, 2015 Hilton-MOA/MSP, Bloomington, MN Participant Packet for CME A link to the program evaluation can be found at www.mnaap.org/annualmeeting.htm. In addition, you will receive an email with a link to the evaluation as well a link to download your certificate of completion. If you have not received these emails, please contact cairns@mnaap.org Primary Educational Objectives: 1. Summarize current knowledge on the relationship of maternal obesity to hormone levels in breast milk 2. Identify provider opportunities to address adversity faced by youth and to promote healing and resilience among youth and families. 3. Identify innovative strategies for improving oral health in medical, dental, and community settings 4. Increase knowledge of resources and strategies to increase immunization rates and culturally sensitive approaches to vaccine promotion with Somali families 5. Identify methods to create a social norm about vaccinating and reduced vaccine exemptions. 6. Increase knowledge of resources and strategies that have been used in pediatric practices to increase HPV rates, reporting HPV in MIIC system, and use of related social media 7. Understand the emotional, physiological and cognitive changes in anxiety and recognize the interpersonal problems, performance and functioning problems and behavior problems that develop as a result. 8. Understand use of a framework to guide one through a process of change that can lead to calming of sustained physicological arousal associated with chronic stress, trauma and anxiety. 9. Describe care delivery changes with EMERALD at a pediatric clinic and related outcomes. 10. Understand the trends and management of adolescent substance abuse and the detox options/process 11. Understand use of school-based mental health services and areas for collaboration with pediatric primary care 12. Understand the type of mental health conditions that led to ED utilization and injury. 13. Understand the problems in the child protection system. 14. Identify steps that can be taken in the clinic and the community to help families prevent child maltreatment Time Topic and Faculty 8:15-9:00am The Milk of Paradise? New research on Maternal Obesity, Breast Milk Quality and Infant Metabolic Health Ellen Demerath, PhD ewd@umn.edu 9:00- 10:00 am How Are Our Children? The Impact of Adverse Experiences on the Health of Minnesota Youth Naomi Duke, MD, MPH, FAAP duke0028@umn.edu 10:30-11:15 am Oral Health: Improving access to services Eileen Crespo, MD, FAAP Eileen.Crespo@hcmed.org Jeffrey Karp, DMD, MS jmkarp@umn.edu Speaker Objectives and comments Define the term "lactational programming" in the context of the transmission of obesity risk from mother to child Summarize current knowledge on the relationship of maternal obesity to hormone levels in breast milk Identify bioactive components of human milk that are being investigated for their relationship to infant metabolic health Comment: The AAP and numerous other medical organizations recommend exclusive breast-feeding for at least 6 months; however human milk varies greatly in the concentration of non-nutritive bioactive hormones and other factors that may be important for infant development; new research is needed. Describe types of social and economic adversities experiences by MN youth. Discuss the health status of MN youth and the health consequences of adverse childhood experiences Identify provider opportunities to address adversity and to promote healing and resilience among youth and families. Comments: The impact of adverse experiences on youth health. Mechanism by which adversity contributes to health disparities. The link between childhood experiences and long-term health. Health providers have a role in fostering healing and resilience among youth. Review the epidemiology and oral health burden of dental caries among children in Minnesota and the United States Discuss barriers to access and utilization of dental and oral health services by underserved children Identify innovative strategies for improving oral health in medical , dental, and community settings Comments: Underserved children in Minnesota and across the United States face oral health disparities that can be improved through multidisciplinary, collaborative oral health programs in medical, dental, and community health settings. 11:15- noon Perspectives on Vaccine Resistance from Minnesota Communities Lynn Bahta, RN, PHN lynn.bahta@state.mn.us Adno Gatah, APRN, CNP adno.gatah@parknicollet.com Karen Ernst MN Childhood Immunization Coalition householdsix@gmail.com Diane Peterson Immunization Action Coalition Diane@immunize.org Noon- 1:00 pm Increasing Low Immunization Rates Among Adolescents Tracy Nelson, MD-moderator Nels8468@umn.edu Lisa Randall, JD, MPH lisa.randall@state.mn.us Lara Hilliard, MPH, CHES Lara.Hilliard@state.mn.us Elyse Kharbanda, MD, MPH Elyse.O.Kharbanda@healthpartner s.com Marjorie J. Hogan, MD Marjorie.Hogan@hcmed.org David Aughey, MD, FAAP Dave.Aughey@childrensmn.org 1:00- 2:15 pm Moving from ANXIETY to optimal WELLNESS: Clinical pearls for the pediatric provider L. Read Sulik, MD, FAAP, DFAACAP Rsulik@prairie-care.com Gain a current understanding of oral health disparities in the United States. Be informed of the current recommendations for establishment of a dental home, use of fluoridated toothpaste by young children, and provision of oral health risk assessment and fluoride varnish application in pediatric primary care. Be informed of oral health projects that have shown promise for reducing oral health disparities in underserved pediatric health settings. Increase knowledge of resources and strategies to increase immunization rates Describe the growing gap in MMR rates among Somali versus non-Somali 24 month old children in Minnesota Enhance provider knowledge about the basis for vaccine refusal by Somali families Explore culturally sensitive approaches to vaccine promotion with Somali families Identify and reduce vaccine hesitancy with Somali families to increase knowledge of resources and strategies that can be used to increase pediatric immunization rates Parental resistance to immunization in Minnesota Creating a social norm about vaccinating Understand of goals to strengthen exemption policies Identify resources for vaccine-hesitant parents Comments: MMR rates among 2 year old Somali children are dangerously low Don't stop offering MMR vaccination for your pediatric patients that initially refuse vaccination. Pockets of unvaccinated children, due to their parents decisions, have contributed to vaccine-preventable disease in Minnesota. It is important to achieve and maintain high vaccination levels to protect children and others that surround them. Choosing an exemption to statemandated vaccinations for children shouldn't be easier than to have children vaccinated. Increase knowledge of resources and strategies that have been used in pediatric practices to increase HPV rates, reporting HPV in MIIC system, and use of related social media Increase HPV vaccine coverage reporting in the MIIC system Increase the use of social media related to HPV vaccine coverage To increase knowledge of resources and strategies that have been used in pediatric practices to increase HPV vaccine coverage. Comments: Too few preteens and teens are vaccinated appropriately against HPV There are several tactics clinicians can use to be more successful in vaccinating their adolescent patients against HPV, including refining their recommendation approach, using MIIC to identify and remind eligible yet unvaccinated patients, and educating patients and parents via social and other media. HPV immunization rates are low among Minnesota adolescents. Vaccination decisions are influenced by social networks and people are increasingly going online to find their health information. Strong social media efforts have a role to play in immunization rates. Missed opportunities for providing vaccines to adolescents. Be proactive in promoting vaccines at every clinical encounter. The need for HPV vaccination coverage in adolescents. Understand the emotional, physiological and cognitive changes in anxiety and recognize the interpersonal problems, performance and functioning problems and behavior problems that develop as a result. Identify barriers for change and develop approaches to prepare individuals more effectively for change Apply a framework to guide one through a process of change that can lead to calming of sustained physicological arousal associated with chronic stress, trauma and anxiety Comments: This will be an interactive workshop where Dr. Sulik will present his 2:15 -2:45 pm EMERALD: A pilot collaborative program in primary care for teens with depression Mark Williams, MD William.Mark@mayo.edu 3:00 – 3:45 pm 3:45 -4:15 pm 4:15 – 5:00 pm Substance abuse in teens: trends, management and detox Jordan Marmet, MD Panel moderator marme001@umn.edu Diana Chapa, MD dchapa1@fairview.org William Hosfield, MD whosfield@yahoo.com Carla Olson COLSON1@fairview.org Kate Worre, Fairview Health System Effective Collaboration across Pediatric Health and School Mental Health Systems Nita Kumar, PhD, LMFT, LPCC Nita.Kumar@anoka.k12.mn.us Mental Health Care: Perspectives from a Trauma Center Anupam Kharbanda, MD, MSc Anupam.Kharbanda@childrensmn. org framework for understanding the physiological arousal experienced in anxiety. Participants will come to understand the Fight, Flight and Freeze response experienced and how the sustained arousal of chronic stress, trauma and anxiety can lead to systemic health as well as severe cognitive, emotional and behavioral problems. Dr. Sulik’s style of teaching through stories and examples will help participants understand how individuals with anxiety are so easily misinterpreted, misunderstood and misdiagnosed. Dr. Sulik will review approaches to prepare an individual to change the conditioned patterns that often develop as a result of chronic anxiety and will introduce a framework for a personal health and wellness transformation he uses in his work with patients. There are 3 areas of change that arousal triggers in children, adolescents and adults: emotional, physiological, and cognitive. The emotional changes in anxiety correspond to the "Fight", "Flight" and "Freeze" response. There are specific activating physiological responses, deactivating physiological responses and a fatigue/ energy craving cycle associated with anxiety. The thinking changes in anxiety include internal distractibility, ruminating intrusive memories and anticipatory worries and cognitive distortions associated with catastrophic thinking. The changes of sustained arousal associated with anxiety lead to relationship problems, performance and functioning problems, behavior problems and can impact an individuals sense of self, meaning and purpose. Perhaps a common mistake made in healthcare is repeatedly applying a "technical fix" to our patient's complex adaptive challenges associated with their anxiety. A comprehensive framework of domains of change is needed to guide a patient through the work they need to do to overcome their triggers of anxiety and develop improved self-soothing skills and improved self-regulation. Adequately supporting a patient's "move from Anxiety to Wellness" requires improving the patient's insight and intention to change, providing appropriate structure to accomplish the change within and practice the needed changes. Describe what changed in care delivery with EMERALD at a pediatric clinic Review outcomes and reasons why this model has been so popular Comments: Teens with depression are often presenting in primary care settings where providers may be uncomfortable managing them while access to specialty care is poor. Collaborative care of depression for teens presenting in pediatrics can be effectively delivered without waiting for payment systems to change. Understand the trends and management of adolescent substance abuse and the detox options/process Understand the of school-based mental health services and areas for collaboration with pediatric primary care Understand the type of mental health conditions that led to ED utilization and injury Comments: Learn more about the role of ED's in providing care to mental health patients Burden of Mental Health Care on Emergency Departments ED's are providing increasing care for patients with MH conditions 7:00 – 8:15 pm Preventing Child Abuse from Making Headlines Brandon Stahl brandon.stahl@startribune.com Vincent Palusci, MD, FAAP vincent.palusci@nyumc.org Understand the problems in the MN child protection system Understand risk factors, protective factors (resilience) and evidence supporting interventions for child abuse and neglect prevention Identify steps that can be taken in the clinic and the community to help families prevent child maltreatment Comments: Tell the audience the key findings of the reporting on Minnesota's child protection system and explain how the reporting was accomplished Explain how press attention on child protection has gone in cycles, with little meaningful change Understand the problems in the MN child protection system -- how the public probably thinks child abuse reports are being adequately addressed, yet in thousands of cases they are not. How to play a role in demanding change to better protect kids in the system. Participants will review key concepts in prevention science and how they can be applied to injury and violence prevention Child Abuse can be reduced and prevented—review the problem of child abuse, what prevention science can teach us, and the important role of pediatricians in preventing child abuse and neglect. There are things we can learn from prevention science to help us do this. Pediatricians have an important role to play. Program Speakers and Contact information: Ellen Demerath, PhD Associated Professor, Epidemiology and Community Health University of Minnesota ewd@umn.edu Ellen Demerath received her M.S. and Ph.D. from the University of Pennsylvania. Her research interests include the developmental origins of chronic disease, with an emphasis on obesity, body composition, and cardiovascular disease risk factors in infancy and childhood. Naomi Duke, MD, MPH, FAAP Assistant Professor University of Minnesota duke0028@umn.edu Naomi Duke is a physician-researcher board certified in Internal Medicine, Pediatrics, and Adolescent Medicine. She earned her medical degree from Harvard Medical School and completed an internship and residency in Internal Medicine and Pediatrics at the University of Michigan Hospitals. After residency training, she completed an MPH in Maternal and Child Health, core concentration in child health advocacy, and a Leadership in Adolescent Health Fellowship at the University of Minnesota. She has worked for the National Health Service Corps. Dr. Duke is currently the Medical Director at West Suburban Teen Clinic and is working toward completion of a PhD in Sociology, with concentrations in life course studies and public health demography at the University of Minnesota. Her research interests include developing strategies to reduce youth health disparities through community partnering and advocacy, studying social determinants of adolescent and young adult health, assessing the effects of periodicity for state and federal health policy agenda on trajectories of health outcomes for young people, and advancing best practices in adolescent health services delivery. Jeffrey Karp, DMD, MS Pediatric Dentist and Director of Pediatric Dentist Residency Program University of Minnesota jmkarp@umn.edu Jeffrey Karp is a Clinical Associate Professor in the Department of Developmental and Surgical Sciences at the University of Minnesota School of Dentistry. He is the Director of the Pediatric Dentistry Residency Program and the University of Minnesota Pediatric Dental Clinic made possible by Delta Dental of Minnesota. Dr. Karp is a Diplomate of the American Board of Pediatric Dentistry. He maintains clinical privileges at the University of Minnesota Children’s Hospital where he works closely with his pediatric dentistry residents in the care of infants, children, and adolescents in the emergency department, sedation unit and operating suites, and the in-patient units. He has been elected to serve as a member of the Executive Committee of the AAP Section on Oral Health, effective November 1. Eileen Crespo, MD, FAAP Pediatrician Hennepin County Medical Center Eileen.Crespo@hcmed.org A member of the Minnesota Oral Health Coalition, Eileen Crespo attended the State University of New York for medical school and completed her residency at the University of Minnesota, where she also served as chief resident. Lynn Bahta, RN, PHN Minnesota Department of Health Immunization, Tuberculosis, International Health Section 624 Robert St N St. Paul, MN 55164 lynn.bahta@state.mn.us Lynn Bahta, RN, PHN is with the Minnesota Department of Health as the Immunization Program Clinical Consultant and Senior Public Health Nurse Advisor. She was also an Immunization Consultant at the Immunization Action Coalition and previously worked as a Public Health Nurse Program Coordinator at the St. Paul Public Health. She has been an Author or co-author for articles related to immunization and has been an Invited speaker for national, state and regional and local conferences and seminars on the topics of Immunization, Hepatitis B, Lead Poisoning prevention, and Tuberculosis. Adno Gatah, APRN, CNP Park Nicollet Clinic-Minneapolis 2001 Blaisdell Ave Minneapolis, MN 55404 adno.gatah@parknicollet.com Adno Gatah is a certified Pediatric Nurse Practitioner in the department of pediatrics at Park Nicollet Clinic in Minneapolis. Adno earned her Bachelor of Science and Master of Science in Nursing degrees from Saint Catherine University School of Nursing. Adno has worked in Somalia and Kenya. Most recently, she practiced in a community clinic in rural Somalia before joining Park Nicollet Clinic. Adno has special interests in international and urban health and is fluent in Somalia and Swahili. Karen Ernst householdsix@gmail.com Karen Ernst, is a parent and provides leadership in the Minnesota Childhood Immunization Coalition. She is also affiliated with Voices for Vaccines (VFV), a parent-driven organization supported by scientists, doctors, and public health officials that provides parents clear, science-based information about vaccines and vaccine-preventable disease, as well as an opportunity to join the national discussion about the importance of on-time vaccination. She is a frequent commenter and blogger on issues relatedd to vaccines for children. Diane Peterson Immunization Action Coalition Diane@immunize.org Diane Peterson’s career in immunization, spanning nearly 40 years, has been devoted to increasing the number of children in Minnesota and nationally who are immunized and to improving the safety and effectiveness with which vaccines are delivered to them. She is currently Associate Director for Immunization Projects with the Immunization Action Coalition (IAC), based in Minnesota. She began her career in immunizations when she joined the immunization section at the Minnesota Department of Health (MDH) in 1974. She led major projects, including developing policies to equitably distribute vaccine resources to children statewide, working with legislators to ensure passage of laws that increase immunization rates in childcare facilities and schools, helping initiate Minnesota’s immunization registry, creating the initial plan for Minnesota’s implementation of the federal Vaccines for Children program, developing innovative education materials for health care professionals and the public and promoting immunization to the media, parents and others through her role as MDH spokesperson. Tracy Nelson, MD University of Minnesota- Pediatric Resident Nels8468@umn.edu Dr. Nelson is a Pediatric Resident at the University of Minnesota. She worked on an HPV quality improvement project with staff from HCMC and other health systems as part of an AAP-funded project. Lisa Randall, JD, MPH Minnesota Department of Health lisa.randall@state.mn.us Lisa Randall is a Policy Specialist with the Minnesota Department of Health. Ms. Randall received her Law degree from the University of Minnesota and an MPH from Johns Hopkins Lara Hilliard, MPH, CHES Minnesota Department of Health Lara.Hilliard@state.mn.us Health Educator and Communications Specialist at the Minnesota Department of Health, in the Infectious Disease Epidemiology section Elyse Kharbanda, MD, MPH HealthPartners Elyse.O.Kharbanda@healthpartners.com Elyse is a practicing pediatrician at HealthPartners and a Clinician Investigator at the HealthPartners Institute for Education and Research. Marjorie J. Hogan, MD Hennepin County Medical Center 701 Park Ave Minneapolis, MN 55415 Marjorie.Hogan@hcmed.org Dr. Hogan graduated from Stanford University Medical School. She completed her pediatric residency training at the University of Minnesota. She is board certified in both General Pediatrics and Adolescent Medicine. She is a recipient of the University of Minnesota Department of Pediatrics 2009 Gold-Headed Cane Award. This award is the highest honor the University of Minnesota Department of Pediatrics can grant to an individual, representing the life-long dedication to children and the practice of medicine. Dr. Hogan is very interested in general pediatrics, adolescent medicine, issues related to child abuse and neglect, the effect of media on children and teens, and medical education. David Aughey, MD, FAAP Children’s Hospitals and Clinics of Minnesota Dave.Aughey@childrensmn.org Dr. David Aughey is an adolescent health specialist and practicing pediatrician at Children’s Hospitals and Clinics L. Read Sulik, MD, FAAP, DFAACAP PrairieCare / PrairieCare Institute Chief Integration Officer Child & Adolescent & Adult Psychiatrist Rsulik@prairie-care.com Dr. Read Sulik is the Chief Integration Officer for PrairieCare. He has worked to develop partnerships leading to the full integration of behavioral health and primary care to improve how behavioral health needs of children and adults are met optimally. Previously, he served as Enterprise Senior Vice President at Sanford Health over Behavioral Health Services and received a $12 million CMS Healthcare Innovation Award to transform primary care clinics into fully integrated primary and behavioral health care medical homes. He also previously served as Assistant Commissioner of the Minnesota Department of Human Services over the Chemical and Mental Health Services Administration. Additionally, he previously served as Medical Director of Child and Adolescent Psychiatry at St. Cloud Hospital/CentraCare Health System Mark Williams, MD Mayo Clinic William.Mark@mayo.edu Dr. Williams is involved in testing and developing collaborative models of care with primary care, and in developing and refining the use of screening instruments (the PHQ-9, MDQ, etc). He has an interest in the interface between primary care and mental health, and projects on depression, prevention in psychiatry, meaningful outcome measures for mental health outpatient treatment, and on population-based approaches to mental health issues. Dr. Williams is certified by the American Board of Psychiatry and Neurology Jordan Marmet, MD University of Minnesota and Fairview Health Services marme001@umn.edu Dr. Marmet is a pediatric hospitalist and sees patients at the Fairview Ridges Hospital and at the University of Minnesota Masonic Children's Hospital. He provided clinical leadership in a federally-funded AHRQ and MN DHS-funded project on pediatric mental health issues in partnership with MNAAP Diana Chapa, MD University of Minnesota, Community University Health Care Clinic dchapa1@fairview.org Dr. Diana Chapa is a psychiatrist in Minneapolis and is affiliated with multiple hospitals in the area. She received her medical degree from University of Wisconsin School of Medicine and Public Health and has been in practice for 20 years. William Hosfield, MD whosfield@yahoo.com University of Minnesota and Fairview Health Systems Dr. William Hosfield is a psychiatrist in Edina, Minnesota and is affiliated with University of Minnesota Medical Center, Fairview. He received his medical degree from University of Minnesota Medical School and has been in practice for 48 years. He specializes in child and adolescent psychiatry and behavioral health. He previously was affiliated with the HealthEast System. Carla Olson Fairview Health System Director Adolescent Recovery Services at University of Minnesota COLSON1@fairview.org Director of the inpatient adolescent dual diagnosis program, and 4 other out -patient chemical dependency and dual diagnosis programs, and an adolescent lodging treatment program. She oversees the practice in these programs and provides program development, care coordination and leads efforts to enhance Patient and family centered care. Kate Worre, Fairview Health System Ms. Worre is a case manager and also completes the substance use assessment for in-patient services Nita Kumar, PhD, LMFT, LPCC Anoka-Hennepin School District Nita.Kumar@anoka.k12.mn.us Dr. Kumar provides oversight for mental health programming, policy and protocol. She works in the Anoka Hennepin School District Anupam Kharbanda, MD, MSc Children's Hospitals and Clinics of Minnesota Anupam.Kharbanda@childrensmn.org Dr. Kharbanda is the Research Director for Emergency Services at Childrens Hospitals and Clinics. He completed medical school at the University of Iowa, a pediatric residency at Columbia University, a Fellowship in pediatric Emergency Medicine at Harvard, and a Masters degree in Biostatistics at Columbia University Brandon Stahl Reporter Star Tribune brandon.stahl@startribune.com Brandon Stahl is a watchdog reporter with the Star Tribune. He previously worked as the investigations editor at the Duluth News Tribune, where his stories on physician malpractice and medical errors, drug abuse, tax dollar waste, sex offenders and police misconduct have won numerous state and national journalism awards. Vincent Palusci, MD, FAAP Professor of Pediatrics, NYU School of Medicine vincent.palusci@nyumc.org Dr. Palusci is Professor of Pediatrics at New York University School of Medicine in Manhattan, NY. Formerly in Grand Rapids and Detroit, Michigan, he has served as faculty for the MidWest Regional CAC and currently sees patients and supervises students, residents and fellow in general as well as Child Abuse Pediatrics. He is a member of the executive committee of the American Academy of Pediatrics Section on Child Abuse and Neglect, the newly approved provisional Section on Child Death Review and Prevention, and the American Board of Pediatrics Subboard of Child Abuse Pediatrics. Dr. Palusci's research has focused on epidemiology and prevention, and he has published several books and articles on the diagnosis, reporting and response to child abuse and neglect. In 2004, he was recognized with the Ray Helfer Award for Child Abuse Prevention from the AAP and the National Alliance of Children's Trust and Prevention Funds. Thank you to Planning Committee Members for this CME event which included: Drs. Elsa Keeler, Emily Chapman, Lori DeFrance, Anne Edwards, Robert Jacobson, Julia Joseph DiCaprio, Jessica Larson, Michael Partington, Michael Severson, and Deborah Smith-Wright. Resources for Clinics and Pediatric Providers Identified by speakers –this will be updated after the presentations. Additional telemed and social media resources for pediatric clinics: A TeleMed and social media toolkit for Pediatric Clinics was developed in partnership with a grant from the American Academy of Pediatrics and participating Minnesota clinics through MNAAP. These resources will be updated as new information becomes available. Telemed toolkit is at http://www.mnaap.org/telemedicine.html Social media toolkit is at http://www.mnaap.org/socialmedia.html Additional Somali Health resources for Clinics: These short Somali Patient education videos were developed by the Mayo Clinic and CentraCare Clinic with funds from the American Academy of Pediatrics, the Minnesota Chapter of AAP and the federal HRSA Program. They are used internationally. Autism http://www.youtube.com/watch?v=xBAmfskuMps Vaccines http://www.youtube.com/watch?v=6nn0LziFpPU Vomiting and Diarrhea http://www.youtube.com/watch?v=WHBcAxu5YHk Temperatures and thermometer use https://www.youtube.com/watch?v=i4YGxLlOoq4&index=10&list=PL7iMuafQx_f7CWOjMadeZgJhS1ZHCoI3L Safety in the home https://www.youtube.com/watch?v=tMDW7kVOPWY&index=7&list=PL7iMuafQx_f7CWOjMadeZgJhS1ZHCoI3L Newborn screening https://www.youtube.com/watch?v=AJzx6dh6RyE&list=PL7iMuafQx_f7CWOjMadeZgJhS1ZHCoI3L&index=4 Developmental Screening https://www.youtube.com/watch?v=LZg9EU3ZU7o&index=5&list=PL7iMuafQx_f7CWOjMadeZgJhS1ZHCoI3L Feeding and Safe Sleeping https://www.youtube.com/watch?v=DwB32dhKUCs&list=PL7iMuafQx_f7CWOjMadeZgJhS1ZHCoI3L&index=6 Car seats https://www.youtube.com/watch?v=vA_1rlifBMI&list=PL7iMuafQx_f7CWOjMadeZgJhS1ZHCoI3L&index=8 Television and children https://www.youtube.com/watch?v=8rv8mwS7YYs&index=9&list=PL7iMuafQx_f7CWOjMadeZgJhS1ZHCoI3L Additional HPV training videos/resources for Clinics: These short education videos were developed by Hennepin County Medical Center with funds from the American Academy of Pediatrics, the Minnesota Chapter of AAP. Additional videos were developed by the Minnesota Department of Health. Training for a strong Provider recommendation for HPV https://vimeo.com/97746876 Provider training videos from MN Department of Health on HPV http://www.health.state.mn.us/divs/idepc/immunize/hcp/adol/hpvvideos.html