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Sand P, Kinberg E, Sundberg F, Forsander G. Parents' and children's experiences of participating in a randomized controlled clinical trial: AIDIT-QS. Int J Qual Stud Health Well-being 2024; 19:2408829. [PMID: 39360673 PMCID: PMC11451326 DOI: 10.1080/17482631.2024.2408829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 09/20/2024] [Indexed: 10/04/2024] Open
Abstract
Participation in a paediatric, complex randomized controlled trial (RCT) might add to the family burden when a child is diagnosed with a severe disease. Although important, there are only a limited number of papers describing this aspect of research from the family point of view. This study explored parents' and children's experiences of participation in a research study shortly after the child had been diagnosed with type 1 diabetes. Sixteen parents (nine mothers, seven fathers) and nine children were interviewed by an independent researcher about their inducement, the decision-making process within the family which led to their participation, and their experience of having done so. The result showed that the parents wanted to contribute to improve treatment for children with diabetes in general but also specifically for their own child. Older children were more involved in the decision making than the younger children. Study information needs to be communicated clearly and effectively since decision-making based on information of a clinical trial directly after the child's diabetes onset proved difficult. Being randomized to the intervention group in this specific study was considered somewhat burdensome. However, parental participants in both intervention and control group claimed that they would recommend participation in research studies to other parents in a similar situation, and so did the children. There was no difference between the mothers' and fathers' experiences.
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Affiliation(s)
- Peter Sand
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - Emelie Kinberg
- Region Västra Götaland, Department of Psychiatry for Affective Disorders, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Frida Sundberg
- Department of Pediatrics, Institute for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Pediatrics, Region Västra Götaland, Sahlgrenska University Hospital, Queen Silvia Children’s Hospital, Gothenburg, Sweden
| | - Gun Forsander
- Department of Pediatrics, Institute for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Bratt EL, Mora MA, Sparud-Lundin C, Saarijärvi M, Burström Å, Skogby S, Fernlund E, Fadl S, Rydberg A, Hanseus K, Kazamia K, Moons P. Effectiveness of the STEPSTONES Transition Program for Adolescents With Congenital Heart Disease-A Randomized Controlled Trial. J Adolesc Health 2023; 73:655-663. [PMID: 37032211 DOI: 10.1016/j.jadohealth.2023.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 01/22/2023] [Accepted: 02/13/2023] [Indexed: 04/11/2023]
Abstract
PURPOSE Adolescents with congenital heart disease transition from childhood to adulthood and transfer from pediatric-oriented to adult-oriented care. High-level empirical evidence on the effectiveness of transitional care is scarce. This study investigated the empowering effect (primary outcome) of a structured person-centered transition program for adolescents with congenital heart disease and studied its effectiveness on transition readiness, patient-reported health, quality of life, health behaviors, disease-related knowledge, and parental outcomes e.g., parental uncertainty, readiness for transition as perceived by the parents (secondary outcomes). METHODS The STEPSTONES-trial comprised a hybrid experimental design whereby a randomized controlled trial was embedded in a longitudinal observational study. The trial was conducted in seven centers in Sweden. Two centers were allocated to the randomized controlled trial-arm, randomizing participants to intervention or control group. The other five centers were intervention-naïve centers and served as contamination check control group. Outcomes were measured at the age of 16 years (baseline), 17 years, and 18.5 years. RESULTS The change in empowerment from 16 years to 18.5 years differed significantly between the intervention group and control group (mean difference = 3.44; 95% confidence interval = 0.27-6.65; p = .036) in favor of intervention group. For the secondary outcomes, significant differences in change over time were found in parental involvement (p = .008), disease-related knowledge (p = .0002), and satisfaction with physical appearance (p = .039). No differences in primary or secondary outcomes were detected between the control group and contamination check control group, indicating that there was no contamination in the control group. DISCUSSION The STEPSTONES transition program was effective in increasing patient empowerment, reducing parental involvement, improving satisfaction with physical appearance, and increasing disease-related knowledge.
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Affiliation(s)
- Ewa-Lena Bratt
- Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Children's Heart Center, Gothenburg, Sweden.
| | - Mariela Acuna Mora
- Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Academy of Caring Science, Work Life and Social Welfare, University of Borås, Sweden
| | - Carina Sparud-Lundin
- Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Markus Saarijärvi
- Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
| | - Åsa Burström
- Department of Neurobiology, Care Sciences and Society Karolinska Institutet, Stockholm, Sweden
| | - Sandra Skogby
- Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Paediatric Cardiology, The Queen Silvia Children's Hospital, Gothenburg, Sweden
| | - Eva Fernlund
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; Division of Paediatrics, Crown Princess Victoria Childreńs Hospital, Linköping University Hospital, Linköping, Sweden; Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, paediatric Cardiology, Lund, Sweden
| | - Shalan Fadl
- Department of Paediatrics, Örebro University Hospital, Örebro, Sweden
| | - Annika Rydberg
- Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | - Katarina Hanseus
- Children's Heart Centre, Skåne University Hospital Lund, Lund, Sweden
| | - Kalliopi Kazamia
- Children's Heart Centre Stockholm-Uppsala, Karolinska University Hospital and Akademiska University Hospital, Sweden; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Philip Moons
- Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; KU Leuven, Department of Public Health and Primary Care, Leuven, Belgium; Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
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3
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van Driessche A, Beernaert K, Deliens L, Kars MC, Lyon ME, Barrera M, Dussel V, Bidstrup P, Rosenberg AR, Akard TF, Cohen J, De Vleminck A. Recruitment and retention challenges and strategies in randomized controlled trials of psychosocial interventions for children with cancer and their parents: a collective case study. Eur J Pediatr 2023; 182:4683-4706. [PMID: 37561196 DOI: 10.1007/s00431-023-05139-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 07/18/2023] [Accepted: 07/26/2023] [Indexed: 08/11/2023]
Abstract
In pediatric oncology there are few examples of successful recruitment and retention strategies in psychosocial care research. This study aims to summarize experiences, challenges, and strategies for conducting randomized controlled trials (RCTs) of psychosocial intervention studies among children with cancer and their parent(s). We conducted a collective case study. To identify the cases, Pubmed and two trial registries were searched for ongoing and finished RCTs of psychosocial intervention studies for children with cancer and their parents. Online semi-structured expert interviews discussing recruitment and retention challenges and strategies were performed with principal investigators and research staff members of the identified cases. Nine studies were identified. Investigators and staff from seven studies participated, highlighting challenges and strategies within three major themes: eligibility, enrollment and retention. Regarding eligibility, collaborating constructively with healthcare professionals and involving them before the start of the study were essential. Being flexible, training the research staff, enabling alignment with the participants' situation, and providing consistency in contact between the research staff member and the families were important strategies for optimizing enrollment and retention. All studies followed a stepped process in recruitment. Conclusion: Although recruitment and retention in some selected studies were successful, there is a paucity of evidence on experienced recruitment and retention challenges in pediatric psychosocial research and best practices on optimizing them. The strategies outlined in this study can help researchers optimize their protocol and trial-implementation, and contribute to better psychosocial care for children with cancer and their parents. Trial Registration: This study is not a clinical trial. What is Known: • Performing RCTs is challenging, particularly in pediatric psychosocial research when both the child and parent are targeted. Recruitment and retention are common concerns. In pediatric oncology, there are few examples of successful recruitment and retention strategies in psychosocial care research. What is New: • Key strategies to collaborate constructively with healthcare professionals were outlined. Being flexible, training the research staff, alignment with the participant's situations and providing consistency in contact between the research staff member and the families were considered as essential strategies.
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Affiliation(s)
- Anne van Driessche
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Laarbeeklaan 103, 1090, Brussels, Belgium.
| | - Kim Beernaert
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Laarbeeklaan 103, 1090, Brussels, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), 1090, Brussels, Belgium
- Department of Public Health and Primary Care, Ghent University, 9000, Ghent, Belgium
| | - Luc Deliens
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Laarbeeklaan 103, 1090, Brussels, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), 1090, Brussels, Belgium
- Department of Public Health and Primary Care, Ghent University, 9000, Ghent, Belgium
| | - Marijke C Kars
- Center of Expertise Palliative Care Utrecht, Julius Center of Health and Primary Care, UMC Utrecht, Universiteitsweg 100, 3584, CG Utrecht, the Netherlands
| | - Maureen E Lyon
- Center for Translational Research, Children's National Hospital, 111 Michigan Avenue, Washington, NW, DC 20010-2970, USA
| | - Maru Barrera
- SickKids Hospital, Research Institute, Child Health and Evaluation Sciences, Toronto, ON, Canada
| | - Veronica Dussel
- Pediatric Palliative Care, Research Mass General for Children, Boston, USA
| | - Pernille Bidstrup
- Danish Cancer Society Research Center, Psychological Aspects of Cancer, Copenhagen, Denmark
| | - Abby R Rosenberg
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Pediatric Palliative Care, Boston Children's Hospital, Boston, MA, USA
- Division of Hematology/Oncology, Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Terrah F Akard
- Graduate School, Vanderbilt University, Nashville, TN, USA
| | - Joachim Cohen
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Laarbeeklaan 103, 1090, Brussels, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), 1090, Brussels, Belgium
| | - Aline De Vleminck
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Laarbeeklaan 103, 1090, Brussels, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), 1090, Brussels, Belgium
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Jong ST, Stevenson R, Winpenny EM, Corder K, van Sluijs EMF. Recruitment and retention into longitudinal health research from an adolescent perspective: a qualitative study. BMC Med Res Methodol 2023; 23:16. [PMID: 36647003 PMCID: PMC9841671 DOI: 10.1186/s12874-022-01802-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 11/23/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND High quality longitudinal studies investigating changes in health behaviours over the transition into early adulthood are critical. However, recruiting and retaining adolescents is challenging. This study explored adolescents' perspectives of signing up to and continuing involvement in a hypothetical longitudinal health research study. METHODS Forty-eight individuals (15-20y) participated in nine in-person focus groups about recruitment and retention in research. Participants were (a) school students in the last year of compulsory school (Year 11, 15-16y), (b) school/college students in Sixth Form (Year 13, 17-18y), (c) Further Education students studying after secondary education, but not higher education (16-18y) and (d) young adults not in education, employment, or training (18-20y) across England. Thematic analysis resulted in seven themes. RESULTS Driving factors for sign-up included social connection e.g., joining with peer groups, personalised feedback, and incentives, primarily financial. Key barriers were lack of interest, the perception of commitment, and timing of recruitment. Young people preferred recruitment processes via social media with messages tailored to their motivations, monthly data collection of maximally 20-30 min, and hybrid data collection with some in-person contact with a consistent, non-judgemental researcher. The provision of autonomy, choice, and financial incentives were perceived to promote retention. CONCLUSIONS Adolescent recruitment and retention strategies need to align with contemporary interests and motivations. Studies should involve adolescents early to develop a planned, systematic approach to participant sign-up and follow-up. Effective and ineffective recruitment and retention strategies should be reported as part of study findings. Future research should trial how perceived barriers to study engagement can be overcome.
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Affiliation(s)
- Stephanie T. Jong
- grid.470900.a0000 0004 0369 9638UKCRC Centre for Diet and Activity Research (CEDAR) at the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Box 285, Cambridge, United Kingdom ,grid.8273.e0000 0001 1092 7967School of Health Sciences, University of East Anglia, Norwich, United Kingdom
| | - Rebecca Stevenson
- grid.470900.a0000 0004 0369 9638UKCRC Centre for Diet and Activity Research (CEDAR) at the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Box 285, Cambridge, United Kingdom
| | - Eleanor M. Winpenny
- grid.470900.a0000 0004 0369 9638UKCRC Centre for Diet and Activity Research (CEDAR) at the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Box 285, Cambridge, United Kingdom
| | - Kirsten Corder
- grid.470900.a0000 0004 0369 9638UKCRC Centre for Diet and Activity Research (CEDAR) at the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Box 285, Cambridge, United Kingdom
| | - Esther M. F. van Sluijs
- grid.470900.a0000 0004 0369 9638UKCRC Centre for Diet and Activity Research (CEDAR) at the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Box 285, Cambridge, United Kingdom
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Marker AM, Patton SR, Clements MA, Egan AE, McDonough RJ. Adjusted Cutoff Scores Increase Sensitivity of Depression Screening Measures in Adolescents With Type 1 Diabetes. Diabetes Care 2022; 45:2501-2508. [PMID: 35984419 DOI: 10.2337/dc22-0275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 07/28/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To measure the acceptability and diagnostic accuracy of commonly used depression screening measures to determine ideal cutoff scores that sensitively identify depressive disorders in adolescents with type 1 diabetes (T1D). RESEARCH DESIGN AND METHODS One hundred adolescents (12-17 years old) completed a reference standard, semistructured diagnostic interview and both long and short versions of five commonly used depression screening measures in the United States. To assess feasibility and acceptability, we used screener completion time and participant ratings, respectively. We used descriptive statistics, area under the receiver operating characteristic (ROC) curve analyses, and paired-sample area differences under the ROC curve to assess each measure's diagnostic validity against our reference standard and to determine ideal cutoff scores for this sample. RESULTS Adolescents had a mean age of 15.0 ± 1.7 years, time since T1D diagnosis of 6.0 ± 4.1 years, and glycated hemoglobin (HbA1c) of 8.9 ± 1.8%. Sixty percent of adolescents were male, 15% endorsed a current depressive disorder, and 15% endorsed lifetime suicidality. Measures demonstrated low sensitivity (0.33-0.67) to detect current depressive disorders using preexisting cutoff scores. However, adjusted cutoff scores increased sensitivity and reduced false negatives. All depression screening measures demonstrated "good" to "excellent" predictive validity, and the Children's Depression Inventory-2 Short version demonstrated significantly greater diagnostic accuracy than the Patient Health Questionnare-2 item version for adolescents. CONCLUSIONS Clinics should consider using screening measures with the greatest diagnostic accuracy as identified in this study and adjusting measure cutoff scores to increase sensitivity and reduce false negatives.
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Affiliation(s)
| | | | | | - Anna E Egan
- Children's Mercy-Kansas City, Kansas City, MO
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Saarijärvi M, Wallin L, Moons P, Gyllensten H, Bratt EL. Implementation fidelity of a transition program for adolescents with congenital heart disease: the STEPSTONES project. BMC Health Serv Res 2022; 22:153. [PMID: 35123454 PMCID: PMC8817652 DOI: 10.1186/s12913-022-07549-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 01/25/2022] [Indexed: 11/14/2022] Open
Abstract
Background Although transition programs have been evaluated for adolescents with chronic conditions, these have rarely involved process evaluations. Indeed, outcomes of complex interventions are dependent on how the intervention is implemented in practice and evaluations of implementation process are therefore pivotal. The aim of this study was to evaluate the extent to which a transition program for adolescents with congenital heart disease was delivered as intended. Research questions were 1) to what level of fidelity was the program delivered? and 2) what potential moderating factors affected the delivery of the program and overall fidelity? Methods A mixed methods design was used, where a process evaluation was embedded in the STEPSTONES randomized controlled trial in Sweden. The implementation fidelity framework by Carrol (2007) and Hasson (2010) was used to design, collect and analyze data. Quantitative data consisted of intervention records on adherence and were analyzed with descriptive statistics. Qualitative data on moderators affecting fidelity were collected through interviews, log-books and focus group interviews with healthcare professionals implementing the intervention and participatory observations of the implementation process. Data were analyzed with deductive content analysis. Triangulation was used to integrate quantitative and qualitative data within the fidelity framework. Results Six out of eight components of the transition program were delivered to an extent that adhered to the program theory or achieved a high level of fidelity. However, components involving peer support had a low attendance by the participating sample (32.2%), and the joint transfer meeting was challenging to implement, despite achieving high adherence. Moderators affecting the implementation process were the adolescent’s and healthcare professional’s engagement in the intervention, contextual factors and a lack of standard operating procedures for all components in the program. Conclusion Barriers and facilitators for a future implementation of transition programs have been illuminated in this study. The use of an implementation fidelity framework in the process evaluation proved successful in providing a comprehensive evaluation of factors affecting the implementation process. However, implementation fidelity must be considered in relation to adaptations to the local and personal prerequisites in order to create interventions that can achieve fit. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07549-7.
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Ahrnberg H, Appelqvist-Schmidlechner K, Mustonen P, Fröjd S, Aktan-Collan K. Evaluating the efficacy of a school-based Finnish Gutsy Go programme in enhancing adolescents' positive mental health, experience of social inclusion, and social competence. J Child Adolesc Ment Health 2022; 34:53-69. [PMID: 38504653 DOI: 10.2989/17280583.2023.2277770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
Background: The Finnish Gutsy Go programme is a positive youth development intervention designed to enhance adolescents' psychosocial well-being by enabling eighth-grade students to develop and execute good deeds within the community.Objective: This study aimed to explore the effect of the Gutsy Go programme on adolescents' positive mental health, experience of social inclusion, and social competence using a quasi-experimental study design.Methods: Data were collected with electronic questionnaires at baseline (n = 236 programme participants and n = 303 controls) and follow-up two weeks after the programme (n = 126, 54.2% programme participants and n = 103, 34.1% controls). Analyses included paired samples t-tests and mixed ANOVA analyses.Results: A statistically significant intragroup change across time was detected in the level of cooperation skills among programme participants (t(127) = -2.460, p = 0.015) but not among controls (t(102) = 1.088, p = 0.279). Statistically significant main effects were found for the intervention group on the experience of social inclusion (F(1, 1) = 9.34, p = 0.003, ηp2 = 0.040), cooperation skills (F(1,1) = 5.28, p = 0.020, ηp2 = 0.020), and empathy (F(1,1) = 6.44, p = 0.010, ηp2 = 0.030) across time.Conclusion: The Gutsy Go programme could be beneficial in improving adolescents' experience of social inclusion, cooperation skills, and empathy. More studies are needed to address the effects of the programme more firmly.
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Affiliation(s)
- Hanna Ahrnberg
- The Finnish Medical Society, Helsinki, Finland
- Department of Adolescent Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
| | | | | | - Sari Fröjd
- Health Sciences Unit, Tampere University, Tampere, Finland
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Lewis KA, Brooks S, Carrasco R, Carter P, Garcia A, Chiou J, Nguyen C, Rana A, Brown SA, Tiziani S, Osier N. Best practices for recruitment of adolescents for biobanking and precision health research: a retrospective analysis comparing juvenile idiopathic arthritis cases with healthy controls. Pediatr Rheumatol Online J 2021; 19:169. [PMID: 34863185 PMCID: PMC8645089 DOI: 10.1186/s12969-021-00652-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 11/16/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Precision health in adolescents relies on the successful collection of data and biospecimens from an adequately sized sample of cases and comparison group(s), often healthy controls, to answer the research question. This research report describes the recruitment strategy, enrollment rates, and approach utilized in a successful biobehavioral research study. The study was designed to examine key health indicators in adolescents (13-17 years of age) with juvenile idiopathic arthritis (JIA) compared to a control group of healthy adolescents. The purpose of this analysis is to establish best practices and identify strategies to overcome barriers to recruitment of older adolescents, an age group that tends to be underrepresented in research studies. METHODS A retrospective secondary analysis of data from a parent study about JIA with high consent rates was employed to explore factors affecting enrollment into the biobehavioral study. RESULTS Of the 113 subjects who were recruited to the study, 74 met the eligibility criteria and reviewed the consent form. The consented group (n=40) represents 54% of those who were eligible upon initial screening. The rate of project enrollment was 2.7 participants per month. The pediatric rheumatologists referred 85% of the JIA group, and the study's principal investigator, a nurse scientist, referred 95% of the control group. Typical recruitment strategies, such as posting on social media, distributing flyers, and cold-calling potential participants from the clinic schedule were ineffective for both cases and controls. Barriers to enrollment included scheduling and fear of venipuncture. There were no demographic characteristics that significantly explained enrollment, differentiating between those who agreed to participate compared to those who refused. Successful strategies for enrollment of adolescents into this biobehavioral research study included scheduling study visits on weekends and school holidays; an informed consent and assent process that addressed adolescent fears of venipuncture; including a JIA patient on the study team; and utilizing existing relationships to maximize enrollment efforts. CONCLUSIONS Effective recruitment and enrollment practices were relationship-specific and patient-centered. Researchers should utilize best practices to ensure that precision health for adolescents is advanced.
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Affiliation(s)
- Kimberly A. Lewis
- grid.266102.10000 0001 2297 6811Department of Physiological Nursing, School of Nursing, University of California at San Francisco, 2 Koret Way, 94143 San Francisco, CA USA ,grid.89336.370000 0004 1936 9924School of Nursing, The University of Texas at Austin, 1710 Red River St, 78712 Austin, TX USA ,grid.413578.c0000 0004 0637 322XDell Children’s Medical Center of Central Texas, 4900 Mueller Blvd, 78723 Austin, TX USA ,grid.266102.10000 0001 2297 6811Department of Physiological Nursing, University of California, San Francisco, 2 Koret Way, CA 94131 San Francisco, USA
| | - Shelby Brooks
- grid.89336.370000 0004 1936 9924School of Nursing, The University of Texas at Austin, 1710 Red River St, 78712 Austin, TX USA ,grid.413578.c0000 0004 0637 322XDell Children’s Medical Center of Central Texas, 4900 Mueller Blvd, 78723 Austin, TX USA
| | - Ruy Carrasco
- grid.264756.40000 0004 4687 2082Texas A&M University, 400 Bizzell St.,, TX 77843 College Station, USA
| | - Patricia Carter
- grid.411015.00000 0001 0727 7545Capstone College of Nursing, University of Alabama, 650 University Blvd E, 35401 Tuscaloosa, AL USA
| | - Alexandra Garcia
- grid.89336.370000 0004 1936 9924School of Nursing, The University of Texas at Austin, 1710 Red River St, 78712 Austin, TX USA
| | - Jennifer Chiou
- grid.89336.370000 0004 1936 9924Department of Nutritional Sciences, College of Natural Sciences, The University of Texas at Austin, Austin, TX USA
| | - Christina Nguyen
- grid.413578.c0000 0004 0637 322XDell Children’s Medical Center of Central Texas, 4900 Mueller Blvd, 78723 Austin, TX USA
| | - Ambreen Rana
- grid.413578.c0000 0004 0637 322XDell Children’s Medical Center of Central Texas, 4900 Mueller Blvd, 78723 Austin, TX USA
| | - Sharon A. Brown
- grid.89336.370000 0004 1936 9924School of Nursing, The University of Texas at Austin, 1710 Red River St, 78712 Austin, TX USA
| | - Stefano Tiziani
- grid.89336.370000 0004 1936 9924Department of Nutritional Sciences, College of Natural Sciences, The University of Texas at Austin, Austin, TX USA
| | - Nico Osier
- grid.89336.370000 0004 1936 9924School of Nursing, The University of Texas at Austin, 1710 Red River St, 78712 Austin, TX USA ,grid.89336.370000 0004 1936 9924Department of Neurology, Dell Medical School, The University of Texas at Austin, Austin, TX USA
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Saarijärvi M, Wallin L, Moons P, Gyllensten H, Bratt EL. Mechanisms of impact and experiences of a person-centred transition programme for adolescents with CHD: the Stepstones project. BMC Health Serv Res 2021; 21:573. [PMID: 34112174 PMCID: PMC8194131 DOI: 10.1186/s12913-021-06567-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 05/21/2021] [Indexed: 01/10/2023] Open
Abstract
Background During the past decade there has been some evaluation of transition programmes for adolescents with chronic conditions. However, this has rarely involved process evaluations focusing on mechanisms leading to outcomes, thus hampering implementation of these complex interventions. Our aim was to (I) describe adolescents’ and parents’ experiences of participating in a person-centred transition programme aiming to empower them in transition to adulthood and (II) explore the mechanisms of impact. Methods A qualitative process evaluation was performed, embedded in a randomized controlled trial evaluating the effectiveness of a transition programme for adolescents with congenital heart disease in Sweden. A purposive sample of 14 adolescents and 12 parents randomized to the intervention group were interviewed after participation in the programme. Data were analysed deductively and inductively in NVivo v12. Results Experiences of participation in the transition programme were generally positive. Meeting a transition coordinator trained in person-centred care and adolescent health and embarking on an educational process based on the adolescents’ prerequisites in combination with peer support were considered key change mechanisms. However, support to parents were not sufficient for some participants, resulting in ambivalence about changing roles and the unmet needs of parents who required additional support. Conclusions Participants experienced increased empowerment in several dimensions of this construct, thus demonstrating that the transition programme was largely implemented as intended and the evidence-based behaviour-change techniques used proved effective in reaching the outcome. These findings can inform future implementation of transition programmes and illuminate challenges associated with delivering a complex intervention for adolescents with chronic conditions. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06567-1.
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Affiliation(s)
- Markus Saarijärvi
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden. .,Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
| | - Lars Wallin
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.,School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Philip Moons
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.,Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.,Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | - Hanna Gyllensten
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ewa-Lena Bratt
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.,Department of Pediatric Cardiology, The Queen Silvia Children's Hospital, Gothenburg, Sweden
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Saarijärvi M, Bratt EL. When face-to-face interviews are not possible: tips and tricks for video, telephone, online chat, and email interviews in qualitative research. Eur J Cardiovasc Nurs 2021; 20:392-396. [PMID: 33893797 PMCID: PMC8135391 DOI: 10.1093/eurjcn/zvab038] [Citation(s) in RCA: 101] [Impact Index Per Article: 33.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 03/26/2021] [Indexed: 11/13/2022]
Abstract
Face-to-face interviews have long been the norm for conducting qualitative interviews in healthcare research. However, the Covid-19 pandemic has accelerated the need to explore alternative methods. This, along with the swift digitalization of healthcare, has led to video, telephone, and online interactions becoming increasingly used. The use of new techniques to carry out interviews through video, telephone, and online applications all come with benefits and drawbacks. In this article, three ways of collecting data through qualitative interviews are described and their uses exemplified through a project investigating the impact of a transition program for adolescents with congenital heart disease.
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Affiliation(s)
- Markus Saarijärvi
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Ewa-Lena Bratt
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Pediatric Cardiology, Queen Silvia’s Childreńs Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
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