Jenny Proimos

Adolescent-friendly health services

The term adolescent-friendly health services has been adopted by the World Health Organization as a framework for providing quality health-care delivery to young people.1 The principles are to promote accessibility, acceptability, appropriateness, equity and effectiveness of health services, with a

Adolescent-friendly health services : What have children's hospitals got to do with it?

The term adolescent-friendly health services has been adopted by the World Health Organization as a framework for providing quality health-care delivery to young people.1 The principles are to promote accessibility, acceptability, appropriateness, equity and effectiveness of health services, with a

Working with young people: evaluation of an education resource for medical trainees.

Many health professionals report interest in consulting more effectively with young people but have unmet training needs. We set out to evaluate a teaching resource in adolescent health and medicine that was designed for Australian trainees in specialist medicine.

Noncommunicable Diseases in Children and Adolescents

* Abbreviations: NCD — : noncommunicable disease We have made great progress in preventing and managing communicable diseases worldwide. Noncommunicable diseases (NCDs), which result from noninfectious and nontransmissible factors, are often caused by factors that are modifiable. Children are the frequent victims of air pollution and behaviors such as tobacco use, physical inactivity, and unhealthy diets leading to the development of the NCDs discussed in this global health perspectives commentary. The worldwide burden of NCDs is enormous, actually accounting for the majority of all deaths. Risk factors such as high blood pressure, raised cholesterol, tobacco use, alcohol consumption, and overweight coupled with poor economic and social conditions create a perfect storm for many of the world’s chronic illnesses diseases. Drs Proimos and Klein bring new focus to the pediatric perspective and suggest an approach to developing strategies internationally to combat these most common health issues of our time. —Jay E. Berkelhamer, MD Editor, Global Health Perspectives Recent global attention has focused on NCDs and their impact on global morbidity and mortality. NCDs are medical conditions or diseases that are nontransmissible and often enduring. Of the 57 million deaths worldwide in 2008, NCDs accounted for 36 million, mainly due to cardiovascular disease, cancers, diabetes, and chronic lung diseases.1 Eighty percent of NCD deaths occur in low and middle income countries.2 NCDs often result from modifiable lifestyle risk factors, such as tobacco use, problem alcohol use, unhealthy diet, … Dr Proimos is a member and Dr Klein is chair of the International Pediatric Association Technical Advisory Group on Noncommunicable Diseases. The International Pediatric Association is a nongovernmental organization of 144 national, regional, and international specialty pediatric societies.

A cluster randomised controlled trial of a brief couple-focused psychoeducational intervention to prevent common postnatal mental disorders among women: study protocol.

Introduction Postnatal common mental disorders among women are an important public health problem internationally. Interventions to prevent postnatal depression have had limited success. What Were We Thinking (WWWT) is a structured, gender-informed, psychoeducational group programme for parents and their first infant that addresses two modifiable risks to postnatal mental health. This paper describes the protocol for a cluster randomised controlled trial to test the clinical effectiveness and cost-effectiveness of WWWT when implemented in usual primary care. Methods and analysis 48 maternal and child health (MCH) centres from six diverse Local Government Areas, in Victoria, Australia are randomly allocated to the intervention group (usual care plus WWWT) or the control group (usual care). The required sample size is 184 women in each group. English-speaking primiparous women receiving postpartum healthcare in participating MCH centres complete two computer-assisted telephone interviews: baseline at 4 weeks and outcome at 6 months postpartum. Women attending intervention MCH centres are invited to attend WWWT in addition to usual care. The primary outcome is meeting Diagnostic and Statistical Manual-IV (DSM-IV) diagnostic criteria for major depressive episode; generalised anxiety disorder; panic disorder with or without agoraphobia, agoraphobia with or without panic, social phobia, adult separation anxiety or adjustment disorder with depressed mood, anxiety or mixed depressed mood and anxiety within the past 30 days at 6 months postpartum. Secondary outcomes are self-rated general and emotional health, infant sleep problems, method of infant feeding, quality of mother–infant relationship and intimate partner relationship, and healthcare costs and outcomes. Ethics and dissemination Approval to conduct the study has been granted. A comprehensive dissemination plan has been devised. Trial registration number Australian New Zealand Clinical Trials Registry ACTRN12613000506796. UTN U1111-1125-8208.

Gender-informed, psychoeducational programme for couples to prevent postnatal common mental disorders among primiparous women: cluster randomised controlled trial

Objectives Interventions to prevent postpartum common mental disorders (PCMD) among unselected populations of women have had limited success. The aim was to determine whether What Were We Thinking (WWWT) a gender-informed, psychoeducational programme for couples and babies can prevent PCMD among primiparous women 6 months postpartum. Design Cluster-randomised controlled trial. Setting 48 Maternal and Child Health Centres (MCHCs) from 6 Local Government Areas in Melbourne, Australia were allocated randomly to usual care (24) or usual care plus WWWT (24). Participants English-speaking primiparous women receiving primary care at trial MCHCs were recruited to the intervention (204) and control (196) conditions. Of these, 187 (91.7%) and 177 (90.3%) provided complete data. Intervention WWWT is a manualised programme comprising primary care from a trained nurse, print materials and a face-to-face seminar. Main outcome measures Data sources were standardised and study-specific measures collected in blinded computer-assisted telephone interviews at 6 and 26 weeks postpartum. The primary outcome was PCMD assessed by Composite International Diagnostic Interviews and Patient Health Questionnaire (PHQ) Depression and Generalised Anxiety Disorder modules. Results In intention-to-treat analyses the adjusted OR (AOR) of PCMD in the intervention compared to the usual care group was 0.78 (95% CI 0.38 to 1.63, ns), but mild to moderate anxiety symptoms (AOR 0.58, 95% CI 0.35 to 0.97) and poor self-rated health (AOR 0.46, 95% CI 0.22 to 0.97) were significantly lower. In a per protocol analysis, comparing the full (three component) intervention and usual care groups, the AOR of PCMD was 0.36, (95% CI 0.14 to 0.95). The WWWT seminar was appraised as salient, comprehensible and useful by >85% participants. No harms were detected. Conclusions WWWT is readily integrated into primary care, enables inclusion of fathers and addresses modifiable risks for PCMD directly. The full intervention appears a promising programme for preventing PCMD, optimising family functioning, and as the first component of a stepped approach to mental healthcare. Trial registration number ACTRN12613000506796; Results.

Socioeconomic and health factors associated with kindergarten retention in Australian children

We aimed to identify key socioeconomic and health factors that are associated with a childs likelihood of being retained in kindergarten prior to commencing first year of school in Australian children.

Adolescent-friendly health services: What have children's hospitals got to do with it?: Adolescent-friendly health services

The term adolescent-friendly health services has been adopted by the World Health Organization as a framework for providing quality health-care delivery to young people.1 The principles are to promote accessibility, acceptability, appropriateness, equity and effectiveness of health services, with a