In aging populations, multimorbidity (two or more chronic diseases in the same person [1, 2] is very common [3-5]. Patients with multimorbidity have complex health and social needs, are at risk of being admitted to the hospital or residential care home and require a wide range of interventions [6]. To satisfy the needs of these patients and their families, new innovative integrated care models are needed. To be effective, they should have primary care as the cornerstone of care [7]; effective integration between care levels [8, 9]; empowered patient´ and carers/families' [8]; and it should be patient-centered. The use of information and communication technology (ICT) platforms could
BackgroundAdolescence is crucial period for laying the foundations for healthy development and mental well-being. The increasing prevalence of mental disorders amongst adolescents makes promotion of mental well-being and prevention interventions at schools important. UPRIGHT (Universal Preventive Resilience Intervention Globally implemented in schools to improve and promote mental Health for Teenagers) is designed as a whole school approach (school community, students and families) to promote a culture of mental well-being and prevent mental disorders by enhancing resilience capacities. The present article aims at describing the rationale, conceptual framework, as well as methodology of implementation and evaluation of the UPRIGHT intervention.MethodsUPRIGHT project is a research and innovation project funded by the European Union’s Horizon 2020 Research and Innovation programme under grant agreement No. 754919 (Duration: 48 months). The theoretical framework has been developed by an innovative and multidisciplinary approach using a co-creation process inside the UPRIGHT Consortium (involving seven institutions from Spain, Italy, Poland, Norway, Denmark, and Iceland). Resulted is the UPRIGHT programme with 18 skills related to 4 components: Mindfulness, Coping, Efficacy and Social and Emotional Learning.Among the five Pan-European regions, 34 schools have been currently involved (17 control; 17 intervention) and around 6000 adolescents and their families are foreseen to participate along a 3-year period of evaluation. Effectiveness of the intervention will be evaluated as a randomized controlled trial including quantitative and qualitative analysis in the five Pan-European regions representative of the cultural and socioeconomic diversity. The cost-effectiveness assessment will be performed by simulation modelling methods.DiscussionWe expect a short- to medium-term improvement of mental well-being in adolescents by enhancing resilience capacities. The study may provide robust evidence on intrapersonal, familiar and social environmental resilience factors promoting positive mental well-being.Trial registrationClinicalTrials.gov Identifier: NCT03951376. Registered 15 May 2019.
The co-creation of educational services that promote youth resilience and mental health is still scarce. UPRIGHT (Universal Preventive Resilience Intervention Globally implemented in schools to improve and promote mental Health for Teenagers) is a research and intervention program in the Basque Country (Spain), Trentino (Italy), Low Silesia (Poland), Denmark and Reykjavik (Iceland). UPRIGHT implemented a co-creation research process whose results, outcomes and policy implications are presented here. The co-creation had a mixed-methods participatory research design with nine specific objectives linked to paired strategies of inquiry for adolescents, families, teachers and school staff. The overarching objective was to generate a valid and feasible regional adaptation strategy for UPRIGHT intervention model. Participants answered surveys ( n = 794) or attended 16 group sessions ( n = 217). The results integrate quantitative and qualitative information to propose a regional adaptation strategy that prioritizes resilience skills, adolescents’ concerns, and preferred methods for implementation across countries and in each school community. In conclusion, a whole-school resilience program must innovate, include and connect different actors, services and communities, and must incorporate new technologies and activities outside the classroom. A participatory co-creation process is an indispensable step to co-design locally relevant resilience interventions with the involvement of the whole-school community.
Zachowania dobrostanu i samodzielności przez osoby starsze wynika z wdrażania zasad „dobrego starzenia się” opartego na aktywności i uczestnictwie w życiu zawodowym i społecznym oraz promocji zdrowego stylu życia. Coraz większe znaczenie przypisuje się rozpowszechnieniu zespołu słabości wśród pacjentów w wieku podeszłym. Pacjenci ci charakteryzują się zwiększoną wrażliwością na bodźce, upośledzoną zdolnością do radzenia sobie z wewnętrznymi i środowiskowymi czynnikami stresogennymi, a także posiadają ograniczoną zdolność do utrzymania stanu fizjologicznej i psychospołecznej homeostazy W takich przypadkach konieczne jest wsparcie pacjentów opieką zintegrowaną polegającą na wsparciu środowiska oraz najnowszej technologii. Zapewnienie mieszkańcom województwa dolnośląskiego wysokiej jakości życia, dopasowanie usług społecznych do potrzeb mieszkańców oraz sama integracja społeczna są zgodne ze Strategia Integracji Społecznej na Dolnym Śląsku. Dlatego też, na Dolnym Śląsku wsparcie takich pacjentów technologią, zostało zapoczątkowane pilotażem projektu CareWell i WRP®. Zastosowanie nowych technologii wymaga kampanii społecznej, informacji w mediach i wzbudzenia społecznego zaciekawienia, wręcz mody na ich stosowanie. Pozwoli to na doskonalenie nowych usług, obniżenie kosztów i poprawę bezpieczeństwa ludzi. W miejsce kosztownej opieki specjalistycznej pacjenci w wieku podeszłym uzyskują opiekę indywidualizowaną, lokowaną w środowisku, mniej kosztowną lecz bardziej intensywną. Projekt FOCUS zajmuje się zmniejszeniem obciążenia zespołem słabości w populacji osób w wieku podeszłym w Europie z uwzględnieniem wzmocnienia wsparcia środowiskowego. Celem projektu SUNFRAIL jest poprawa identyfikacji, zapobiegania i zarządzanie zespołem słabości oraz opieką nad wielochorobowością wśród osób po 65 roku życia mieszkających w społeczności lokalnej przez regionalne ośrodki i instytucje krajów UE.
This paper describes recent work conducted in the EU project UPRIGHT regarding the design of a resilience-based intervention promoting mental wellbeing in early adolescence, including smart coaching solutions for families. In particular, the project is currently conducting a co-design phase, where the content of the training program and the digital tools to deliver it are discussed and assessed in collaboration with the schools' stakeholders. The intervention will be validated within 5 large-scale pilot studies in Spain, Italy, Iceland, Denmark and Poland, involving about six thousand families over the next 4 years.
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