Development of a Protocol for Transitioning Adolescents With HIV Infection to Adult Care

Maturo, Donna; Powell, Alexis; Major-Wilson, Hanna; Sanchez, Kenia; Santis, Joseph P. De; Friedman, Lawrence B.

doi:10.1016/j.pedhc.2009.12.005

Cited by 56 publications

(53 citation statements)

References 19 publications

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“…The aim is to promote youth self‐confidence, improve the communication skills of youth and their caretakers, and to allow youth to share experiences and receive support from their peers and caretakers for issues related to sexual reproductive health, career plans, and HIV care [10]. The programme engaged adult providers to participate in the one‐day workshop and half‐day meetings so that adult providers and youth could work together to coordinate the transition from one provider to another [1,2,21,22]. In Thailand, many youth live with their parents or relatives and are under the direct supervision of adult caretakers.…”

Section: Resultsmentioning

confidence: 99%

“…In Thailand, some hospitals transfer youth living with HIV to adult care at the age of 15 years. The Thai guidelines for transitioning youth from paediatric to adult HIV care services recommend that preparations begin at least one year before the planned transition to help adolescents progress towards self‐management [13] and to encourage communications among youth, families/caretakers, and their providers for transition plan [8,13,22,27]. …”

Section: Resultsmentioning

confidence: 99%

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The Happy Teen programme: a holistic outpatient clinic‐based approach to prepare HIV‐infected youth for the transition from paediatric to adult medical care services in Thailand

Lolekha

Boon-yasidhi

Na-Nakorn

et al. 2017

Journal of the International AIDS Society

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Introduction: We developed an 18‐month Happy Teen 2 (HT2) programme comprised of a one‐day workshop, two half‐day sessions, and three individual sessions to prepare HIV‐infected youth for the transition from paediatric to adult HIV care services. We describe the programme and evaluate the change in youth's knowledge scores.Methods: We implemented the HT2 programme among HIV‐infected Thai youth aged 14–22 years who were aware of their HIV status and receiving care at two hospitals in Bangkok (Siriraj Hospital, Queen Sirikit National Institute of Child Health [QSNICH]). Staff interviewed youth using a standardized questionnaire to assess HIV and health‐related knowledge at baseline and at 12 and 18 months while they participated in the programme. We examined factors associated with a composite knowledge score ≥95% at month 18 using logistic regression.Results: During March 2014–July 2016, 192 of 245 (78%) eligible youth were interviewed at baseline. Of these, 161 (84%) returned for interviews at 12 and 18 months. Among the 161 youth, the median age was 17 years, 74 (46%) were female, and 99% were receiving antiretroviral treatment. The median composite score was 45% at baseline and increased to 82% at 12 months and 95% at 18 months (P < 0.001). The range of median knowledge scores for antiretroviral management, HIV monitoring, HIV services, and family planning significantly increased from baseline (range 0–75%) to (range 67–100%) at 12 months and to 100% at 18 months (P < 0.001). Almost all youth were able to describe education and career goals at 12 and 18 months compared to 75% at baseline. In multivariable analysis, a composite knowledge score at 18 months >95% was associated with education level >high school (aOR: 2.15, 95%CI, 1.03–4.48) and receipt care at QSNICH (aOR: 2.43, 95%CI, 1.18–4.98). Youth whose mother and father had died were less likely to have score ≥95% (aOR: 0.22, 95%CI, 0.07–0.67) than those with living parents.Conclusions: Knowledge useful for a successful transition from paediatric to adult HIV care increased among youth participating in the HT2 programme. Youth follow‐up will continue to assess the impact of improved knowledge on outcomes following the transition to adult care services.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The Happy Teen programme: a holistic outpatient clinic‐based approach to prepare HIV‐infected youth for the transition from paediatric to adult medical care services in Thailand

Lolekha

Boon-yasidhi

Na-Nakorn

et al. 2017

Journal of the International AIDS Society

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“…Guidelines specific to transitioning HIV-infected youth are also available. 20,21 There are 4 major steps in the transition process:…”

Section: Recommendationsmentioning

confidence: 99%

“…This variability is reflected in differences in addressing comprehensive care needs as part of the transition, including medical, psychosocial, and financial aspects of transitioning. [17][18][19][20][21] In a survey of providers of pediatric HIV care in the United States, 81% had designated a transition coordinator, but few had established policies to define the details of the transition. 22 One university-based program elected to begin the process at 23 years of age because of a high failure rate when initiated at 21 years of age.…”

Section: Introductionmentioning

confidence: 99%

“…22 One university-based program elected to begin the process at 23 years of age because of a high failure rate when initiated at 21 years of age. 20 Results of this strategy are not yet available. Most models are characterized by flexibility, allowing youth to move back and forth between stages of the transition with the anticipation of completing the process by 25 years of age.…”

Section: Introductionmentioning

confidence: 99%

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Transitioning HIV-Infected Youth Into Adult Health Care

Chakraborty¹,

Dyke²,

Flynn³

et al. 2013

Pediatrics

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With advances in antiretroviral therapy, most HIV-infected children survive into adulthood. Optimal health care for these youth includes a formal plan for the transition of care from primary and/or subspecialty pediatric/adolescent/family medicine health care providers (medical home) to adult health care provider(s). Successful transition involves the early engagement and participation of the youth and his or her family with the pediatric medical home and adult health care teams in developing a formal plan. Referring providers should have a written policy for the transfer of HIV-infected youth to adult care, which will guide in the development of an individualized plan for each youth. The plan should be introduced to the youth in early adolescence and modified as the youth approaches transition. Assessment of developmental milestones is important to define the readiness of the youth in assuming responsibility for his or her own care before initiating the transfer. Communication among all providers is essential and should include both personal contact and a written medical summary. Progress toward the transition should be tracked and, once completed, should be documented and assessed. Pediatrics

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Primary-level and community worker interventions for the prevention of mental disorders and the promotion of well-being in low- and middle-income countries

Purgato,

Prina,

Ceccarelli

et al. 2023

Cochrane Database of Systematic Reviews

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Background There is a significant research gap in the field of universal, selective, and indicated prevention interventions for mental health promotion and the prevention of mental disorders. Barriers to closing the research gap include scarcity of skilled human resources, large inequities in resource distribution and utilization, and stigma. Objectives To assess the effectiveness of delivery by primary workers of interventions for the promotion of mental health and universal prevention, and for the selective and indicated prevention of mental disorders or symptoms of mental illness in low‐ and middle‐income countries (LMICs). To examine the impact of intervention delivery by primary workers on resource use and costs. Search methods We searched CENTRAL, MEDLINE, Embase, CINAHL, Global Index Medicus, PsycInfo, WHO ICTRP, and ClinicalTrials.gov from inception to 29 November 2021. Selection criteria Randomized controlled trials (RCTs) of primary‐level and/or community health worker interventions for promoting mental health and/or preventing mental disorders versus any control conditions in adults and children in LMICs. Data collection and analysis Standardized mean differences (SMD) or mean differences (MD) were used for continuous outcomes, and risk ratios (RR) for dichotomous data, using a random‐effects model. We analyzed data at 0 to 1, 1 to 6, and 7 to 24 months post‐intervention. For SMDs, 0.20 to 0.49 represented small, 0.50 to 0.79 moderate, and ≥ 0.80 large clinical effects. We evaluated the risk of bias (RoB) using Cochrane RoB2. Main results Description of studies We identified 113 studies with 32,992 participants (97 RCTs, 19,570 participants in meta‐analyses) for inclusion. Nineteen RCTs were conducted in low‐income countries, 27 in low‐middle‐income countries, 2 in middle‐income countries, 58 in upper‐middle‐income countries and 7 in mixed settings. Eighty‐three RCTs included adults and 30 RCTs included children. Cadres of primary‐level workers employed primary care health workers (38 studies), community workers (71 studies), both (2 studies), and not reported (2 studies). Interventions were universal prevention/promotion in 22 studies, selective in 36, and indicated prevention in 55 RCTs. Risk of bias The most common concerns over risk of bias were performance bias, attrition bias, and reporting bias. Intervention effects 'Probably', 'may', or 'uncertain' indicates 'moderate‐', 'low‐', or 'very low‐'certainty evidence. *Certainty of the evidence (using GRADE) was assessed at 0 to 1 month post‐intervention as specified in the review protocol. In the abstract, we did not report results for outcomes for which evidence was missing or very uncertain. Adults Promotion/universal prevention, compared...

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Development of a Protocol for Transitioning Adolescents With HIV Infection to Adult Care

Cited by 56 publications

References 19 publications

The Happy Teen programme: a holistic outpatient clinic‐based approach to prepare HIV‐infected youth for the transition from paediatric to adult medical care services in Thailand

The Happy Teen programme: a holistic outpatient clinic‐based approach to prepare HIV‐infected youth for the transition from paediatric to adult medical care services in Thailand

Transitioning HIV-Infected Youth Into Adult Health Care

Primary-level and community worker interventions for the prevention of mental disorders and the promotion of well-being in low- and middle-income countries

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