·                     Reproductive Health

·                     Reproductive Rights

·                     Body Image & Self Esteem

·                     Community Organizing

·                     Abortion

·                     Healthy Adolescent Relationships

·                     Emergency Contraception

·                     Culture and Health

The program has had great success, consistently receiving high scores on the evaluations filled out by supervisors at the host organization after each presentation.  The average satisfaction rating from the sixty-seven workshops presented in 2006-07 was 92%.  They have also presented at numerous national conferences, including the National Organization for Adolescent Pregnancy, Parenting and Prevention’s 2004’s Annual Conference (now known as the Healthy Teen Network), and SisterSong’s 2007 National Conference.

TORCH recognized that the sexual health of adolescents in the U.S. would improve significantly if, in addition to learning about health and safety from peer educators, teens were convinced that they should visit their health care providers frequently for preventive, informational, and treatment services, and that they would receive appropriate care once they arrived.

The program conducted a series of focus groups in 2003, surveying adolescent females about their experiences with health services and what they perceived as the barriers to high quality care. The findings showed that providers were not effectively communicating with teens, and that they were not reassuring their teenage patients of confidentiality. Instead of looking to providers as resources and confidantes, teens avoided health services, fearing judgment, disapproval, and the loss of their privacy.

TORCH responded to these results by developing the Adolescent Health Care Communication Project (AHCCP) in 2003, consisting of two workshops targeted at health care providers and teens: 

“Keepin' It Real With Your Doctor,” is an interactive and informative presentation in which trained teen educators teach their peers about their health care rights — such as confidentiality, emotional support, and accurate, thorough sexual education — and empower them to take advantage of the knowledge, advice, and treatment that health care providers can offer. 

Its counterpart, “Keeping It Real With Your Patients,” is presented to health care providers.  With handouts, skits, and group discussions, the adolescent educators respond to the providers’ questions, dispel their misconceptions about what teens want and need at the doctor’s office and share strategies to better communicate with teens.

While fulfilling a need in medical education, the workshops also made it clear that providers needed actual opportunities to practice interacting with real teens. 

• STIs
• sexual orientation 
• relationship problem
•  improper usage of contraception
•  pregnancy
• drug and alcohol usage

They then role-play as these characters while the providers practice screening and counseling them (with an emphasis on making the teen feel safe, comfortable, and therefore receptive to the provider’s advice).  Afterwards, the teens step out of character and offer feedback on the provider’s actions, questions, and behavior. 

In this way, health care providers can put their adolescent communication skills into practice, and receive individualized feedback from real New York City teens; simultaneously, the peer educators become more confident, well-informed health care consumers. 

Successes and National Expansion

With the support of the AHCCP and ASPP Advisory Board, composed of leaders in adolescent, family, and internal medicine from across New York, these two programs have earned powerful reputations. In little more than three years, TORCH educators have performed trainings at leading New York medical institutions such as: Albany Medical College, Coney Island Hospital, Harlem Health Center, Jacobi Medical Center, St. Barnabas Hospital, Maimonides Medical Center,  The Brooklyn Hospital Center, St. Vincent’s Catholic Medical Center, Nassau University Medical Center, St . John’s Queen’s Hospital, Brookdale Hospital Medical Center and Richmond University Medical Center.  In addition, TORCH educators have presented at four national conferences, including the Association of Pediatric Program Directors (APPD) in 2003, the American Academy on Communication in Healthcare (AACH) in 2003 and 2005, and the National Organization for Adolescent Pregnancy, Parenting and Prevention (NOAPPP- now known as the Healthy Teen Network) in 2004.

The AHCCP and the ASPP have had great success in New York, and received requests from different parts of the country for replication. In response to these requests, and the perceived need for large-scale improvements to adolescent health care, the National Institute for Reproductive Health  is preparing a national expansion of these two projects, joined together to become the Adolescent Health Care Communication Program (AHCCP). The National Institute is currently developing an Action Kit for this expansion, which will outline the current state of adolescent health services and guide interested organizations through the set-up, implementation, and sustainable management of the AHCCP.