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

Abstract

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.

“Because we all have to grow up”: supporting adolescents in Uganda to develop core competencies to transition towards managing their HIV more independently

“…For this purpose, established “transition checklists” may provide a valuable tool to broadly establish the extent of individual transition preparedness and guide ongoing care (where adapted, contextually suitable checklists are available [33,34]). We suggest that HIV‐counselling content increase in sophistication pre‐emptively with evolving maturity [35‐37]. Ultimately, the optimal timing and rate of adolescent transition should be tailored to the neurocognitive developmental status of the individual, based on longitudinal assessment and contemporaneous understanding of individual capacity [25,38], rather than chronological age [39].…”

Tracking the transition of adolescents into adult HIV care: a global assessment

“…The final paper in this group is an evaluation of the “Happy Teen Program”, which was developed to directly address transition in Thai youth. Lolekha et al describe an intervention to improve and standardize pre-transition preparation through group and individual training sessions [ 9 ]. Developed through a multidisciplinary collaboration between the government, public health, and hospital sectors, participation in the program successfully improved knowledge around health (e.g.…”

CHAMP+ Thailand: Pilot Randomized Control Trial of a Family-Based Psychosocial Intervention for Perinatally HIV-Infected Early Adolescents

“…[19][20][21] However, few evidence-based interventions exist, and the very few published studies on interventions with Thai PHIV youth are largely limited to older youth/young adults and focused on changes in HIV knowledge and attitudes only. 19,22 Given that early prevention of risk behavior and promotion of health behaviors are significantly more effective than efforts to intervene once behaviors are established, 23 there is an urgent need for risk prevention and health promotion interventions for younger adolescents. There is increasing evidence that intervening with adult caregivers or family members is necessary to promote mental health and adherence and reduce youth sexual and substance-related risk-taking behaviors.…”