Ingo Menrath

Evaluation of school-based life skills programmes in a high-risk sample: a controlled longitudinal multi-centre study

AimPrevious studies have demonstrated a positive effect of school-based life skills programmes on the prevention of substance abuse and other health-risk behaviours in children and adolescents. However, the comparison and interpretation of study results is difficult due to methodological problems. In particular, the effectiveness of such programmes within high-risk groups remains uncertain. In this study, we investigated the effects of two school-based life skills programmes on substance abuse and subjective health in a sample with a high proportion of socially disadvantaged pupils.Subjects and methodsWe conducted a randomised controlled intervention study with repeated measurements over time. The sample included pupils of secondary schools in northern Germany with an overrepresentation of pupils with low socioeconomic status. We evaluated effects of the programmes on substance abuse and psychosocial outcomes. In addition, we conducted a process evaluation.ResultsThe sample included 102 classes with a total of 1,561 pupils. Twenty-five per cent of the pupils were of a low socioeconomic status. We found significant positive effects regarding the reduction of smoking and some improvements in the pupils’ life skills in the intervention group compared to the control group. Socioeconomic status had no moderating effect on the results.ConclusionSchool-based life skills programmes have a positive effect on smoking prevention regardless of socioeconomic status. Socially disadvantaged children benefit from such programmes to a similar extent as other pupils. Pupils and teachers appreciate the programmes. A supportive school environment appears to be an important factor in the successful implementation of school-based life skills programmes.

Effectiveness of a generic transition-oriented patient education program in a multicenter, prospective and controlled study

Abstract Objectives For young people (YP) with a chronic condition growing up is a challenging process. This stage of life is associated with a higher risk for non-adherence, insufficient disease control, acute deteriorations and irregular consultations. Patient education programs can support YP cope with the independent disease management and the transition into adulthood. However, there is a lack of transition-oriented patient education programs for most chronic conditions. In this study, an existing generic transition-oriented education program was expanded by a module for parents and evaluated in a multicenter study all over Germany. Methods YP with chronic conditions and their parents were quasi-randomized into a control group (CG) and an intervention group (IG). The IG took part in the 1.5-day standardized education program ModuS-T while the CG received treatment as usual. The education program was designed as a compact workshop in a group setting for youth (15–24 years) and their parents. The education program contained youth specific topics such as the transfer to adult care, the influence of disease on the daily life of YP, and other important issues like detachment from parents, occupational career, intimate relationships and family planning. The parent module dealt with the topics transition from child-centered to adult health services, and supporting children to become adults. The program focused on improving competencies relevant for transition and self-management skills of the families. Satisfaction with the program, transition-specific knowledge, transition competencies, patient activation and health-related quality of life (HRQoL) were measured at baseline and after 4 weeks. Results A total of 300 YP (overall mean age 17.6 years; 47% female; IG = 166, CG = 134) with 12 different conditions and their parents participated in 37 transition programs. The participants were highly satisfied with the program. The program significantly affected transition-specific knowledge, transition competence and patient activation (p < 0.001). There were no effects on HRQoL. Conclusion The generic transition-oriented education program empowers YP with chronic conditions and their parents in the transition process. Due to a modular approach, the program is successful in a variety of chronic conditions.

Differential effect of a patient-education transition intervention in adolescents with IBD vs. diabetes

Patient education programs (PEPs) to improve disease management are part of standard and regular treatment in adolescents with diabetes. In Germany, youth with inflammatory bowel disease (IBD) receive individual counseling but not PEPs in group settings. Generic PEPs have been developed in order to improve transition from child-centered to adolescent health services. The aim of the study was to investigate the effects of a transition-oriented PEP on quality of life (QoL) and self-management in young patients with IBD (PEP naive), compared to patients with diabetes (familiar with PEPs). A 2-day transition workshop was oriented at improving psychosocial skills and addressed both generic as well as specific aspects of the condition. A controlled trial on the outcomes of a generic transition-oriented PEP was conducted in 14- to 20-year-old patients with IBD (n = 99) and diabetes (n = 153). Transition competence and QoL were assessed at baseline and 6-month follow-up. Results show that the intervention lead to a significant increase in QoL only in patients with IBD. The PEP significantly improved transition competence in both groups, however to a higher extent in subjects with IBD.Conclusion: Transition-oriented PEPs can have differential effects in different patient groups. However, this needs further longitudinal investigations.What is Known:• To date, evidence has accumulated concerning the effectiveness of patient education programs (PEPs) in pediatric health care for chronic conditions such as type 1 diabetes, asthma, atopic dermatitis, or obesity but is less documented in inflammatory bowel disease (IBD). In particular, PEPs in the transition period have not been investigated in youth with IBD.• The current study focuses on evaluating a PEP for transition preparation and management designed to be generically used across different chronic conditions since many aspects of managing chronic conditions share commonalities across conditions. The 2-day workshop included condition-specific modules adapted to the specific medical needs but was otherwise similar in quality and organization among different conditions.What is New:• The transition-oriented PEP was effective in enhancing self-management and transition management skills in both patients with IBD and diabetes; however, effects were higher in youth with IBD. A significant impact of the intervention on patients’ QoL compared to the control group was only identified in youth with IBD.• We recommend that patients with IBD have access to PEP as a standard treatment as well as to a transition program during the course of illness.

Transition of Patients with Esophageal Atresia to Adult Care: Results of a Transition-Specific Education Program

Aim of the Study A history of esophageal atresia (EA) may result in chronic morbidity. The transition of patients from pediatric to adult care has been recognized as an important factor to maintain disease‐specific follow‐up and prevent exacerbation of chronic disease. Patient education is recognized as a necessary part of transition programs for children with chronic diseases. Structured education programs for patients with EA have not yet been developed. We aimed to evaluate the efficacy of a transition‐specific educational program in adolescents with a history of EA. Methods An ethical approval was obtained. Patients with a history of EA (age 14‐21 years) and their parents were invited to participate in a 2‐day transition‐specific educational program. Overall, 29 patients and 25 parents were recruited out of whom 10/7 were allocated to the intervention group (program) and 19/18 to the control group (no program). Subjective satisfaction (ZUF‐8) and expected effects of the program on the future course of the disease, transition‐specific knowledge (standardized questionnaire addressing organizational and health‐related aspects of transition), health‐related quality of life (DISABKIDS), and confidence for self‐management (Patient Activation Measure‐13) were measured with appropriate psychological instruments. Nonparametric tests were used for statistical analysis. Main Results Subjects participating were highly satisfied with the program (patients 26/32 points, parents 25/32; ZUF‐8). Overall, 90% of the patients and 67% of the parents anticipated a positive effect on the future course of the disease. Patients transition‐specific knowledge was low before the program (36% correct answers). It improved by 18% after the intervention (56% correct answers; p = 0.004). It did not change in the control group (54 vs. 52%; n.s.). Parents transition‐specific knowledge did not change after the intervention (66 vs. 67% correct answers; ns). In patients, there were no detectable effects on health‐related quality of life (79.7 intervention vs. 81.5 controls; DISABKIDS general score) or self‐management (44.4 intervention vs. 41.4 controls; PAM‐13). Conclusions We identified a deficit of transition‐specific knowledge in adolescents with a history of EA. These patients benefit from a transition‐specific education program. Thus, the transition to adult care may be facilitated resulting in an improved long‐term care of patients with EA.

Patientenschulungen in der TransitionPatient education in transition

ZusammenfassungFür Jugendliche mit einer chronischen Erkrankung stellt das Erwachsenwerden und das selbstständige Krankheitsmanagement eine Herausforderung dar. Durch eine Patientenschulung kann der Übergang in die Erwachsenenmedizin vorbereitet und ein Empowerment der Zielgruppe erreicht werden.In der Kinderklinik Lübeck und dem Institut für Psychologie der Universität Greifswald wurde nun erstmals eine eigenständige Transitionsschulung entwickelt, die zunächst für Jugendliche mit Typ-1-Diabetes, Mukoviszidose und chronisch-entzündlichen Darmerkrankungen konzipiert wurde, um ihre Gesundheitskompetenz und ihre Selbstständigkeit bezüglich ihrer Erkrankung zu fördern.Auf Basis qualitativer Interviews wurde ein Curriculum entwickelt; Themen sind die Organisation des Krankheitsmanagements, Perspektiven der Weiterbehandlung, Kennenlernen krankheitsspezifischer Unterstützungsangebote, Ablösung von den Eltern, Berufsfindung/-ausbildung und Partnerschaft. Die Schulung wurde anschließend auf alle Jugendliche mit chronischen Erkrankungen erweitert und um eine Elternschulungskomponente und eine interaktive Internetseite ergänzt.AbstractFor young people with a chronic disease growing up and independent disease management are challenging. Through patient education, the transition into adult medicine and an empowerment of the target group will be reached.At the Children’s Hospital Luebeck and the Department of Psychology at the University of Greifswald independent transition training has now been developed for the first time; this was initially designed for young people with type 1 diabetes, cystic fibrosis and inflammatory bowel disease, to promote their health literacy and their autonomy with regard to their disease.Based on qualitative interviews, a curriculum was developed, which includes the topics of the organization of disease management, prospects of further treatment, getting to know disease-specific support services, detachment from family, career choice/education and partnership. The training was then extended to all young people with chronic diseases and supplemented by a parent training component and an interactive website.

Patientenschulungen in der Transition

ZusammenfassungFür Jugendliche mit einer chronischen Erkrankung stellt das Erwachsenwerden und das selbstständige Krankheitsmanagement eine Herausforderung dar. Durch eine Patientenschulung kann der Übergang in die Erwachsenenmedizin vorbereitet und ein Empowerment der Zielgruppe erreicht werden.In der Kinderklinik Lübeck und dem Institut für Psychologie der Universität Greifswald wurde nun erstmals eine eigenständige Transitionsschulung entwickelt, die zunächst für Jugendliche mit Typ-1-Diabetes, Mukoviszidose und chronisch-entzündlichen Darmerkrankungen konzipiert wurde, um ihre Gesundheitskompetenz und ihre Selbstständigkeit bezüglich ihrer Erkrankung zu fördern.Auf Basis qualitativer Interviews wurde ein Curriculum entwickelt; Themen sind die Organisation des Krankheitsmanagements, Perspektiven der Weiterbehandlung, Kennenlernen krankheitsspezifischer Unterstützungsangebote, Ablösung von den Eltern, Berufsfindung/-ausbildung und Partnerschaft. Die Schulung wurde anschließend auf alle Jugendliche mit chronischen Erkrankungen erweitert und um eine Elternschulungskomponente und eine interaktive Internetseite ergänzt.AbstractFor young people with a chronic disease growing up and independent disease management are challenging. Through patient education, the transition into adult medicine and an empowerment of the target group will be reached.At the Children’s Hospital Luebeck and the Department of Psychology at the University of Greifswald independent transition training has now been developed for the first time; this was initially designed for young people with type 1 diabetes, cystic fibrosis and inflammatory bowel disease, to promote their health literacy and their autonomy with regard to their disease.Based on qualitative interviews, a curriculum was developed, which includes the topics of the organization of disease management, prospects of further treatment, getting to know disease-specific support services, detachment from family, career choice/education and partnership. The training was then extended to all young people with chronic diseases and supplemented by a parent training component and an interactive website.

Patientenschulungen in der Transition@@@Patient education in transition: Empowerment für Jugendliche mit chronischen Erkrankungen@@@Empowerment for young people with chronic illnesses

ZusammenfassungFür Jugendliche mit einer chronischen Erkrankung stellt das Erwachsenwerden und das selbstständige Krankheitsmanagement eine Herausforderung dar. Durch eine Patientenschulung kann der Übergang in die Erwachsenenmedizin vorbereitet und ein Empowerment der Zielgruppe erreicht werden.In der Kinderklinik Lübeck und dem Institut für Psychologie der Universität Greifswald wurde nun erstmals eine eigenständige Transitionsschulung entwickelt, die zunächst für Jugendliche mit Typ-1-Diabetes, Mukoviszidose und chronisch-entzündlichen Darmerkrankungen konzipiert wurde, um ihre Gesundheitskompetenz und ihre Selbstständigkeit bezüglich ihrer Erkrankung zu fördern.Auf Basis qualitativer Interviews wurde ein Curriculum entwickelt; Themen sind die Organisation des Krankheitsmanagements, Perspektiven der Weiterbehandlung, Kennenlernen krankheitsspezifischer Unterstützungsangebote, Ablösung von den Eltern, Berufsfindung/-ausbildung und Partnerschaft. Die Schulung wurde anschließend auf alle Jugendliche mit chronischen Erkrankungen erweitert und um eine Elternschulungskomponente und eine interaktive Internetseite ergänzt.AbstractFor young people with a chronic disease growing up and independent disease management are challenging. Through patient education, the transition into adult medicine and an empowerment of the target group will be reached.At the Children’s Hospital Luebeck and the Department of Psychology at the University of Greifswald independent transition training has now been developed for the first time; this was initially designed for young people with type 1 diabetes, cystic fibrosis and inflammatory bowel disease, to promote their health literacy and their autonomy with regard to their disease.Based on qualitative interviews, a curriculum was developed, which includes the topics of the organization of disease management, prospects of further treatment, getting to know disease-specific support services, detachment from family, career choice/education and partnership. The training was then extended to all young people with chronic diseases and supplemented by a parent training component and an interactive website.