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Jacobs P, Power L, Davidson G, Devaney J, McCartan C, McCusker P, Jenkins R. A Scoping Review of Mental Health and Wellbeing Outcome Measures for Children and Young People: Implications for Children in Out-of-home Care. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2024; 17:159-185. [PMID: 38938951 PMCID: PMC11199430 DOI: 10.1007/s40653-023-00566-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/11/2023] [Indexed: 06/29/2024]
Abstract
Purpose One of the challenges for mental health research is the lack of an agreed set of outcome measures that are used routinely and consistently between disciplines and across studies in order to build a more robust evidence base for how to better understand young people's mental health and effectively address diverse needs. Methods This study involved a scoping review of reviews on consensus of the use of mental health and wellbeing measures with children and young people. We were particularly interested to identify if there are differences in measures that are recommended for children and young people with care experience including those with developmental disabilities. Findings We identified 41 reviews, of which two had a focus on child welfare settings, three on childhood trauma and 14 focused on children and young people with developmental disabilities. Overall, our review highlights a lack of consensus and a diversity of measures within the field. We identified 60 recommended measures, of which only nine were recommended by more than one review. Conclusions Our review highlights the need for greater agreement in the use of mental health outcome measures. While our review highlights that there is value in identifying measures that can be used with any child or young person, researchers need to take into account additional considerations when working with children and young people with care experience and those with developmental disabilities, to ensure measures are accessible and sensitive to their life experiences.
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Affiliation(s)
- Paula Jacobs
- Faculty of Social Sciences, Social Work, University of Stirling, Colin Bell Building, Stirling, UK
| | - Luke Power
- School of Social and Political Science, University of Edinburgh, Edinburgh, UK
| | - Gavin Davidson
- School of Social Sciences, Education and Social Work, Queen’s University Belfast, Belfast, UK
| | - John Devaney
- School of Social and Political Science, University of Edinburgh, Edinburgh, UK
| | - Claire McCartan
- School of Social Sciences, Education and Social Work, Queen’s University Belfast, Belfast, UK
| | - Pearse McCusker
- School of Social and Political Science, University of Edinburgh, Edinburgh, UK
| | - Ruth Jenkins
- Academic Support Librarian, University of Edinburgh, Edinburgh, UK
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Joshi D, Nayagam J, Clay L, Yerlett J, Claridge L, Day J, Ferguson J, Mckie P, Vara R, Pargeter H, Lockyer R, Jones R, Heneghan M, Samyn M. UK guideline on the transition and management of childhood liver diseases in adulthood. Aliment Pharmacol Ther 2024; 59:812-842. [PMID: 38385884 DOI: 10.1111/apt.17904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/15/2023] [Accepted: 02/03/2024] [Indexed: 02/23/2024]
Abstract
INTRODUCTION Improved outcomes of liver disease in childhood and young adulthood have resulted in an increasing number of young adults (YA) entering adult liver services. The adult hepatologist therefore requires a working knowledge in diseases that arise almost exclusively in children and their complications in adulthood. AIMS To provide adult hepatologists with succinct guidelines on aspects of transitional care in YA relevant to key disease aetiologies encountered in clinical practice. METHODS A systematic literature search was undertaken using the Pubmed, Medline, Web of Knowledge and Cochrane database from 1980 to 2023. MeSH search terms relating to liver diseases ('cholestatic liver diseases', 'biliary atresia', 'metabolic', 'paediatric liver diseases', 'autoimmune liver diseases'), transition to adult care ('transition services', 'young adult services') and adolescent care were used. The quality of evidence and the grading of recommendations were appraised using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. RESULTS These guidelines deal with the transition of YA and address key aetiologies for the adult hepatologist under the following headings: (1) Models and provision of care; (2) screening and management of mental health disorders; (3) aetiologies; (4) timing and role of liver transplantation; and (5) sexual health and fertility. CONCLUSIONS These are the first nationally developed guidelines on the transition and management of childhood liver diseases in adulthood. They provide a framework upon which to base clinical care, which we envisage will lead to improved outcomes for YA with chronic liver disease.
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Affiliation(s)
- Deepak Joshi
- Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, UK
| | - Jeremy Nayagam
- Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, UK
| | - Lisa Clay
- Paediatric Liver, GI and Nutrition service, King's College Hospital NHS Foundation Trust, London, UK
| | - Jenny Yerlett
- Paediatric Liver, GI and Nutrition service, King's College Hospital NHS Foundation Trust, London, UK
| | - Lee Claridge
- Leeds Liver Unit, St James's University Hospital, Leeds, UK
| | - Jemma Day
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - James Ferguson
- National Institute for Health Research, Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK
| | - Paul Mckie
- Department of Social Work, King's College Hospital NHS Foundation Trust, London, UK
| | - Roshni Vara
- Paediatric Liver, GI and Nutrition service, King's College Hospital NHS Foundation Trust, London, UK
- Evelina London Children's Hospital, London, UK
| | | | | | - Rebecca Jones
- Leeds Liver Unit, St James's University Hospital, Leeds, UK
| | - Michael Heneghan
- Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, UK
| | - Marianne Samyn
- Paediatric Liver, GI and Nutrition service, King's College Hospital NHS Foundation Trust, London, UK
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Krane V, Kaasbøll J, Kaspersen SL, Ådnanes M. 'It's not like real therapy': young people receiving child welfare services' experiences of video consultations in mental healthcare in Norway: a mixed methods approach. BMC Health Serv Res 2023; 23:949. [PMID: 37670314 PMCID: PMC10481608 DOI: 10.1186/s12913-023-09939-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 08/18/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND Video consultations has been suggested to lower the threshold for child and adolescent mental healthcare treatment. This study explores how young people receiving child welfare services experience video consultations in child and adolescent mental healthcare. The study is part of a larger Norwegian study of access to health services for this target group. METHODS The study has a mixed methods design including qualitative interviews and a quantitative survey, with young people receiving child welfare services. The qualitative interviews included 10 participants aged 15-19. The survey included 232 participants aged 16-24 of which 36 reported having received video consultations in mental healthcare. The interviews were analysed using thematic analysis. The survey data was presented as frequencies to clarify the distribution of positive and negative perceptions of video consultation. RESULTS The results show that the participants experienced video consultations as more superficial and less binding, compared to in-person sessions. They raised concerns of the therapeutic relationship, however some found it easier to regulate closeness and distance. In the survey several reported that their relationship with the therapist got worse, and that it was much more difficult to talk on screen. Moreover, a large proportion (42%) claimed that video consultations did not fit their treatment needs overall. However, a minority of the participants found it easier to talk to the therapist on screen. CONCLUSIONS The study reveals important weaknesses and disadvantages of online therapy as experienced by young people receiving child welfare services. It is particularly worrying that their criticism involves the relational aspects of treatment, as children receiving child welfare services often have relational experiences which make them particularly sensitive to challenges in relationships. This study shows that youth involvement in decision making of video consultations in therapy has been rare. Clinicians should be aware of these young people's doubts regarding the quality of video consultations in child and adolescent mental health care. Further studies should examine how user involvement can be incorporated in video consultations in therapy and how this could improve experiences and the quality of video consultations.
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Affiliation(s)
- Vibeke Krane
- Faculty of Health and Social Sciences, Department of Health, Social and Welfare Studies, University of South-Eastern Norway, Drammen, 3007, Norway.
| | - Jannike Kaasbøll
- Department of Mental Health, Faculty of Medicine and Health Sciences, Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Norwegian University of Science and Technology, Trondheim, Norway
- Department of Health Research, SINTEF Digital, Trondheim, Norway
| | | | - Marian Ådnanes
- Department of Health Research, SINTEF Digital, Trondheim, Norway
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Virk P, Arora R, Burt H, Finnamore C, Gadermann A, Barbic S, Doan Q. Evaluating the Psychometric Properties and Clinical Utility of a Digital Psychosocial Self-Screening Tool (HEARTSMAP-U) for Postsecondary Students: Prospective Cohort Study. JMIR Ment Health 2023; 10:e48709. [PMID: 37556180 PMCID: PMC10448294 DOI: 10.2196/48709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/08/2023] [Accepted: 06/11/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Existing screening tools for mental health issues among postsecondary students have several challenges, including a lack of standardization and codevelopment by students. HEARTSMAP-U was adapted to address these issues. OBJECTIVE This study aimed to evaluate the suitability of HEARTSMAP-U as a self-screening tool for psychosocial issues among postsecondary students by evaluating its validity evidence and clinical utility. METHODS A prospective cohort study was conducted with University of British Columbia Vancouver students to evaluate HEARTSMAP-U's predictive validity and convergent validity. Participating students completed baseline and 3-month follow-up assessments via HEARTSMAP-U and a clinician-administered interview. RESULTS In a diverse student sample (n=100), HEARTSMAP-U demonstrated high sensitivity (95%-100%) in identifying any psychiatric concerns that were flagged by a research clinician, with lower specificity (21%-25%). Strong convergent validity (r=0.54-0.68) was demonstrated when relevant domains and sections of HEARTSMAP-U were compared with those of other conceptually similar instruments. CONCLUSIONS This preliminary evaluation suggests that HEARTSMAP-U may be suitable for screening in the postsecondary educational setting. However, a larger-scale evaluation is necessary to confirm and expand on these findings.
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Affiliation(s)
- Punit Virk
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Ravia Arora
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Heather Burt
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | | | - Anne Gadermann
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
- Centre for Health Evaluation and Outcome Sciences, Providence Health, Vancouver, BC, Canada
| | - Skye Barbic
- Centre for Health Evaluation and Outcome Sciences, Providence Health, Vancouver, BC, Canada
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Quynh Doan
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
- Department of Paediatrics, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
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Waller D, Bailey S, Zolfaghari E, Ho J, Feuerlicht D, Ross K, Steinbeck K. Psychosocial assessment of adolescents and young adults in paediatric hospital settings: patient and staff perspectives on implementation of the e-HEEADSSS. BMC Health Serv Res 2023; 23:683. [PMID: 37349759 DOI: 10.1186/s12913-023-09621-2] [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: 02/17/2023] [Accepted: 05/30/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND The main causes of morbidity and mortality for adolescents and young adults are preventable and stem from psychosocial and behavioural concerns. Psychosocial assessments can help clinicians to identify and respond holistically to risks and strengths that may impact upon a young person's physical and mental health. Despite broad support at a policy level, the implementation of routine psychosocial screening for young people remains varied in Australian health settings. The current study focused on the pilot implementation of a digital patient-completed psychosocial assessment (the e-HEEADSSS) at the Sydney Children's Hospital Network. The aim of this research was to evaluate patient and staff barriers and facilitators to local implementation. METHODS The research used a qualitative descriptive research design. Semi-structured interviews were conducted online with 8 young patients and 8 staff members who had completed or actioned an e-HEEADSSS assessment within the prior 5 weeks. Qualitative coding of interview transcripts was carried out in NVivo 12. The Consolidated Framework for Implementation Research guided the interview framework and qualitative analyses. RESULTS Results demonstrated strong support for the e-HEEADSSS from patients and staff. Key reported facilitators included strong design and functionality, reduced time requirements, greater convenience, improved disclosure, adaptability across settings, greater perceived privacy, improved fidelity, and reduced stigma for young people. The key barriers were related to concerns over available resources, the sustainability and continuity of staff training, perceived availability of clinical pathways for follow-up and referrals, and risks related to off-site completions. Clinicians need to adequately explain the e-HEEADSSS assessment to patients, educate them about it, and make sure that they receive timely feedback on the results. Greater reassurance and education regarding the rigour of confidentiality and data handling procedures is required for patients and staff. CONCLUSIONS Our findings indicate that continued work is required to support the integration and sustainability of digital psychosocial assessments for young people at the Sydney Children's Hospital Network. The e-HEEADSSS shows promise as an implementable intervention to achieve this goal. Further research is required to determine the scalability of this intervention across the broader health system.
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Affiliation(s)
- Daniel Waller
- Sydney Children's Hospitals Network, Sydney, Australia.
- The University of Sydney, Sydney, Australia.
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2006, Australia.
| | | | | | - Jane Ho
- Sydney Children's Hospitals Network, Sydney, Australia
- The University of Sydney, Sydney, Australia
| | | | - Kirsty Ross
- Sydney Children's Hospitals Network, Sydney, Australia
- The University of Sydney, Sydney, Australia
| | - Katharine Steinbeck
- Sydney Children's Hospitals Network, Sydney, Australia
- The University of Sydney, Sydney, Australia
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Calvo V, Masaro C, Fusco C, Pellicelli C, Ghedin S, Marogna C. Eudaimonic Well-Being of Italian Young Adults during the COVID-19 Pandemic: Predictive and Mediating Roles of Fear of Death and Psychological Inflexibility. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5960. [PMID: 37297564 PMCID: PMC10252345 DOI: 10.3390/ijerph20115960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/17/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023]
Abstract
The literature has widely acknowledged the impact of the COVID-19 pandemic on the mental health of young adults. Despite extensive research, eudaimonic well-being, which focuses on self-knowledge and self-realization, has been scarcely investigated. This cross-sectional study aimed to add knowledge on the eudaimonic well-being of young adults one year after the outbreak of the COVID-19 pandemic, verifying its potential linkages with fear of death and psychological inflexibility. A total of 317 young Italian adults (18-34 years), recruited through a chain sampling method, completed measures of psychological inflexibility, fear of death, and eudaimonic well-being included in an online survey. The study's hypotheses were tested with multivariate multiple regression and mediational analyses. Results showed that psychological inflexibility was negatively associated with all the dimensions of well-being, while fear of the death of others was associated with autonomy, environmental mastery, and self-acceptance. Furthermore, in the association between fear of death and well-being, the mediation role of psychological inflexibility was verified. These results contribute to the extant literature on the factors associated with eudaimonic well-being, providing clinical insights into the work with young adults within challenging times.
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Affiliation(s)
- Vincenzo Calvo
- Department of Philosophy, Sociology, Pedagogy, and Applied Psychology, University of Padova, 35131 Padua, Italy
| | - Chiara Masaro
- Department of Philosophy, Sociology, Pedagogy, and Applied Psychology, University of Padova, 35131 Padua, Italy
| | - Chiara Fusco
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy
| | - Camilla Pellicelli
- Department of Philosophy, Sociology, Pedagogy, and Applied Psychology, University of Padova, 35131 Padua, Italy
| | - Simona Ghedin
- Servizio per le Dipendenze ASL Roma 6, 00041 Anzio, Italy
| | - Cristina Marogna
- Department of Philosophy, Sociology, Pedagogy, and Applied Psychology, University of Padova, 35131 Padua, Italy
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Black L, Panayiotou M, Humphrey N. Measuring general mental health in early-mid adolescence: A systematic meta-review of content and psychometrics. JCPP ADVANCES 2023; 3:e12125. [PMID: 37431313 PMCID: PMC10241476 DOI: 10.1002/jcv2.12125] [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: 12/08/2021] [Accepted: 10/07/2022] [Indexed: 12/25/2022] Open
Abstract
Background Adolescent mental health is a major concern and brief general self-report measures can facilitate insight into intervention response and epidemiology via large samples. However, measures' relative content and psychometrics are unclear. Method A systematic search of systematic reviews was conducted to identify relevant measures. We searched PsycINFO, MEDLINE, EMBASE, COSMIN, Web of Science, and Google Scholar. Theoretical domains were described, and item content was coded and analysed, including via the Jaccard index to determine measure similarity. Psychometric properties were extracted and rated using the COSMIN system. Results We identified 22 measures from 19 reviews, which considered general mental health (GMH) (positive and negative aspects together), life satisfaction, quality of life (mental health subscales only), symptoms, and wellbeing. Measures were often classified inconsistently within domains at the review level. Only 25 unique indicators were found and several indicators were found across the majority of measures and domains. Most measure pairs had low Jaccard indexes, but 6.06% of measure pairs had >50% similarity (most across two domains). Measures consistently tapped mostly emotional content but tended to show thematic heterogeneity (included more than one of emotional, cognitive, behavioural, physical and social themes). Psychometric quality was generally low. Conclusions Brief adolescent GMH measures have not been developed to sufficient standards, likely limiting robust inferences. Researchers and practitioners should attend carefully to specific items included, particularly when deploying multiple measures. Key considerations, more promising measures, and future directions are highlighted. PROSPERO registration: CRD42020184350 https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020184350.
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Bellairs-Walsh I, Byrne SJ, Bendall S, Perry Y, Krysinska K, Lin A, Michail M, Lamblin M, Li TY, Hetrick S, Robinson J. Working with Young People at Risk of Suicidal Behaviour and Self-Harm: A Qualitative Study of Australian General Practitioners' Perspectives. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12926. [PMID: 34948536 PMCID: PMC8701929 DOI: 10.3390/ijerph182412926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/03/2021] [Accepted: 12/04/2021] [Indexed: 11/25/2022]
Abstract
General Practitioners (GPs) play a crucial role in the identification and support of young people at risk of suicidal behaviour and self-harm; however, no studies have explored GPs' perspectives, approaches, challenges, and resource needs when working with this cohort in an Australian setting. This was a qualitative study where fifteen GPs (Mage = 45.25 years) from multiple clinics in Western Australia took part in semi-structured interviews, and data were analysed thematically. Seven main themes were identified: (1) working with young people has its unique challenges; (2) screening and assessment tools can help to manage uncertainty and discomfort; (3) going beyond tools-the dialogue and relationship are most important; (4) there are limits to what we can offer in the time available; (5) the service access and referral pathways lack clarity and coordination; (6) the provision of mental health support should not fall on GPs alone; and (7) more comprehensive training in suicide and self-harm is needed. The findings highlight a number of opportunities to enhance care and better assist GPs working with young people who present with suicidal behaviour and self-harm, including considerations for conducting assessments, targeted resources such as training, and system and service improvements.
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Affiliation(s)
- India Bellairs-Walsh
- Orygen, Parkville, VIC 3052, Australia; (S.J.B.); (S.B.); (K.K.); (M.L.); (T.Y.L.); (J.R.)
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3010, Australia;
| | - Sadhbh J. Byrne
- Orygen, Parkville, VIC 3052, Australia; (S.J.B.); (S.B.); (K.K.); (M.L.); (T.Y.L.); (J.R.)
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3010, Australia;
- Centre for Global Health, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Sarah Bendall
- Orygen, Parkville, VIC 3052, Australia; (S.J.B.); (S.B.); (K.K.); (M.L.); (T.Y.L.); (J.R.)
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3010, Australia;
| | - Yael Perry
- Telethon Kids Institute, Perth Children’s Hospital, Nedlands, WA 6009, Australia; (Y.P.); (A.L.)
| | - Karolina Krysinska
- Orygen, Parkville, VIC 3052, Australia; (S.J.B.); (S.B.); (K.K.); (M.L.); (T.Y.L.); (J.R.)
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3010, Australia;
- Centre for Mental Health, School of Population and Global Health, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Ashleigh Lin
- Telethon Kids Institute, Perth Children’s Hospital, Nedlands, WA 6009, Australia; (Y.P.); (A.L.)
| | - Maria Michail
- School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham B15 2TT, UK;
| | - Michelle Lamblin
- Orygen, Parkville, VIC 3052, Australia; (S.J.B.); (S.B.); (K.K.); (M.L.); (T.Y.L.); (J.R.)
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3010, Australia;
| | - Tina Yutong Li
- Orygen, Parkville, VIC 3052, Australia; (S.J.B.); (S.B.); (K.K.); (M.L.); (T.Y.L.); (J.R.)
- Townsville University Hospital, Douglas, QLD 4814, Australia
| | - Sarah Hetrick
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3010, Australia;
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1010, New Zealand
| | - Jo Robinson
- Orygen, Parkville, VIC 3052, Australia; (S.J.B.); (S.B.); (K.K.); (M.L.); (T.Y.L.); (J.R.)
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC 3010, Australia;
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Hanmer J, Ray KN, McCracken P, Ferrante L, Wardlaw S, Fleischman L, Wolfson D. Uptake of an Integrated Electronic Questionnaire System in Community Pediatric Clinics. Appl Clin Inform 2021; 12:310-319. [PMID: 33853141 DOI: 10.1055/s-0041-1727198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE The study aimed to evaluate an integrated electronic questionnaire system implementation in outpatient community pediatric practices on workflow, completion rates, and recorded scores. METHODS We evaluated the implementation and outcomes of an integrated electronic questionnaire system at 45 community pediatric practices that used standardized questionnaires to screen for autism, depression, and substance use and to measure asthma control. Electronic health record (EHR) data for all well child visits were extracted for the 3 months before and after implementation. We used statistical process control charts to evaluate questionnaire completion rates and Chi-square tests to evaluate screening completion and positive screening rates. The collection and entry of questionnaire information was observed and timed. RESULTS EHR data included 107,120 encounters across 45 practices that showed significant and sustained improvement in completion rates for all questionnaires. The rate of recorded concerning questionnaires decreased for asthma control (19.3 vs. 12.8%, p < 0.001), stayed the same for autism (96.6 vs. 96.2%, p = 0.38), decreased for depression (9.5 vs. 6.7%, p ≤ 0.001), and increased for any substance use (9.8 vs. 12.8%, p < 0.001). Twelve practices were observed, and patient time and staff time managing questionnaires were decreased after implementation. DISCUSSION Electronic questionnaire administration saved staff time and patient time. We report overall improvement in questionnaire completion rates, with notable variation in improvement in completion across practices and in change in concerning recorded result rates across measures. CONCLUSION Conversion of four standard paper questionnaires to an integrated electronic system reduces patient and staff time while increasing completion rates when well integrated into routine care.
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Affiliation(s)
- Janel Hanmer
- Department of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Kristin N Ray
- Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Polly McCracken
- Department of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Lorraine Ferrante
- UPMC Children's Community Pediatrics, Pittsburgh, Pennsylvania, United States
| | - Sharon Wardlaw
- UPMC Children's Community Pediatrics, Pittsburgh, Pennsylvania, United States
| | - Lauren Fleischman
- UPMC Children's Community Pediatrics, Pittsburgh, Pennsylvania, United States
| | - David Wolfson
- UPMC Children's Community Pediatrics, Pittsburgh, Pennsylvania, United States
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Previsit Multidomain Psychosocial Screening Tools for Adolescents and Young Adults: A Systematic Review. J Adolesc Health 2021; 68:449-459. [PMID: 33221191 DOI: 10.1016/j.jadohealth.2020.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 10/01/2020] [Accepted: 10/04/2020] [Indexed: 11/21/2022]
Abstract
Adolescence and young adulthood constitute a period when exploratory behaviors can evolve into risky behaviors. Most causes of adolescent ill health are preventable; therefore, it is a priority to detect them early before they turn into health problems. Previsit multidomain psychosocial screening tools are used by professionals to detect and prioritize potentially problematic issues. In conjunction with appropriate clinician training, these tools have improved clinician screening rates in several areas of adolescent health. This article reviews existing multidomain previsit psychosocial screening tools developed in the 21st century and describes their characteristics using a systematic methodology. We reviewed 10,623 records to identify 15 different tools in use since 2000 and described their characteristics. Results show that all tools were developed in high-income countries. The tools provide sufficient coverage of many psychosocial domains relevant to young people's health. However, some psychosocial domains such as screen use and strengths are seldomly addressed. Furthermore, the tools rarely focus on young adults as a target population. Future research should assess the effectiveness, acceptability, and psychometric properties of validated psychosocial screening tools and examine how to expand their use in low- and middle-income countries.
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11
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Howie C, Potter C, Shannon C, Davidson G, Mulholland C. Screening for the at-risk mental state in educational settings: A systematic review. Early Interv Psychiatry 2020; 14:643-654. [PMID: 31883215 DOI: 10.1111/eip.12926] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 10/10/2019] [Accepted: 12/14/2019] [Indexed: 12/20/2022]
Abstract
AIM The at-risk mental state (ARMS) allows clinicians to identify individuals who have an increased risk of developing psychosis. At present, most screening for psychosis-risk is carried out within help-seeking populations; however, screening within educational settings may allow clinicians to identify individuals at-risk earlier and to increase the rate of detection. This review aimed to examine screening for the ARMS in educational settings, with the key questions: what screening tools have been used in educational settings, can screening in educational settings detect individuals with ARMS, what threshold scores in screening tools indicate a positive screen in educational settings, are there comorbid mental health conditions associated with the ARMS in educational settings? METHODS Searches were carried out in PsycINFO, MEDLINE, EMBASE, Scopus and Web of Science and reference lists of included articles searched. Results were summarized using narrative synthesis. RESULTS Nine papers were included for narrative synthesis. A variety of screening tools have been used when screening for the ARMS in educational settings. The majority of studies have been conducted in schools. The prevalence of the ARMS reported in ranges from 1% to 8%. CONCLUSIONS The ARMS indicates the presence of distressing symptoms for which intervention may be beneficial. Screening programmes within educational settings may allow outreach for prodromal symptoms at an earlier stage than clinical settings currently provided for.
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Affiliation(s)
- Clare Howie
- School of Medicine, Queen's University Belfast, Belfast, UK
| | - Claire Potter
- School of Medicine, Queen's University Belfast, Belfast, UK
| | - Ciaran Shannon
- Holywell Hospital, Northern Health and Social Care Trust, Antrim, UK
| | - Gavin Davidson
- School of Social Sciences, Education and Social Work, Queen's University Belfast, Belfast, UK
| | - Ciaran Mulholland
- School of Medicine, Queen's University Belfast, Belfast, UK.,Holywell Hospital, Northern Health and Social Care Trust, Antrim, UK
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12
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Social Cognitive Orientations, Social Support, and Physical Activity among at-Risk Urban Children: Insights from a Structural Equation Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186745. [PMID: 32947944 PMCID: PMC7558557 DOI: 10.3390/ijerph17186745] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/10/2020] [Accepted: 09/12/2020] [Indexed: 11/17/2022]
Abstract
This study investigates the effects of cognitive orientations associated with social cognitive theory (SCT) and exercise enjoyment on physical activity (PA) of urban at-risk children, accounting for mediating effects associated with various sources of social support. We use 2016–2017 survey data from 725 school-age children in an urban school district in Akron, Ohio in the United States (US) to inform a structural equation model, which assesses direct and indirect effects of self-efficacy, behavioral intention, and exercise enjoyment on children’s PA, using mediating variables that measure social support that children report receiving from parents, Physical Education (PE) teachers, and peers. We find that self-efficacy and exercise enjoyment have notable direct and indirect effects on the children’s PA. We also find that the support children receive from PE teachers and peers appears to have greater effects on PA than does the children’s reported social support from parents. These findings suggest that children’s social cognitive orientations may influence both sources of perceived social support and the extent to which children engage in PA. While these findings have potential implications for intervention strategies to increase PA among at-risk children, further research is appropriate to improve our understanding of the determinants of PA among at-risk urban children.
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13
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Field S, Abrahams Z, Honikman S. Adolescent mothers: A qualitative study on barriers and facilitators to mental health in a low-resource setting in Cape Town, South Africa. Afr J Prim Health Care Fam Med 2020; 12:e1-e9. [PMID: 32501029 PMCID: PMC7300943 DOI: 10.4102/phcfm.v12i1.2279] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 02/14/2020] [Accepted: 02/22/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Pregnant and postnatal adolescent women are a high-risk group for common mental disorders (CMDs); however, they have low levels of engagement and retention with mental health services. Negative consequences of CMDs have been documented for both mother and child. AIM The study aimed to explore the barriers and facilitators to service access for adolescents in low-resource settings. SETTING We interviewed 12 adolescents, aged 15-19 years, from low-resource settings in Cape Town, South Africa. Participants had previously engaged with a mental health service, integrated into maternity care. METHODS Twelve semi-structured, individual interviews were used for this qualitative study. Interviews were recorded, transcribed and coded. A framework analysis was employed for data analysis. RESULTS Adolescents perceived considerable stigma around both teenage pregnancy and mental illness, which inhibited use of mental health services. Other barriers included fearing a lack of confidentiality as well as logistical and environmental obstacles. Service uptake was facilitated by support from other adults and flexible appointment times. Face-to-face individual counselling was their preferred format for a mental health intervention. CONCLUSION Several key components for adolescent-friendly mental health services emerged from our findings: integrate routine mental health screening into existing obstetric services to de-stigmatise mental health problems and optimise screening coverage; coordinate obstetric and counselling appointment times to rationalise the use of limited resources; and sensitise care providers to the needs of adolescents to reduce stigma around adolescent sexual activity and mental illness. A non-judgemental, caring and confidential relationship between counsellors and clients is crucial for successful interactions.
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Affiliation(s)
- Sally Field
- Perinatal Mental Health Project, Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town.
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Ho J, Fong CK, Iskander A, Towns S, Steinbeck K. Digital psychosocial assessment: An efficient and effective screening tool. J Paediatr Child Health 2020; 56:521-531. [PMID: 31883286 DOI: 10.1111/jpc.14675] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 06/11/2019] [Accepted: 10/14/2019] [Indexed: 11/30/2022]
Abstract
AIM A large proportion of young people with chronic health conditions are surviving into adulthood. They face the same challenges as their healthy peers and are at increased risk of mental health problems. Psychosocial assessment is a crucial aspect of clinical care. Interviews using the internationally used and accepted HEEADSSS (home environment, education/employment, eating, peer-related activities, drugs, sexuality, suicide/depression, and safety) framework require trained clinicians, rapid interpersonal engagement, time and manual documentation. HEEADSSS-derived digital self-report surveys can be initiated by non-trained staff. This study compares the utility and information recorded using both methods. METHODS A retrospective analysis comparing documentation from HEEADSSS guided face-to-face interview and a digital survey tool was conducted using 146 records collected by the Trapeze transition service across the two locations of the Sydney Children's Hospital Network (NSW, Australia) between 2013 and 2016. A panel of four experts used an iterative process to identify 29 data verification points, falling into seven categories. Wilcoxon signed-rank tests were used to compare category scores. RESULTS The digital survey took an average of 15 min and showed a significantly higher rate of disclosure across all psychosocial categories, particularly in the sensitive areas of emotions, drug use, sex and safety, compared to electronic medical record documentation of interview. CONCLUSIONS Digital survey provided a time-efficient psychosocial screening tool that was self-administered, able to be introduced by non-trained staff, had a consistent record of responses, and elicited a substantially higher disclosure rate for important areas of strength and risk that may otherwise be avoided or not recorded.
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Affiliation(s)
- Jane Ho
- Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia.,Trapeze, Centre for Adolescent and Young Adult Health, Sydney Children's Hospitals Network, Sydney, New South Wales, Australia
| | - Cameron K Fong
- Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia.,Trapeze, Centre for Adolescent and Young Adult Health, Sydney Children's Hospitals Network, Sydney, New South Wales, Australia
| | - Andrew Iskander
- Trapeze, Centre for Adolescent and Young Adult Health, Sydney Children's Hospitals Network, Sydney, New South Wales, Australia
| | - Susan Towns
- Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia.,Department of Adolescent Medicine, Sydney Children's Hospital Network, Sydney, New South Wales, Australia
| | - Katharine Steinbeck
- Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia
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15
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Wright J, Elwell L, McDonagh J, Kelly D, McClean P, Ferguson J, Wray J. Healthcare transition in pediatric liver transplantation: The perspectives of pediatric and adult healthcare professionals. Pediatr Transplant 2019; 23:e13530. [PMID: 31240785 DOI: 10.1111/petr.13530] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 05/20/2019] [Accepted: 05/25/2019] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Transition from pediatric to adult services of young people with a liver transplant is an important priority due to increasing numbers of young people surviving into adulthood. There is increased incidence of graft loss and non-adherence following transfer to adult services. Although studies have considered the views and perceptions of young people who have undergone liver transplantation and their parents about transition, there is currently no qualitative research with healthcare professionals working in the field of liver transplantation. The aim of this study was to elicit the views of this group of stakeholders about barriers and facilitators of an effective transition process. METHODS Semi-structured interviews were carried out with 11 HCPs from pediatric and adult liver transplant programs and from a range of professional backgrounds. Interviews were transcribed verbatim and analyzed using thematic analysis. RESULTS Four themes were identified: "non-adherence and psychosocial issues," "need for better psychological support," "the role of parents," and "the emotional impact of transition on healthcare professionals." Within these themes, professionals described factors which hindered or promoted an effective transition process. CONCLUSIONS Screening tools which address psychological and social aspects of the lives of young people should be used in routine practice to identify patients requiring psychosocial support and to identify those at risk of non-adherence. All staff involved with transition should be trained in the use of psychosocial screening strategies. The development of a formal referral pathway so that young people can access psychological support in adult services is recommended.
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Affiliation(s)
- Jessica Wright
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
| | - Laura Elwell
- Health and Wellbeing, National Grid, Warwick, UK
| | - Janet McDonagh
- Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, University of Manchester, Manchester, UK.,NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK.,Manchester Academic Health Science Centre, Manchester, UK
| | - Deirdre Kelly
- Liver Unit, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
| | - Patricia McClean
- Liver Unit, Leeds Teaching Hospitals NHS Foundation Trust, Leeds, UK
| | - James Ferguson
- Liver Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Jo Wray
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.,NIHR Great Ormond Street Hospital Biomedical Research Centre, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
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16
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Conti AA, Humphris GM. Patient centred consultation, satisfaction and young patients: A cross-country analysis. PATIENT EDUCATION AND COUNSELING 2019; 102:782-789. [PMID: 30473248 DOI: 10.1016/j.pec.2018.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 11/16/2018] [Accepted: 11/17/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES The aim of this study was to investigate the link between perceived dimensions of patient centred care and the satisfaction of adolescents and young adults within the UK, USA, Australian, Italian, and Chinese healthcare systems. METHODS One thousand and thirty-four participants (212 from China,206 from Australia,208 from UK, 202 from USA, and 206 from Italy) answered a self-report questionnaire assessing the perceived dimensions of patient centred care. Factor analysis (PFA) was conducted on the data to identify relevant dimensions. One-way ANOVAs were run to identify differences between country samples related to perceived dimensions of patient centredness, and a multi-level multiple regression model was computed to assess the link between satisfaction and dimensions of patient centred care. RESULTS Countries' mean scores on 'Satisfaction with Care' (PF1) and on 'Psychosocial Context' (PF2) were statistically significant by inspecting the ANOVAs (p < .05). Satisfaction with care was predicted by PF2 and clinical utilization. CONCLUSION An online survey collected meaningful data on perceptions of healthcare received by respondents from five countries. This initial international study highlights important associations worthy of closer investigation. PRACTICE IMPLICATIONS Healthcare providers should assess comprehensively the psychosocial context of young patients during consultations.
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Affiliation(s)
- A A Conti
- University of St Andrews, School of Medicine, United Kingdom
| | - G M Humphris
- University of St Andrews, School of Medicine, United Kingdom; Western General Hospital, NHS Lothian, Edinburgh, United Kingdom.
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Martel RM, Darragh ML, Lawrence AJ, Shepherd MJ, Wihongi T, Goodyear-Smith FA. YouthCHAT as a Primary Care E-Screening Tool for Mental Health Issues Among Te Tai Tokerau Youth: Protocol for a Co-Design Study. JMIR Res Protoc 2019; 8:e12108. [PMID: 30626568 PMCID: PMC6329425 DOI: 10.2196/12108] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 10/08/2018] [Accepted: 10/09/2018] [Indexed: 01/13/2023] Open
Abstract
Background In New Zealand (NZ), 1 in 4 adolescents is affected by mental health issues (eg, depression and anxiety) and engages in risk behaviors (eg, harmful drinking and substance abuse), with rates among Māori youth being significantly higher. The majority of NZ secondary school students visit their local primary health care providers (PHPs) at least annually, yet most do not seek help for mental health and risk behavior (MHB) concerns. While youth think it acceptable to discuss sensitive issues during a consultation with their PHPs, unless problems are severe, such conversations are not initiated by PHPs. Early intervention for MHB concerns can prevent long-term health and well-being issues. However, this relies on the early identification of developing problems and youth being offered and accepting help. YouthCHAT is an electronic, multi-item screening tool developed in 2016 to assess MHB concerns among youth. YouthCHAT is completed before a consultation with the PHP, who can access a summary report straight away. A help question allows young people to identify issues that need addressing. A resource pack uses stepped care pathways to guide providers to use appropriate brief interventions. Objective This study aimed to explore the utility, feasibility, and acceptability of YouthCHAT when tailored for use with youth in primary care settings with large Māori populations. Objectives of the study are to evaluate the implementation of YouthCHAT in nurse-led youth clinics, school-based clinics, and general practice in Te Tai Tokerau (Northland, NZ); to develop a framework for the scaling up of YouthCHAT across further settings; to assess health provider and youth acceptability of the tool; to improve screening rates for mental health and help-seeking behavior; to enable early identification of emerging problems; and to improve brief intervention delivery. Methods Using a bicultural mixed-methods co-design approach, 3 phases over a 3-year period will provide an iterative evaluation of the utility, feasibility, and acceptability of YouthCHAT, aiming to create a framework for wider-scale rollout and implementation. Results Recruitment for the first phase began in September 2018. YouthCHAT was implemented at the first site in October 2018 and is expected to be at a further two sites in late January to early February 2019. The study is due for completion at the end of 2021. Conclusions YouthCHAT has potential as a user-friendly, time efficient, and culturally safe screening tool for early detection of MHB issues in NZ youth. The resource pack assists the clinician to provide appropriate interventions for emerging and developed youth mental health and lifestyle issues. Involving input from community providers, users, and stakeholders will ensure that modifiable elements of YouthCHAT are tailored to meet the health needs specific to each context and will have a positive influence on future mental, physical, and social outcomes for NZ youth. International Registered Report Identifier (IRRID) PRR1-10.2196/12108
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Affiliation(s)
- Rhiannon Mary Martel
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Science, The University of Auckland, Auckland, New Zealand
| | - Margot Louise Darragh
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Science, The University of Auckland, Auckland, New Zealand
| | - Aniva Joanne Lawrence
- Manaia Health Primary Health Organisation, Whangarei, New Zealand.,Te Tai Tokerau Primary Health Organisation, Kerikeri, New Zealand
| | - Matthew John Shepherd
- Faculty of Education and Social Work, Department of Counselling, Human Services and Social Work, The University of Auckland, Auckland, New Zealand
| | | | - Felicity Anne Goodyear-Smith
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Science, The University of Auckland, Auckland, New Zealand
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Major Depressive Disorder Screening Remains Low Even Among Privately Insured Adolescents. J Pediatr 2019; 204:203-207. [PMID: 30244990 DOI: 10.1016/j.jpeds.2018.07.086] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 07/09/2018] [Accepted: 07/25/2018] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To determine if screening for major depressive disorder (MDD) increased in a national sample of privately insured adolescents following the US Preventive Services Task Force 2009 endorsement of universal screening for adolescent MDD. STUDY DESIGN This was a retrospective cohort study of 12- to 14-year-old adolescents, continuously insured from 2010 to 2014 based on the MarketScan database. The primary outcome was the frequency of MDD screening, defined by International Classification of Diseases, Ninth Revision or Current Procedural Terminology code within the context of a well-visit. Multivariable analysis identified factors associated with MDD screening. RESULTS Adolescents (n = 413 080) were 49% female and 89% urban, and 21% had a family history of depression. Adolescents averaged 2.9 ± 1.6 well-visits during the 5-year study period. Of the cohort, 1.8% had MDD screening coded. Coding for MDD screening was more likely for urban residents (OR, 1.95; 95% CI, 1.69-2.25; P < .001), those with conduct disorder (OR, 1.37; 95% CI, 1.14-1.64; P < .001), and adolescents with more well visits (OR, 1.25; 95% CI, 1.21-1.31; P < .001). Coding for MDD screening was 96% less likely for those switching between multiple provider types for well-visits compared with pediatric providers. A family history of depression did not influence coding for MDD screening. CONCLUSIONS MDD screening remains insufficient to address the youth mental health crisis. Furthermore, this study captures those adolescents most able to receive such services, given their continuous enrollment in private insurance. Disparities persist, with adolescents who are rural, less frequently seen, and with poor continuity of care less likely to receive screening.
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Goodyear-Smith F, Martel R, Darragh M, Warren J, Thabrew H, Clark TC. Screening for risky behaviour and mental health in young people: the YouthCHAT programme. Public Health Rev 2017; 38:20. [PMID: 29450092 PMCID: PMC5810064 DOI: 10.1186/s40985-017-0068-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 08/23/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The prevalence of mental health concerns and risky health behaviours among young people is of global concern. A large proportion of young people in New Zealand (NZ) are affected by depression, suicidal ideation and other mental health concerns, but the majority do not access help. For NZ indigenous Māori, the burden of morbidity and mortality associated with mental health is considerably higher. Targeted screening for risky behaviours and mental health concerns among youth in primary care settings can lead to early detection and intervention for emerging or current mental health and psychosocial issues. Opportunistic screening for youth in primary care settings is not routinely undertaken due to competing time demands, lack of context-specific screening tools and insufficient knowledge about suitable interventions. Strategies are required to improve screening that are acceptable and appropriate for the primary care environment. This article outlines the development, utilisation and ongoing evaluation and implementation strategies for YouthCHAT. YOUTHCHAT YouthCHAT is a rapid, electronic, self-report screening tool that assesses risky health-related behaviours and mental health concerns, with a 'help question' that enables youth to prioritise areas they want help with. The young person can complete YouthCHAT in the waiting room prior to consultation, and after completion, the clinician can immediately access a summary report which includes algorithms for stepped-care interventions using a strength-based approach. A project to scale up the implementation is about to commence, using a co-design participatory research approach to assess acceptability and feasibility with successive roll-out to clinics. In addition, a counter-balanced randomised trial of YouthCHAT versus clinician-administered assessment is underway at a NZ high school. CONCLUSION Opportunistic screening for mental health concerns and other risky health behaviours during adolescence can yield significant health gains and prevent unnecessary morbidity and mortality. The systematic approaches to screening and provision of algorithms for stepped-care intervention will assist in delivering time efficient, early, more comprehensive interventions for youth with mental health concerns and other health compromising behaviours. The early detection of concerns and facilitation to evidence-based interventions has the potential to lead to improved health outcomes, particularly for under-served indigenous populations.
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Affiliation(s)
- Felicity Goodyear-Smith
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Science, University of Auckland, PB 92019, Auckland, New Zealand
| | - Rhiannon Martel
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Science, University of Auckland, PB 92019, Auckland, New Zealand
| | - Margot Darragh
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Science, University of Auckland, PB 92019, Auckland, New Zealand
| | - Jim Warren
- Department of Computer Science, Faculty of Science, University of Auckland, PB 92019, Auckland, New Zealand
| | - Hiran Thabrew
- Department of Psychological Medicine, Faculty of Medical and Health Science, University of Auckland, PB 92019, Auckland, New Zealand
| | - Terryann C. Clark
- School of Nursing, Faculty of Medical and Health Science, University of Auckland, PB 92019, Auckland, New Zealand
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20
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Webb MJ, Wadley G, Sanci LA. Improving Patient-Centered Care for Young People in General Practice With a Codesigned Screening App: Mixed Methods Study. JMIR Mhealth Uhealth 2017; 5:e118. [PMID: 28801302 PMCID: PMC5573432 DOI: 10.2196/mhealth.7816] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 06/03/2017] [Accepted: 07/12/2017] [Indexed: 11/29/2022] Open
Abstract
Background Despite experiencing a high prevalence and co-occurrence of mental health disorders and health-compromising behaviors, young people tend not to seek professional help for these concerns. However, they do regularly attend primary care, making primary care providers ideally situated to identify and discuss mental health and lifestyle issues as part of young people’s routine health care. Objective The aim was to investigate whether using a codesigned health and lifestyle-screening app, Check Up GP, in general practice influenced young people’s assessment of the quality of their care (measures of patient-centered care and youth friendliness), and their disclosure of sensitive issues. In addition, this study aimed to explore young people’s acceptance and experience of using a screening app during regular health care. Methods This was a mixed methods implementation study of Check Up GP with young people aged 14 to 25 years attending a general practice clinic in urban Melbourne, Australia. A 1-month treatment-as-usual group was compared to a 2-month intervention group in which young people and their general practitioners (GPs) used Check Up GP. Young people in both groups completed an exit survey immediately after their consultation about disclosure, patient-centered and youth-friendly care, and judgment. In addition, participants in the intervention group were surveyed about app acceptability and usability and their willingness to use it again. Semistructured interviews with participants in the intervention group expanded on themes covered in the survey. Results The exit survey was completed by 30 young people in the treatment-as-usual group and 85 young people in the intervention group. Young people using Check Up GP reported greater disclosure of health issues (P<.001), and rated their GP higher in patient-centered care: communication and partnership (P=.01), personal relationship (P=.01), health promotion (P=.03), and interest in effect on life (P<.001). No differences were found on core indicators of youth-friendly care: trust, level of comfort, expectations met, and time to ask questions. In all, 86% (73/85) of young people felt the app was a “good idea” and only 1% (1/85) thought it a “bad idea.” Thematic analysis of qualitative interviews with 14 participants found that Check Up GP created scope to address unmet health needs and increased sense of preparedness, with use moderated by honesty, motivation, app content and functionality, and app administration. Conclusions Integrating a health and lifestyle-screening app into face-to-face care can enrich young people’s experience of seeing their GP, create scope to identify and address unmet health needs, and increase patient-centered care. Further research is needed to investigate the effect of using a health and lifestyle-screening app in a diverse range of clinic types and settings, and with a diverse range of GPs and youth.
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Affiliation(s)
- Marianne Julie Webb
- Department of General Practice, Melbourne Medical School, Faculty of Medicine, University of Melbourne, Parkville, Australia
| | - Greg Wadley
- School of Computing and Information Systems, University of Melbourne, Parkville, Australia
| | - Lena Amanda Sanci
- Department of General Practice, Melbourne Medical School, Faculty of Medicine, University of Melbourne, Parkville, Australia
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Churchill RD. Young People: Understanding the Links Between Satisfaction With Services and Their Health Outcomes in Primary Care. J Adolesc Health 2017; 60:358-359. [PMID: 28340869 DOI: 10.1016/j.jadohealth.2017.01.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 01/25/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Richard D Churchill
- Division of Primary Care, University of Nottingham Medical School, Nottingham, England
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22
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Webb MJ, Kauer SD, Ozer EM, Haller DM, Sanci LA. Does screening for and intervening with multiple health compromising behaviours and mental health disorders amongst young people attending primary care improve health outcomes? A systematic review. BMC FAMILY PRACTICE 2016; 17:104. [PMID: 27488823 PMCID: PMC4973106 DOI: 10.1186/s12875-016-0504-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 07/28/2016] [Indexed: 01/09/2023]
Abstract
BACKGROUND Adolescence and young adulthood are important developmental periods. Screening for health compromising behaviours and mental health disorders during routine primary care visits has the potential to assist clinicians to identify areas of concern and provide appropriate interventions. The objective of this systematic review is to investigate whether screening and subsequent interventions for multiple health compromising behaviours and mental health disorders in primary care settings improves the health outcomes of young people. METHODS Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, literature searches were conducted in Medline, PsycINFO, Scopus and Cochrane Library databases (Prospero registration number CRD42013005828) using search terms representing four thematic concepts: primary care, young people, screening, and mental health and health compromising behaviour. To be eligible for inclusion, studies had to: include a measure of health outcome; include at least 75 % of participants aged under 25 years; use a screening tool that assessed more than one health domain; and be conducted within a primary care setting. Risk of bias was assessed using the Quality Rating Scale. RESULTS From 5051 articles identified, nine studies fulfilled the inclusion criteria and were reviewed: two randomised controlled trials (RCTs), one pilot RCT, two clustered RCTs, one randomised study with multiple intervention groups and no control group, one cluster RCT with two active arms, one longitudinal study and one pre-post study. Seven studies, including two RCTs and one clustered RCT, found positive changes in substance use, diet, sexual health or risky sexual behaviour, alcohol-related risky behaviour, social stress, stress management, helmet use, sleep and exercise. Of only two studies reporting on harms, one reported a negative health outcome of increased alcohol use. CONCLUSIONS There is some evidence that the use of screening and intervention with young people for mental health disorder or health compromising behaviours in clinical settings improves health outcomes. Along with other evidence that young people value discussions of health risks with their providers, these discussions should be part of the routine primary care of young people. Further quality studies are needed to strengthen this evidence.
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Affiliation(s)
- Marianne J. Webb
- Department of General Practice, University of Melbourne, 200 Berkeley Street, Carlton, 3053 Australia
| | - Sylvia D. Kauer
- Department of General Practice, University of Melbourne, 200 Berkeley Street, Carlton, 3053 Australia
| | - Elizabeth M. Ozer
- Division of Adolescent & Young Adult Medicine, Department of Pediatrics, UCSF Benioff Children’s Hospital, University of California San Francisco, San Francisco, 94118 USA
- UCSF Office of Diversity and Outreach, University of California San Francisco, San Francisco, 94118 USA
| | - Dagmar M. Haller
- Department of General Practice, University of Melbourne, 200 Berkeley Street, Carlton, 3053 Australia
- Primary Care Unit, Faculty of Medicine, University of Geneva, 9 av de Champel, 1211 Geneva 4, Switzerland
- Adolescent and Young Adult Program, Department of Community, Primary Care and Emergency Medicine and Department of Pediatrics, Geneva University Hospitals, 87 bvd de la Cluse, Geneva, 1205 Switzerland
| | - Lena A. Sanci
- Department of General Practice, University of Melbourne, 200 Berkeley Street, Carlton, 3053 Australia
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Irritable and defiant sub-dimensions of ODD: their stability and prediction of internalizing symptoms and conduct problems from adolescence to young adulthood. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2016; 43:407-21. [PMID: 25028284 DOI: 10.1007/s10802-014-9908-3] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Emerging research has identified sub-dimensions of oppositional defiant disorder - irritability and defiance - that differentially predict internalizing and externalizing symptoms in preschoolers, children, and adolescents. Using a theoretical approach and confirmatory factor analyses to distinguish between irritability and defiance, we investigate the associations among these dimensions and internalizing (anxiety and depression) and externalizing problems (conduct problems) within and across time in a community-based sample of 662 youth (342 females) spanning ages 12 to 18 years old at baseline. On average, irritability was stable across assessment points and defiance declined. Within time, associations of irritability with internalizing were consistently stronger than associations of irritability with conduct problems. Defiance was similarly associated within time with both internalizing and conduct problems in mid-adolescence, but was more highly related to internalizing than to conduct problems by early adulthood (ages 18 to 25). Over time, increasing irritability was related to changes in both internalizing and conduct problems; whereas increases in defiance predicted increases in conduct problems more strongly than internalizing symptoms. Increases in both internalizing and conduct problems were also associated with subsequent increases in both irritability and defiance. Sex differences in these associations were not significant.
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Thompson KD, Leadbeater BJ, Ames ME. Reciprocal Effects of Internalizing and Oppositional Defiance Symptoms on Heavy Drinking and Alcohol-Related Harms in Young Adulthood. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2016; 9:21-31. [PMID: 26819553 PMCID: PMC4723048 DOI: 10.4137/sart.s33928] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 10/29/2015] [Accepted: 11/03/2015] [Indexed: 12/16/2022]
Abstract
There is a need for longitudinal research to understand how psychopathology relates to the onset and maintenance of substance use from adolescence into young adulthood. Hence, we investigate the longitudinal, reciprocal influences of internalizing (anxiety and depression) and externalizing (oppositional defiance) symptoms on heavy episodic drinking (HED; ≥5 drinks per occasion) and alcohol-related harms in a community-based sample of youth aged 12–27 years. Participants were chosen from the Victoria Healthy Youth Survey, followed six times, biennially between 2003 and 2013 (N = 662). Analyses used cross-lagged panel models to examine reciprocal relations over time. Differences across age and sex were also tested. Defiance symptoms predicted increases in HED, which reciprocally predicted increases in defiance symptoms for females. Internalizing symptoms were related to HED within time for females. Alcohol-related harms had reciprocal positive associations with internalizing and defiance symptoms for both males and females. Associations were largely invariant across age groups, suggesting that the presence and strength of associations persisted across development. While psychopathology preceded the onset of HED and harms, the overall findings suggest that these risk processes are mutually reinforcing across development and that youth may become entrenched in an interdependent cycle that significantly increases their risk of comorbid disorders in adulthood.
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Affiliation(s)
- Kara D Thompson
- Assistant Professor, Department of Psychology, St. Francis Xavier University, Antigonish, NS, Canada
| | - Bonnie J Leadbeater
- Professor, Department of Psychology, University of Victoria, Victoria, BC, Canada
| | - Megan E Ames
- Postdoctoral Fellow, Department of Psychology, University of Victoria, Victoria, BC, Canada
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Bradford S, Rickwood D. Acceptability and utility of an electronic psychosocial assessment (myAssessment) to increase self-disclosure in youth mental healthcare: a quasi-experimental study. BMC Psychiatry 2015; 15:305. [PMID: 26627041 PMCID: PMC4667517 DOI: 10.1186/s12888-015-0694-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 11/28/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Technology is increasingly being used in youth mental healthcare to support service delivery and improve health outcomes. The current study trialed a new electronic psychosocial application (myAssessment) that aims to provide a holistic assessment of relevant risk and protective factors in youth mental healthcare. The study aimed to determine whether myAssessment was acceptable to all users, and whether it affected: reporting of certain behaviors and ratings of self-disclosure; youth ratings of control, fears of judgmental reactions or time-efficiency; clinician ratings of time-efficiency or their ability to formulate a treatment plan; and the therapeutic alliance. METHOD The application was tested at a youth mental health service using a quasi-experimental two phase Treatment-as-Usual/Intervention design. Three hundred thirty nine youth and 13 clinicians participated across both phases. Reporting of behaviors, self-disclosure, youth control, judgmental reactions, time efficiency, ability to formulate treatment plans, and the therapeutic alliance were compared between groups. RESULTS myAssessment was found to be widely accepted by both young people and clinicians. Use of myAssessment resulted in reporting of behaviors that were 2.78 through 10.38 times higher for a variety of substances (use of tobacco, alcohol, cannabis, sedatives, hallucinogens, and opioids), in identifying non-heterosexual sexual orientation, having had sex, an STI check, sex without a condom, having felt pressured to have sex in the past, having self-harmed, and in having put themselves in an unsafe situation. Participants who used the application also reported being less likely to lie on past experiences of being bullied, substance use, and self-harm. Use of the application resulted in improved youth ratings of time efficiency in session. The application was found to have no impact on youth control, judgmental reactions, formulation of treatment plans, or the therapeutic alliance. CONCLUSIONS Electronic psychosocial assessments can increase rates of self-disclosure and, therefore, provide an earlier and more comprehensive picture of young people's risks without negatively impacting the therapeutic alliance. Additionally, this type of technology has been shown to be widely accepted by both young people and clinicians and can improve youth beliefs that there is enough time in session to speak about what is most important to them.
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Affiliation(s)
- Sally Bradford
- Faculty of Health, University of Canberra, Building 12, D20, College St, Bruce, ACT, 2617, Australia.
| | - Debra Rickwood
- Faculty of Health, University of Canberra, Building 12, D11, College St, Bruce, ACT, 2617, Australia. .,headspace National Youth Mental Health Foundation, Melbourne, VIC, Australia.
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Kwan B, Rickwood DJ. A systematic review of mental health outcome measures for young people aged 12 to 25 years. BMC Psychiatry 2015; 15:279. [PMID: 26573269 PMCID: PMC4647516 DOI: 10.1186/s12888-015-0664-x] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 10/27/2015] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Mental health outcome measures are used to monitor the quality and effectiveness of mental health services. There is also a growing expectation for implementation of routine measurement and measures being used by clinicians as a feedback monitoring system to improve client outcomes. The recent focus in Australia and elsewhere targeting mental health services to young people aged 12-25 years has meant that outcome measures relevant to this age range are now needed. This is a shift from the traditional divide of child and adolescent services versus adult services with a transitioning age at 18 years. This systematic review is the first to examine mental health outcome measures that are appropriate for the 12 to 25 year age range. METHODS MEDLINE and PsychINFO databases were systematically searched to identify studies using mental health outcome measures with young people aged 12 to 25 years. The search strategy complied with the relevant sections of the PRISMA statement. RESULTS A total of 184 published articles were identified, covering 29 different outcome measures. The measures were organised into domains that consisted of eight measures of cognition and emotion, nine functioning measures, six quality of life measures, and six multidimensional mental health measures. No measures were designed specifically for young people aged 12 to 25 years and only two had been used by clinicians as a feedback monitoring system. Five measures had been used across the whole 12 to 25 year age range, in a range of mental health settings and were deemed most appropriate for this age group. CONCLUSIONS With changes to mental health service systems that increasingly focus on early intervention in adolescence and young adulthood, there is a need for outcome measures designed specifically for those aged 12 to 25 years. In particular, multidimensional measures that are clinically meaningful need to be developed to ensure quality and effectiveness in youth mental health. Additionally, outcome measures can be clinically useful when designed to be used within routine feedback monitoring systems.
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Affiliation(s)
- Benjamin Kwan
- Faculty of Health, University of Canberra, Kirinari Street, Bruce, ACT, 2601, Australia.
| | - Debra J Rickwood
- Faculty of Health, University of Canberra, Kirinari Street, Bruce, ACT, 2601, Australia.
- Headspace National Youth Mental Health Foundation National Office, 485 La Trobe Street, Melbourne, VIC, 3000, Australia.
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Sanci L, Chondros P, Sawyer S, Pirkis J, Ozer E, Hegarty K, Yang F, Grabsch B, Shiell A, Cahill H, Ambresin AE, Patterson E, Patton G. Responding to Young People's Health Risks in Primary Care: A Cluster Randomised Trial of Training Clinicians in Screening and Motivational Interviewing. PLoS One 2015; 10:e0137581. [PMID: 26422235 PMCID: PMC4589315 DOI: 10.1371/journal.pone.0137581] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 08/17/2015] [Indexed: 11/24/2022] Open
Abstract
Objective To evaluate the effectiveness of a complex intervention implementing best practice guidelines recommending clinicians screen and counsel young people across multiple psychosocial risk factors, on clinicians’ detection of health risks and patients’ risk taking behaviour, compared to a didactic seminar on young people’s health. Design Pragmatic cluster randomised trial where volunteer general practices were stratified by postcode advantage or disadvantage score and billing type (private, free national health, community health centre), then randomised into either intervention or comparison arms using a computer generated random sequence. Three months post-intervention, patients were recruited from all practices post-consultation for a Computer Assisted Telephone Interview and followed up three and 12 months later. Researchers recruiting, consenting and interviewing patients and patients themselves were masked to allocation status; clinicians were not. Setting General practices in metropolitan and rural Victoria, Australia Participants General practices with at least one interested clinician (general practitioner or nurse) and their 14–24 year old patients. Intervention This complex intervention was designed using evidence based practice in learning and change in clinician behaviour and general practice systems, and included best practice approaches to motivating change in adolescent risk taking behaviours. The intervention involved training clinicians (nine hours) in health risk screening, use of a screening tool and motivational interviewing; training all practice staff (receptionists and clinicians) in engaging youth; provision of feedback to clinicians of patients’ risk data; and two practice visits to support new screening and referral resources. Comparison clinicians received one didactic educational seminar (three hours) on engaging youth and health risk screening. Outcome Measures Primary outcomes were patient report of (1) clinician detection of at least one of six health risk behaviours (tobacco, alcohol and illicit drug use, risks for sexually transmitted infection, STI, unplanned pregnancy, and road risks); and (2) change in one or more of the six health risk behaviours, at three months or at 12 months. Secondary outcomes were likelihood of future visits, trust in the clinician after exit interview, clinician detection of emotional distress and fear and abuse in relationships, and emotional distress at three and 12 months. Patient acceptability of the screening tool was also described for the intervention arm. Analyses were adjusted for practice location and billing type, patients’ sex, age, and recruitment method, and past health risks, where appropriate. An intention to treat analysis approach was used, which included multilevel multiple imputation for missing outcome data. Results 42 practices were randomly allocated to intervention or comparison arms. Two intervention practices withdrew post allocation, prior to training, leaving 19 intervention (53 clinicians, 377 patients) and 21 comparison (79 clinicians, 524 patients) practices. 69% of patients in both intervention (260) and comparison (360) arms completed the 12 month follow-up. Intervention clinicians discussed more health risks per patient (59.7%) than comparison clinicians (52.7%) and thus were more likely to detect a higher proportion of young people with at least one of the six health risk behaviours (38.4% vs 26.7%, risk difference [RD] 11.6%, Confidence Interval [CI] 2.93% to 20.3%; adjusted odds ratio [OR] 1.7, CI 1.1 to 2.5). Patients reported less illicit drug use (RD -6.0, CI -11 to -1.2; OR 0·52, CI 0·28 to 0·96), and less risk for STI (RD -5.4, CI -11 to 0.2; OR 0·66, CI 0·46 to 0·96) at three months in the intervention relative to the comparison arm, and for unplanned pregnancy at 12 months (RD -4.4; CI -8.7 to -0.1; OR 0·40, CI 0·20 to 0·80). No differences were detected between arms on other health risks. There were no differences on secondary outcomes, apart from a greater detection of abuse (OR 13.8, CI 1.71 to 111). There were no reports of harmful events and intervention arm youth had high acceptance of the screening tool. Conclusions A complex intervention, compared to a simple educational seminar for practices, improved detection of health risk behaviours in young people. Impact on health outcomes was inconclusive. Technology enabling more efficient, systematic health-risk screening may allow providers to target counselling toward higher risk individuals. Further trials require more power to confirm health benefits. Trial Registration ISRCTN.com ISRCTN16059206.
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Affiliation(s)
- Lena Sanci
- Department of General Practice, Melbourne Medical School, The University of Melbourne, 200 Berkeley St., Carlton, VIC, 3053, Australia
- * E-mail:
| | - Patty Chondros
- Department of General Practice, Melbourne Medical School, The University of Melbourne, 200 Berkeley St., Carlton, VIC, 3053, Australia
| | - Susan Sawyer
- Centre for Adolescent Health, Royal Children’s Hospital, 50 Flemington Rd., Parkville, VIC, 3052, Australia
- Department of Paediatrics, The University of Melbourne, VIC, 3010, Australia
- Murdoch Children’s Research Institute, 50 Flemington Rd., Parkville, VIC, 3052, Australia
| | - Jane Pirkis
- Melbourne School of Population and Global Health, Level 5, 207 Bouverie St., The University of Melbourne, VIC, 3010, Australia
| | - Elizabeth Ozer
- Division of Adolescent & Young Adult Medicine, University of California San Francisco, San Francisco, 94118, United States of America
- UCSF Office of Diversity and Outreach, University of California San Francisco, San Francisco, 94118, United States of America
| | - Kelsey Hegarty
- Department of General Practice, Melbourne Medical School, The University of Melbourne, 200 Berkeley St., Carlton, VIC, 3053, Australia
| | - Fan Yang
- Department of General Practice, Melbourne Medical School, The University of Melbourne, 200 Berkeley St., Carlton, VIC, 3053, Australia
| | - Brenda Grabsch
- Department of General Practice, Melbourne Medical School, The University of Melbourne, 200 Berkeley St., Carlton, VIC, 3053, Australia
| | - Alan Shiell
- Centre of Excellence in Intervention and Prevention Science Limited, 15–31 Pelham St., P.O. Box 35, Carlton, VIC, 3053, Australia
| | - Helen Cahill
- Youth Research Centre, Melbourne Graduate School of Education, The University of Melbourne, 100 Leicester St., Carlton, VIC, 3053, Australia
| | - Anne-Emmanuelle Ambresin
- Division Interdisciplinaire de santé des adolescents, Centre Hospitalier Universitaire Vaudois Lausanne Switzerland, Av. De Beaumont 48, CH-101, Lausanne, Switzerland
| | - Elizabeth Patterson
- Department of Nursing, Melbourne School of Health Sciences, The University of Melbourne, 161 Barry St., Carlton, VIC, 3053, Australia
| | - George Patton
- Centre for Adolescent Health, Royal Children’s Hospital, 50 Flemington Rd., Parkville, VIC, 3052, Australia
- Department of Paediatrics, The University of Melbourne, VIC, 3010, Australia
- Murdoch Children’s Research Institute, 50 Flemington Rd., Parkville, VIC, 3052, Australia
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It gets better or does it? Peer victimization and internalizing problems in the transition to young adulthood. Dev Psychopathol 2015; 26:675-88. [PMID: 25047291 DOI: 10.1017/s0954579414000315] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Consistent research shows that peer victimization predicts internalizing symptoms in childhood and adolescence, but the extent to which peer victimization and its harmful effects on mental health persists into young adulthood is unclear. The current study describes patterns of physical and relational victimization during and after high school, and examines concurrent and prospective associations between internalizing symptoms (depressive and anxious symptoms) and peer victimization (physical and relational) from adolescence to young adulthood (ages 12-27). Data were collected from the Victoria Healthy Youth Survey, a five-wave multicohort study conducted biennially between 2003 and 2011 (N = 662). Physical victimization was consistently low and stable over time. Relational victimization increased for males after high school. Both types of victimization were associated concurrently with internalizing symptoms across young adulthood for males and for females. Although sex differences were important, victimization in high school also predicted increases in internalizing problems over time.
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Bradford S, Rickwood D. Young People's Views on Electronic Mental Health Assessment: Prefer to Type than Talk? JOURNAL OF CHILD AND FAMILY STUDIES 2015; 24:1213-1221. [PMID: 25960628 PMCID: PMC4412384 DOI: 10.1007/s10826-014-9929-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
For mental health professionals to provide personalized early interventions, young people need to disclose sensitive information to a clinician they are unlikely to have yet formed a relationship with. We conducted in-depth qualitative interviews with 129 young people aged 12-25 years from several sites across Australia to gauge views on whether young people thought that an electronic psychosocial assessment tool could help them initially disclose personal information. Additionally, we were interested in whether young people from different demographic groups held similar views around using the e-tool. Results provided support for the use of an e-tool, with most young people stating that it could help in the disclosure of particularly embarrassing problems. The main advantages reported were that the e-tool would support disclosure without fear of judgment by health professionals, and would enable young people greater input in deciding what to focus on. Young people who held a preference to simply talk were most concerned about the clinician missing non-verbal cues. These findings highlight the value of incorporating electronic options within clinical practice, but also the need for health professionals to work within a flexible framework guided by the individual preferences of each of their clients.
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Affiliation(s)
- Sally Bradford
- Faculty of Health, University of Canberra, Building 12, D27, Canberra, ACT Australia
| | - Debra Rickwood
- Faculty of Health, University of Canberra, Building 12, D27, Canberra, ACT Australia
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Bradford S, Rickwood D, Boer D. Health Professionals’ Attitudes towards Electronic Psychosocial Assessments in Youth Mental Healthcare. Health (London) 2014. [DOI: 10.4236/health.2014.614214] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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A Noncategorical Approach to the Psychosocial Care of Persons with DSD and Their Families. GENDER DYSPHORIA AND DISORDERS OF SEX DEVELOPMENT 2014. [DOI: 10.1007/978-1-4614-7441-8_5] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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