TY - JOUR A1 - Reinauer, Christina A1 - Viermann, Rabea A1 - Foertsch, Katharina A1 - Linderskamp, Hannah A1 - Warschburger, Petra A1 - Holl, Reinhard W. A1 - Staab, Doris A1 - Minden, Kirsten A1 - Muche, Rainer A1 - Domhardt, Matthias A1 - Baumeister, Harald A1 - Meissner, Thomas T1 - Motivational Interviewing as a tool to enhance access to mental health treatment in adolescents with chronic medical conditions and need for psychological support (COACH-MI) BT - study protocol for a clusterrandomised controlled trial JF - Trials N2 - Background This cluster-randomised monocentric controlled trial focuses on improving the uptake symptoms of mental health care in adolescents with chronic medical conditions who have been identified by screening to have depression or anxiety. The study aims to determine the efficacy of motivational interviewing (MI) delivered by trained physicians to increase 12- to 20-year-old adolescents’ utilisation of psychological health care for symptoms of anxiety or depression. Methods/design In this single-centre approach, n = 1,000 adolescents will be screened (using PHQ-9 and GAD-7), and adolescents with results indicative of anxiety or depressive symptoms (n = 162) will be advised to seek psychological health care in clusters from treating physicians in specialised outpatient departments. Participants who screen positive will receive either two sessions of MI or treatment as usual (TAU; regarded as the typical daily clinical practice), which is focused on recommending them to seek psychological health care for further evaluation. MI efficacy will be compared to the current TAU as the control condition. The primary outcome is the utilisation rate of psychological health care after counselling by an MI-trained physician vs. an untrained physician. Additionally, reasons for not claiming psychological support and changes in disease-related parameters will be evaluated in a 6-month follow-up session. Discussion This trial will evaluate the feasibility of MI as a way to improve the utilisation of mental health-care services by adolescents who need further support other than that provided by standard care for chronic diseases. Physicians offering MI to adolescents may serve as a model for optimising health-care management in daily clinical practice, which may improve adolescents’ long-term well-being by improving adherence to medical treatment and preventing negative lifelong consequences into adulthood. KW - Adolescents KW - adherence to medical treatment KW - anxiety KW - chronic condition KW - depression KW - motivational interviewing Y1 - 2018 U6 - https://doi.org/10.1186/s13063-018-2997-5 SN - 1745-6215 VL - 19 PB - BMC CY - London ER - TY - JOUR A1 - Geirhos, Agnes A1 - Domhardt, Matthias A1 - Lunkenheimer, Frederike A1 - Temming, Svenja A1 - Holl, Reinhard W. A1 - Minden, Kirsten A1 - Warschburger, Petra A1 - Meissner, Thomas A1 - Mueller-Stierlin, Annabel S. A1 - Baumeister, Harald T1 - Feasibility and potential efficacy of a guided internet- and mobile-based CBT for adolescents and young adults with chronic medical conditions and comorbid depression or anxiety symptoms (youthCOACH(CD)): a randomized controlled pilot trial JF - BMC pediatrics N2 - Background: Adolescents and young adults (AYA) with a chronic medical condition show an increased risk for developing mental comorbidities compared to their healthy peers. Internet- and mobile-based cognitive behavioral therapy (iCBT) might be a low-threshold treatment to support affected AYA. In this randomized controlled pilot trial, the feasibility and potential efficacy of youthCOACH(CD), an iCBT targeting symptoms of anxiety and depression in AYA with chronic medical conditions, was evaluated. Methods: A total of 30 AYA (M-age 16.13; SD= 2.34; 73% female), aged 12-21 years either suffering from cystic fibrosis, juvenile idiopathic arthritis or type 1 diabetes, were randomly assigned to either a guided version of the iCBT youthCOACH(CD) (IC, n=15) or to a waitlist control group (CG, n=15), receiving an unguided version of the iCBT six months post-randomization. Participants of the IG and the CG were assessed before (t0), twelve weeks after (t1) and six months after (t2) randomization. Primary outcome was the feasibility of the iCBT. Different parameters of feasibility e.g. acceptance, client satisfaction or potential side effects were evaluated. First indications of the possible efficacy with regard to the primary efficacy outcome, the Patient Health Questionnaire Anxiety and Depression Scale, and further outcome variables were evaluated using linear regression models, adjusting for baseline values. Results: Regarding feasibility, intervention completion was 60%; intervention satisfaction (M = 25.42, SD = 5.85) and perceived therapeutic alliance (M = 2.83, SD = 1.25) were moderate and comparable to other iCBTs. No patterns emerged regarding subjective and objective negative side effects due to participation in youthCOACH(CD). Estimates of potential efficacy showed between group differences, with a potential medium-term benefit of youthCOACH(CD) (beta = -0.55, 95%Cl: -1.17; 0.07), but probably not short-term (beta = 0.20, 95%Cl: -0.47; 0.88). Conclusions: Our results point to the feasibility of youthCOACH(CD) and the implementation of a future definitive randomized controlled trial addressing its effectiveness and cost-effectiveness. Due to the small sample size, conclusions are premature, however, further strategies to foster treatment adherence should be considered. KW - Chronic medical condition KW - Depression KW - Anxiety KW - Internet- and mobile KW - based intervention KW - Cognitive behavioral therapy KW - Randomized controlled KW - pilot trial KW - Type 1 diabetes KW - Cystic fibrosis KW - Juvenile idiopathic KW - arthritis Y1 - 2022 U6 - https://doi.org/10.1186/s12887-022-03134-3 SN - 1471-2431 VL - 22 IS - 1 PB - Springer Nature CY - London ER - TY - JOUR A1 - Göldel, Julia M. A1 - Kamrath, Clemens A1 - Minden, Kirsten A1 - Wiegand, Susanna A1 - Lanzinger, Stefanie A1 - Sengler, Claudia A1 - Weihrauch-Blüher, Susann A1 - Holl, Reinhard W. A1 - Tittel, Sascha René A1 - Warschburger, Petra T1 - Access to Healthcare for Children and Adolescents with a Chronic Health Condition during the COVID-19 Pandemic: First Results from the KICK-COVID Study in Germany JF - Children N2 - This study examines the access to healthcare for children and adolescents with three common chronic diseases (type-1 diabetes (T1D), obesity, or juvenile idiopathic arthritis (JIA)) within the 4th (Delta), 5th (Omicron), and beginning of the 6th (Omicron) wave (June 2021 until July 2022) of the COVID-19 pandemic in Germany in a cross-sectional study using three national patient registries. A paper-and-pencil questionnaire was given to parents of pediatric patients (<21 years) during the routine check-ups. The questionnaire contains self-constructed items assessing the frequency of healthcare appointments and cancellations, remote healthcare, and satisfaction with healthcare. In total, 905 parents participated in the T1D-sample, 175 in the obesity-sample, and 786 in the JIA-sample. In general, satisfaction with healthcare (scale: 0–10; 10 reflecting the highest satisfaction) was quite high (median values: T1D 10, JIA 10, obesity 8.5). The proportion of children and adolescents with canceled appointments was relatively small (T1D 14.1%, JIA 11.1%, obesity 20%), with a median of 1 missed appointment, respectively. Only a few parents (T1D 8.6%; obesity 13.1%; JIA 5%) reported obstacles regarding health services during the pandemic. To conclude, it seems that access to healthcare was largely preserved for children and adolescents with chronic health conditions during the COVID-19 pandemic in Germany. KW - chronic health condition KW - children and adolescents KW - health care KW - COVID-19 pandemic KW - diabetes KW - rheumatic diseases KW - obesity Y1 - 2022 U6 - https://doi.org/10.3390/children10010010 SN - 2227-9067 VL - 10 SP - 1 EP - 11 PB - MDPI CY - Basel, Schweiz ET - 1 ER - TY - JOUR A1 - Warschburger, Petra A1 - Petersen, Ann-Christin A1 - von Rezori, Roman Enzio A1 - Buchallik, Friederike A1 - Baumeister, Harald A1 - Holl, Reinhard A1 - Minden, Kirsten A1 - Müller-​Stierlin, Annabel Sandra A1 - Reinauer, Christina A1 - Staab, Doris A1 - COACH consortium, T1 - A prospective investigation of developmental trajectories of psychosocial adjustment in adolescents facing a chronic condition - study protocol of an observational, multi-center study JF - BMC Pediatrics N2 - Background Relatively little is known about protective factors and the emergence and maintenance of positive outcomes in the field of adolescents with chronic conditions. Therefore, the primary aim of the study is to acquire a deeper understanding of the dynamic process of resilience factors, coping strategies and psychosocial adjustment of adolescents living with chronic conditions. Methods/design We plan to consecutively recruit N = 450 adolescents (12–21 years) from three German patient registries for chronic conditions (type 1 diabetes, cystic fibrosis, or juvenile idiopathic arthritis). Based on screening for anxiety and depression, adolescents are assigned to two parallel groups – “inconspicuous” (PHQ-9 and GAD-7 < 7) vs. “conspicuous” (PHQ-9 or GAD-7 ≥ 7) – participating in a prospective online survey at baseline and 12-month follow-up. At two time points (T1, T2), we assess (1) intra- and interpersonal resiliency factors, (2) coping strategies, and (3) health-related quality of life, well-being, satisfaction with life, anxiety and depression. Using a cross-lagged panel design, we will examine the bidirectional longitudinal relations between resiliency factors and coping strategies, psychological adaptation, and psychosocial adjustment. To monitor Covid-19 pandemic effects, participants are also invited to take part in an intermediate online survey. Discussion The study will provide a deeper understanding of adaptive, potentially modifiable processes and will therefore help to develop novel, tailored interventions supporting a positive adaptation in youths with a chronic condition. These strategies should not only support those at risk but also promote the maintenance of a successful adaptation. Trial registration German Clinical Trials Register (DRKS), no. DRKS00025125. Registered on May 17, 2021. KW - Chronic conditions KW - Adolescents KW - Prospective KW - Quality of life KW - Resiliency KW - Coping KW - Protective factors KW - Type 1 diabetes KW - Juvenile idiopathic arthritis KW - Cystic fibrosis Y1 - 2021 U6 - https://doi.org/10.1186/s12887-021-02869-9 SN - 1471-2431 VL - 21 SP - 1 EP - 13 PB - BMC pediatrics CY - London ER -