Established Evidence Results

Intervention Components (click on component to see a list of all articles that use that intervention): Parent Mentors, Training (Parent/Family), Education on Disease/Condition,

Intervention Description: NAMI Basics is a six-class manualized curriculum offered in English and Spanish. Classes occur weekly and are approximately 2.5 hours long. The curriculum covers the following content: an introduction to mental disorders and how they affect families, information about treatment of mental illness, communication skills, managing difficult child behaviors, crisis management, information about systems of care, and self-care and advocacy. NAMI-trained peer parents describe their own experiences parenting a child with mental health concerns to frame content and foster sharing of personal stories (see online supplement for more details). NAMI Basics peer parents are caregivers of a child who experienced mental health symptoms before age 13. NAMI relies on a referral process for identifying peer parents, and those who are trained to lead the course have typically taken a course previously. Training to become a peer parent takes approximately 15 hours. Training is led by NAMI state trainers, who have undergone this training previously, have experience observing and leading NAMI Basics classes, and have been recommended by their local affiliate. This study included 33 separate NAMI Basics courses across the five study sites. Nine of these courses occurred at affiliate 1, five at affiliate 2, six at affiliate 3, nine at affiliate 4, and four at affiliate 5. NAMI Basics courses were considered part of the study if at least one study participant attended any of the six classes. Classes were led by one or two peer parents; most were female (79%); half were Caucasian (50%), followed by Hispanic/Latinx (34%), and African American (16%). Fidelity was assessed by NAMI Basics–trained individuals who attended one randomly selected class for each study course and completed an adherence checklist indicating presence or absence of prescribed content (see online supplement). Class 3 was excluded from fidelity monitoring, because this session has a focus on sharing personal experiences. Fidelity to the intervention ranged from 79% to 100% (mean±SD=94.27±6.13).

Intervention Results: Compared with caregivers in the waitlist condition, NAMI Basics participants reported significant increases in parent engagement and activation, as well as intentions to engage with mental health services. NAMI Basics participants also reported significant decreases in their child’s intrapersonal and interpersonal distress, compared with those in the waitlist group. No significant differences were noted on measures of parenting stress, attitudes toward mental health services, or stigma.

Conclusion: NAMI Basics is a peer-parent support program that is readily available to support caregivers of children with mental health concerns, particularly those who experience barriers to service engagement. NAMI Basics significantly increased caregiver activation and engagement, as well as intentions to engage in services, and the children of participants showed decreases in some symptoms. Future research should examine the effects of NAMI Basics on outcomes over a longer duration and assess pathways that may result in child-level changes. Given well-documented barriers to mental health services engagement (1–3, 7–9), peer-parent support is an important resource to be leveraged.

Study Design: Randomized controlled trial

Setting: 5 NAMI affiliate locations in a southwestern U.S. state

Population of Focus: Caregivers of children under age 22 with mental health concerns

Sample Size: 111 caregivers

Age Range: Children were ages 3-22

Intervention Components (click on component to see a list of all articles that use that intervention): Education on Disease/Condition, Assessment, Consultation (Parent/Family),

Intervention Description: "The whole health care model embedded monitoring of overall health and wellness education within the center’s outpatient mental and substance use disorder treatment services, and it improved care coordination with primary care providers."

Intervention Results: "For the first two-and-a-half years of the program, Medicare expenditures decreased by $266 per month on average for each enrolled beneficiary in the intervention group relative to the comparison group (p,.01). Intervention clients had .02 fewer hospitalizations, .03 fewer emergency department (ED) visits, and .13 fewer office visits per month relative to the comparison group (p,.05 for all estimates)."

Conclusion: "Overall, the whole health model reduced Medicare expenditures, ED visits, and hospitalization rates. These results may be due in part to the availability of more comprehensive medical data and staff’s improved awareness of client’s overall health needs."

Study Design: The study design was a difference-in-differences model using fee-for-service Medicare administrative claims and enrollment data.

Setting: The setting for the study was a community mental health center.

Population of Focus: The target audience for the study would include healthcare providers, mental health professionals, policymakers, and researchers interested in integrated care models and their impact on service utilization and expenditures.

Sample Size: he sample size for the intervention group was N=846, and the matched comparison group was N=2,643.

Age Range: The age range of the participants was not explicitly mentioned in the provided excerpts.

Intervention Components (click on component to see a list of all articles that use that intervention): Adult-led Support/Counseling/Remediation, Teacher/Staff Training, Education on Disease/Condition,

Intervention Description: We compared three interventions of different durations (Sensitivity Programme (SP), MHL programme and MHL + SR programme) of the EspaiJove.net programme.

Intervention Results: Although a trend of increasing knowledge was found in both parts of the questionnaire in the MHL and MHL + SR groups post-intervention and at 12-month follow-up, in comparison with the SP and the CG, no significant differences were found between groups (SP, MHL and MHL + SR) over time in either of the two parts.

Conclusion: The three interventions of the EspaiJove.net programme (SP, MHL and MHL + SR) seem not to be effective in terms MHL, Stigma and help-seeking behaviours in the short (post-intervention) and long term (6 and 12 months follow up).

Study Design: Cluster randomized controlled trial

Setting: 18 secondary schools in Barcelona, Spain

Population of Focus: 13-14 year old students

Sample Size: 1,032 students

Age Range: 13-14 years old

Intervention Components (click on component to see a list of all articles that use that intervention): Education on Disease/Condition, Motivational Interviewing/Counseling,

Intervention Description: The study evaluated the impact of a public health strategy to counteract an 'epidemic panic' that occurred in the district of Palermo following four cases of meningococcal disease in the summer of 2016. The strategy included effective communication strategies to provide timely and effective information on appropriate prevention measures and regulated access for the population to receive vaccination services. Healthcare workers of the vaccination services targeted counseling to adolescents and young adults in order to promote greater confidence in vaccination

Intervention Results: The study found a significant increase in the anti-meningococcal vaccination coverage in each local health unit and at a regional level. Concurrent catch-up of other recommended vaccinations for age (diphtheria-tetanus-pertussis-poliomyelitis and papillomavirus) resulted in a further increase of administered doses.

Conclusion: The study concluded that a public health strategy that includes effective communication strategies and measures provided by public health authorities can lead to an increase in vaccination coverage in the target population and positive effects on vaccine compliance in the general population.

Study Design: The study used a retrospective observational design.

Setting: The study was conducted in the district of Palermo, Sicily, Italy.

Population of Focus: Adolescents and young adults.

Sample Size: The study included a total of 10,735 individuals.

Age Range: The target population included individuals aged 14-30 years.

Intervention Components (click on component to see a list of all articles that use that intervention): Education on Disease/Condition, Planning for Transition, HEALTH_CARE_PROVIDER_PRACTICE, YOUTH

Intervention Description: This study aimed to evaluate the transition to adult care program instituted for liver transplant recipients (LTRs) at a large tertiary pediatric hospital in Melbourne, Australia.

Intervention Results: Twenty-eight LTRs participated in the study; 20 received the transition intervention and 8 served as controls. Within the intervention group, all domains of transition competency and reported anxiety regarding transferring had significantly improved at the conclusion of the intervention and all reported satisfaction with the transition program with most (81%) reporting readiness to transfer. There were no significant differences in rejection rates or failure to attend rates between those who did and did not receive the transition intervention.

Conclusion: A longitudinal holistic transition program has the potential to positively impact the competencies and readiness of LTRs to successful transition and transfer to adult care.

Intervention Components (click on component to see a list of all articles that use that intervention): Education on Disease/Condition, Peer-led Mentoring/Support Counseling, YOUTH

Intervention Description: To evaluate whether these effects are long lasting, we questioned young people (YP) from the intervention group (IG) and the control group (CG; no program) 2 years after participation.

Intervention Results: A total of 181 YP (109 IG, 72 CG) completed the questionnaires (60% of previous interviewees; mean age 20 years, 46% female). Compared to the CG, the IG reported significant improvements in transition-specific knowledge, competencies, and patient activation (p < .001) and lower parents' responsibility for their condition (p = .004). The proportion of YP who had already transferred to adult health care was nearly the same (54% IG/56% CG), but the CG was more likely to lose access to medical care (6% IG/14% CG). There were no effects on health-related quality of life.

Conclusion: The 1.5-day ModuS-T program has long-lasting positive effects on knowledge and competencies relevant for the transition of YP. Transition-specific patient education programs close an important care gap and should be integrated into standard care.

Intervention Components (click on component to see a list of all articles that use that intervention): Assessment (patient/consumer), Assessment (Provider), Education on Disease/Condition,

Intervention Description: The study evaluated the impact of a community-based mobile crisis service intervention in Connecticut, which provides crisis stabilization and support, screening and assessment, suicide assessment and prevention, brief, solution-focused interventions, and referral and linkage to ongoing care.

Intervention Results: Youths who received mobile crisis services had a significant reduction in odds of a subsequent behavioral health ED visit compared with those who did not receive mobile crisis services.

Conclusion: The study provides evidence suggesting that community-based mobile crisis services, such as Mobile Crisis, reduce ED use among youths with behavioral health service needs.

Study Design: Quasi-experimental study

Setting: Connecticut, United States

Population of Focus: Healthcare providers, policymakers, and researchers interested in improving behavioral health services for youths.

Sample Size: Not specified

Age Range: Youths who were age 18 and younger, as well as older youths who were still attending high school.

Intervention Components (click on component to see a list of all articles that use that intervention): Adult-led Curricular Activities/Training, Presentation/meeting/information Session (Classroom), Education on Disease/Condition

Intervention Description: Implementation of a translated and adapted version of a Canadian mental health literacy curriculum called "The Mental Health and High School Curriculum Guide (MHC)" Delivered in six modules over 1 day on topics like destigmatization, mental health/illness, specific disorders, lived experiences, help-seeking, and positive mental health Includes individual and group activities using printed materials, videos, presentation slides etc. Implemented by teachers and a school counselor Incorporated personal stories from mental health experts with lived experience (in-person in 2 classes, via video in 3 classes)

Intervention Results: Data from 188 students was eligible for analysis. The analysis of the baseline data reveals a high comparability of the two groups in terms of demographics, and initial mental health knowledge and help-seeking efficacy scores. ANOVA results showed significant improvements for the intervention group having a large effect size for mental health knowledge (f = 0.574, p < 0.001, partial η2 = 0.25) and a medium effect size for help-seeking efficacy (f = 0.311, p < 0.001, partial η2 = 0.09).

Conclusion: The first-time application and evaluation of an adapted mental health literacy school curriculum shows significant increases in mental health knowledge and help-seeking efficacy, two core dimensions of mental health literacy, among 10th grade students in Germany. Further studies are needed to confirm these results as well as have a more in-depth analysis on the interrelations of the different dimensions of mental health knowledge and help-seeking practices.

Study Design: Quasi-experimental pre-post evaluation with a control group

Setting: Secondary schools in Germany

Population of Focus: 10th grade students

Sample Size: 188

Age Range: 14-17 years old

Intervention Components (click on component to see a list of all articles that use that intervention): Education on Disease/Condition, Outreach (School Staff), Patient Navigation,

Intervention Description: The New York City Department of Health and Mental Hygiene’s Office of Health Insurance Services has partnered with the department’s Early Intervention Program to implement a Service Integration Model to enroll CSHCN, aged 0 to 3, into public health insurance. This model is based on a combined approach of educational messaging to clients and individual counseling or assistance to facilitate enrollment and renewal of health insurance serving a hard-to-reach and vulnerable population. This model uses data from program databases and staff from children’s programs to proactively identify uninsured and underinsured children and facilitate their enrollment into public health insurance. The model has 3 key components allowing for comprehensive and continuous coverage for CSHCN: (1) integration of program messages within the Early Intervention Program (e.g., welcome letter to parents, brochure and poster for provider agencies), (2) data matching with child program data (Early Intervention data, Medicaid data, Census data), and (3) incorporation of program staff (Office of Health Insurance Services child benefit advisors) to work directly with parents (e.g., available in multiple languages and at convenient hours and locations). The model overcomes enrollment barriers by using consumer-friendly enrollment materials and one-on-one assistance, and shows the benefits of a comprehensive and collaborative approach to assisting families with enrollment into public health insurance. A key strategy is to prevent gaps in coverage resulting when parents fail to renew their children’s coverage. Staff are strategically co-located at the offices of providers who serve children enrolled in the Early Intervention Program.

Intervention Results: Since 2008, more than 5,000 children in the Early Intervention Program have been successfully enrolled and coverage renewed in Medicaid through the Service Integration Model. In 2008, the study team found that children in the Early Intervention Program had a34% churning rate for Medicaid because of enrollment barriers and misconception of the Early Intervention Program as a replacement for Medicaid. By 2010, the churning rate for clients assisted through Office of Health Insurance Services was reduced from 34% to 8%. The Office of Health Insurance Services will modify the Service Integration Model to respond to New York State’s implementation of the Health Insurance Exchange required by the 2010 ACA. The model is replicable by other government agencies serving the uninsured and underinsured. Partnerships across government programs and agencies offer opportunities to enroll hard-to-reach populations into public health insurance.

Conclusion: Partnerships across government programs and agencies offer opportunities to enroll hard-to-reach populations into public health insurance. The model reflects how government programs can work together to improve rates of enrollment and retention in public health insurance. The key elements of integration of program messages, data matching, and staff involvement allow for the model to be tailored to the specific needs of other government programs.

Study Design: Program evaluation

Setting: Community (New York City Department of Health and Mental Hygiene’s Office of Health Insurance Services and the Early Intervention Program)

Population of Focus: Young children with special health care needs

Sample Size: 6,500 children in early intervention with a Medicaid number

Age Range: 0-3 years

Intervention Components (click on component to see a list of all articles that use that intervention): Education on Disease/Condition, Online Material/Education/Blogging, Online Games

Intervention Description: An anti-tobacco educational board game, Smoke Stacks, was designed to engage youth in critical thinking regarding marketing practices of tobacco companies and tobacco's harmful effects. A pilot study was conducted to examine whether playing this theoretically informed that board game increased knowledge about tobacco use and negative attitudes toward tobacco companies, and decreased behavioral intentions to use tobacco.

Intervention Results: Compared to baseline, participants reported substantially increased self-perceived knowledge of the health effects of tobacco (P = 0.001) and were significantly more likely to agree that tobacco companies encourage young people to start smoking (P = 0.001), and that tobacco companies deny that cigarettes cause cancer and other diseases (P = 0.002).

Conclusion: This pilot study demonstrates that youth who played Smoke Stacks gained perceived knowledge and increased negative attitudes toward tobacco company tactics for encouraging smoking and discounting potential health risks of cigarettes.

Study Design: Pre/post evaluation

Setting: Chicago metro area, Illinois

Population of Focus: Researchers, public health professionals, policymakers

Sample Size: 67 youth

Age Range: ages 14-18

Intervention Components (click on component to see a list of all articles that use that intervention): Education on Disease/Condition, Notification/Information Materials (Online Resources, Information Guide), Planning for Transition, PARENT_FAMILY, YOUTH, HEALTH_CARE_PROVIDER_PRACTICE

Intervention Description: This quality improvement project focused on improving transition to adult health care by creating varied supports for the patient, family, and the health care team and putting them into action within a pediatric medical practice that serves over 250 adolescent and young adult patients with autism spectrum disorder.

Intervention Results: Before the supports were put into place, patients and families received limited and inconsistent communication to help them with transition. While the supports helped increase the amount and quality of help patients and families received, medical providers skipped or put off transition discussion in approximately half of well visits for targeted patients. Challenges in implementing the transition process included finding time to discuss transition-related issues with patients/families, preference of medical providers to have social workers discuss transition, and difficulty identifying adult health care providers for patients.

Conclusion: This suggests more work is needed to both train and partner with patients, families, and health staff to promote smooth and positive health transitions.

Intervention Components (click on component to see a list of all articles that use that intervention): Peer-led Mentoring/Support Counseling, Education on Disease/Condition, Adult-led Support/Counseling/Remediation,

Intervention Description: The tMHFA training program for adolescents to improve mental health first aid skills and behaviors towards peers

Intervention Results: The primary outcome—quality of first aid intentions towards the John vignette—showed statistically significant group x time interactions, with tMHFA students reporting more helpful and less unhelpful first aid intentions, than PFA students did over time. Confidence in providing first aid also showed significant interactions. First aid behaviours—both those provided to a peer with a mental health problem and those received from a peer—showed null results. Ratings of both beliefs about adult help and help-seeking intentions were found to be significantly improved among tMHFA students at follow-up. A group x time interaction was found on one stigma scale (would not tell anyone).

Conclusion: This trial showed that, one year after training, tMHFA improves first aid intentions towards peers with depression and suicide risk, confidence in helping peers with mental health problems, willingness to tell someone and seek help from an adult or health professional if experiencing a mental health problem.

Study Design: Cluster randomized controlled trial

Setting: Secondary schools in Victoria, Australia

Population of Focus: Students in Years 10-12 (ages 16-18)

Sample Size: 1,624 participants

Age Range: 16-18 years

Intervention Components (click on component to see a list of all articles that use that intervention): Education on Disease/Condition, Online Material/Education/Blogging,

Intervention Description: The tobacco intervention in the study included a brief advice message for clinicians, an interactive computer program, a motivational interview, and booster sessions. The control group received a brief dietary intervention to promote fruit and vegetable consumption.

Intervention Results: Abstinence rates after 2 years were significantly higher for the tobacco intervention arm, relative to the control group, in the combined sample of baseline smokers and nonsmokers (odds ratio [OR]: 1.23; 95% confidence interval [CI]: 1.03–1.47). Treatment effects were particularly strong among baseline self-described smokers (OR: 2.42; 95% CI: 1.40–4.16) but were not significant for baseline nonsmokers (OR: 1.25; 95% CI: 0.97–1.61) or for those who had “experimented” in the past month at baseline (OR: 0.95; 95% CI: 0.45–1.98).

Conclusion: Brief, computer-assisted, tobacco intervention during routine medical care increased the smoking cessation rate among self-described smokers but was less effective in preventing smoking onset.

Study Design: Randomized controlled trial

Setting: Pediatric and family practice departments within a group practice health maintenance organization

Population of Focus: Adolescent patients waiting for family practice or pediatric care

Sample Size: 2526 youth

Age Range: ages 14-17

Intervention Components (click on component to see a list of all articles that use that intervention): Education on Disease/Condition, Notification/Information Materials (Online Resources, Information Guide), Planning for Transition, HEALTH_CARE_PROVIDER_PRACTICE, PARENT_FAMILY, YOUTH

Intervention Description: This study evaluated the impact of establishing a transition clinic in a regional Australian setting on the lives of young adults living with severe chronic kidney disease and their families.

Intervention Results: Four key themes were identified as follows: The Model of Care; Peer support; Transition towards self-management: Building life skills; Suggestions for improvement and limitations of the service model. The non-institutional, informal clinic setting and social/educational activities facilitated engagement, self-management and peer support for young people and parents. Suggestions for improvement included involvement of older peers, additional life skills sessions and a youth worker.

Conclusion: This regional transition clinic is valued by the young people and their parents for generating peer support, building self-management and life skills. Sustainability of the clinic depends upon having the appropriate expertise available, access to a suitable venue and offering a program that meets the needs of young people.

Intervention Components (click on component to see a list of all articles that use that intervention): Educational Material, Training (Parent/Family), Education on Disease/Condition,

Intervention Description: The 5-component intervention included an HPV fact sheet library, a tailored parent education website, a set of HPV-related disease images, an HPV vaccine decision aid, and 2½ hours of communication training on using a presumptive vaccine recommendation, followed by motivational interviewing if parents were resistant to vaccination

Intervention Results: Adolescents in the intervention practices had significantly higher odds of HPV vaccine series initiation and completion than those in the control practices

Conclusion: The study concluded that there were substantial and sustained increases in HPV vaccine series initiation in intervention practices compared with controls over time

Study Design: The study was a cluster randomized clinical trial using covariate-constrained randomization to assign study arms and an intent-to-treat protocol

Setting: The study was conducted in 16 primary care practices in the Denver, Colorado, metropolitan area

Population of Focus: The target audience included 188 medical professionals and 43,132 adolescents

Sample Size: The final sample size was 16,000 adolescents (8000 per arm)

Age Range: The study included adolescents aged 11 to 17 years

Intervention Components (click on component to see a list of all articles that use that intervention): Education on Disease/Condition, Online Material/Education/Blogging, Online Games

Intervention Description: The ASPIRE web-based smoking prevention program targeted adolescents to reduce intention to smoke. It featured interactive elements, multimedia content, and engaging activities to educate about tobacco risks. The intervention group experienced the full ASPIRE program, while the control group had a text-based version. By comparing outcomes, the study assessed the impact of interactivity and entertainment on smoking prevention. ASPIRE aimed to engage adolescents effectively and prevent smoking initiation

Intervention Results: A total of 82 participants completed the study and were included in the analysis. Participants in the experimental condition were more likely to show a decrease in their intention to smoke than those in the control condition (beta=-0.18, P=.008). Perceived interactivity (beta=-0.27, P=.004) and entertainment (beta=-0.20, P=.04) were each associated with a decrease in intention to smoke independently. Results of path analyses indicated that perceived interactivity and perceived entertainment mediated the relationship between ASPIRE use and emotional involvement. Furthermore, perceived presence mediated the relationship between perceived interactivity and emotional involvement. There was a direct relationship between perceived entertainment and emotional involvement. Emotional involvement predicted a decrease in intention to smoke (beta=-0.16, P=.04).

Conclusion: Adolescents' experience of interactivity and entertainment contributed to the expected outcome of lower intention to smoke. Also, emphasis needs to be placed on the emotional experience during Web-based interventions in order to maximize reductions in smoking intentions. Going beyond mere evaluation of the effectiveness of a Web-based smoking prevention program, this study contributes to the understanding of adolescents' psychological experience and its effect on their intention to smoke. With the results of this study, researchers can work to (1) enhance the experience of interactivity and entertainment and (2) amplify concepts of media effects (eg, presence and emotional involvement) in order to better reach health behavior outcomes.

Study Design: Randomized controlled trial

Setting: Houston, Texas metro area

Population of Focus: Adolescents in secondary school settings

Sample Size: 82 youth

Age Range: ages 12-17

Intervention Components (click on component to see a list of all articles that use that intervention): Peer-led Mentoring/Support Counseling, Education on Disease/Condition, Assessment,

Intervention Description: The intervention evaluated in the study "Improving Care Linkage for Racial-Ethnic Minority Youths Receiving Emergency Department Treatment for Suicidality: SAFETY-A" is the SAFETY-A program. This program is a brief strengths-based, cognitive-behavioral family intervention aimed at enhancing care continuity and mental health equity for racial-ethnic minority youths at risk for suicide. The study involved a randomized controlled trial comparing the effects of SAFETY-A versus enhanced usual care on care linkage and treatment outcomes for racial-ethnic minority youths receiving emergency department treatment for suicidal episodes

Intervention Results: Racial-ethnic minority youths who received SAFETY-A had higher treatment linkage rates than those receiving usual care. Adequate treatment dose rates did not differ by group.

Conclusion: "SAFETY-A is a promising approach to enhance care continuity and mental health equity for racial-ethnic minority youths at risk for suicide."

Study Design: Randomized controlled trial

Setting: Emergency Department

Population of Focus: Racial-ethnic minority youths at risk for suicide

Sample Size: 105 racial-ethnic minority youths

Age Range: Ages 10–18 years

Intervention Components (click on component to see a list of all articles that use that intervention): Planning for Transition, Pediatric to Adult Transfer Assistance, Integration into Adult Care, PROVIDER/PRACTICE, YOUTH, Education on Disease/Condition

Intervention Description: Adolescents with a kidney transplant (KT) require special attention during the transition of care. Few longitudinal studies have assessed the effect of transition models (TM) on patient outcomes. Between 1986 and 2013, 239 pediatric patients underwent KT in Finland, of whom 132 have been transferred to adult care. In 2005, a TM was developed following international recommendations. We compared patient (PS) and graft survival (GS) rates before and after the introduction of the TM.

Intervention Results: PS and GS at 10 years were similar before and after the implementation of the TM (PS 85% and 90% respectively, P = 0.626; GS 60% and 58%, respectively, P = 0.656). GS was lower in patients transplanted at age 10-18 than in patients transplanted at a younger age in the TM cohort (79% vs 95%, P < 0.001). During the first five years after transfer, 63% of patients had stable KT function, 13% had deteriorating function and 24% lost their KT. Altogether 32 out of 132 patients lost their kidney allograft within five years after transfer to adult care (13 before and 19 after TM implementation, P = 0.566).

Conclusion: The implementation of this TM had no effect on PS or GS. Further measures to improve our TM are in progress.

Study Design: Quasi- experimental retrospective prepost design

Setting: Hospital/clinicbased

Population of Focus: Adolescents who received kidney transplants

Data Source: Finnish Registry of Kidney Diseases: date of transplant, demographics, etiology of kidney disease, number of operations, type of donor, rejection episodes, date/age of transition, and health/ morbidity/death data

Sample Size: 132

Age Range: 18 years (at time of study)

Intervention Components (click on component to see a list of all articles that use that intervention): Nurse/Nurse Practitioner, Planning for Transition, Pediatric to Adult Transfer Assistance, Integration into Adult Care, YOUTH, Education on Disease/Condition, HEALTH_CARE_PROVIDER_PRACTICE

Intervention Description: A cluster randomized clinical trial was conducted of a nurse-led transition intervention for 16- to 17-year-olds with moderate or complex CHD versus usual care. The intervention group received two 1-h individualized sessions targeting CHD education and self-management skills. The primary outcome was excess time to adult CHD care, defined as the interval between the final pediatric and first adult cardiology appointments, minus the recommended time interval, analyzed by using Cox proportional hazards regression accounting for clustering. Secondary outcomes included scores on the MyHeart CHD knowledge survey and the Transition Readiness Assessment Questionnaire.

Intervention Results: A total of 121 participants were randomized to receive the intervention (n = 58) or usual care (n = 63). At the recommended time of first adult appointment (excess time = 0), intervention participants were 1.8 times more likely to have their appointment within 1 month (95% confidence interval: 1.1 to 2.9; Cox regression, p = 0.018). This hazard increased with time; at an excess time of 6 months, intervention participants were 3.0 times more likely to have an appointment within 1 month (95% confidence interval: 1.1 to 8.3). The intervention group had higher scores at 1, 6, 12, and 18 months on the MyHeart knowledge survey (mixed models, p < 0.001) and the Transition Readiness Assessment Questionnaire self-management index (mixed models, p = 0.032).

Conclusion: A nurse-led intervention reduced the likelihood of a delay in adult CHD care and improved CHD knowledge and self-management skills.

Study Design: Cluster randomizedclinical trial

Setting: Clinic-based (Outpatient clinic)

Population of Focus: Adolescents attending outpatient clinics in 1 of 2 tertiary care pediatric cardiology programs in Canada

Data Source: Questionnaires

Sample Size: 121 (58 intervention, 63 control)

Age Range: 16-17 years

Intervention Components (click on component to see a list of all articles that use that intervention): Nurse/Nurse Practitioner, Education on Disease/Condition, Planning for Transition, HEALTH_CARE_PROVIDER_PRACTICE, YOUTH

Intervention Description: To evaluate the impact of a novel nurse-led transition intervention program designed for young adolescents (age 13-14 years) with congenital heart disease (CHD). We hypothesized that the intervention would result in improved self-management skills and CHD knowledge.

Intervention Results: We randomized 60 participants to intervention (n = 30) or usual care (n = 30). TRANSITION-Q score (range 0-100) increased from 49 ± 10 at baseline to 54 ± 9.0 at 6 months (intervention) vs 47 ± 14 to 44 ± 14 (usual care). Adjusted for baseline score, TRANSITION-Q scores at 1 and 6 months were greater in the intervention group (mean difference 5.9, 95% CI 1.3-10.5, P = .01). MyHeart score (range 0-100) increased from 48 ± 24 at baseline to 71 ± 16 at 6 months (intervention) vs 54 ± 24 to 57 ± 22 (usual care). Adjusted for baseline score, MyHeart scores at 1 and 6 months were greater in the intervention group (mean difference 19, 95% CI 12-26, P < .0001). Participants aged 14 years had a greater increase in TRANSITION-Q score at 6 months compared with 13-year-old participants (P < .05).

Conclusion: A nurse-led program improved transition readiness and CHD knowledge among young adolescents. This simple intervention can be readily adopted in other healthcare settings.

Intervention Components (click on component to see a list of all articles that use that intervention): School-Based Health Centers, Education on Disease/Condition,

Intervention Description: School-based health centers (SBHCs) are an essential part of a comprehensive approach to address the health needs of youth. SBHCs that provide sexual health services (SHS) show promising results in improving reproductive health outcomes among youth. Despite the positive impact SBHCs can have, few school districts have SBHCs, and even fewer provide SHS. This article describes a successful 5-year project to provide SHS through SBHCs in a large county in the southeast United States. A community collaborative, including the schools, health department, community agencies and a local university, was created to address the project goals and objectives. Various steps were taken to plan for the SBHCs, including documenting community support for SHS offered through SBHCs, identifying school sites for SBHCs, and the process for offering pregnancy, STD (sexually transmitted disease), and HIV testing, treatment, and referrals.

Intervention Results: The staff at the SBHCs were successful in recruiting students to attend educational sessions and to receive testing and treatment. Student feedback was overwhelmingly positive.

Conclusion: Lessons learned about the importance of the partnership's collaboration, using recommended clinic protocol, ensuring clear communication with school staff, and employing youth friendly recruitment and clinic practices are shared.

Study Design: Program evaluation

Setting: School-Based Health Centers (SBHCs) with Sexual Health Services (SHS) within the Duval County Public Schools (DCPS) system in Duval County, Florida

Population of Focus: Adolescents aged 13 to 19 years old who attended public schools in Duval County, Florida

Sample Size: 2,200 teens

Age Range: Adolescents aged 13 to 19 years old

Intervention Components (click on component to see a list of all articles that use that intervention): Education on Disease/Condition, Counseling (Parent/Family), School-Based Health Centers,

Intervention Description: SACRED Connections was a 5-year RCT that formed an effective university-community partnership to culturally adapt, implement, and evaluate a brief evidence-based motivational substance use intervention among NA youth in Midwestern rural communities.

Intervention Results: Findings of this 5-year RCT revealed a statistically significant protective relationship between Native Reliance and baseline lifetime and past month alcohol and marijuana use; additionally, the likelihood of reporting marijuana use at 3 months post-intervention was significantly lower among the active condition than among the control condition.

Conclusion: As supported by the literature (Getty, 2010; Liddell & Burnette, 2017; Marsiglia & Booth, 2015), the partnership between the researchers and the tribal community was critical to the success of this project and resulted in effective cultural tailoring. The partnership with the tribal community ensured that NA cultural values were integrated into implementation and not simply acknowledged (Burnette & Figley, 2016; Whitbeck, 2006; Whitbeck et al., 2012), which facilitated tribal community ownership (Whitbeck, 2006). D&I science, specifically the RE-AIM model, provided a framework that guided the adaptation of the evidence-based practice, Motivational Interviewing, for implementation allowing for adaptations while still holding to the integrity of the evidence-based practice and supporting “long standing partnerships beyond the term of the research” (Whitbeck, 2006). Results demonstrated that: (1) a culturally responsive MI-based brief intervention may be effective in reducing substance use among NA youth with statistically significant reductions in marijuana use at 3 months; (2) Native Reliance theory is an appropriate framework and protective factor; and (3) an intentional, well planned, and flexible university-tribal partnership utilizing CBPR methods and a D&I model allowed effective implementation and engagement with a hard to reach underserved community.

Study Design: Randomized Controlled Trial (RCT)

Setting: The study "SACRED Connections" took place in Midwestern rural communities in the United States. The setting for the study was school-based initiatives, specifically targeting Native American youth aged 12-17 in six rural public high schools across two counties

Population of Focus: Native American youth aged 12-17

Sample Size: The study included 434 participants, including tribal community elders, Health Educators, and youth.

Age Range: Adolescents aged 12-17

Intervention Components (click on component to see a list of all articles that use that intervention): Education on Disease/Condition, Community Events,

Intervention Description: The purpose of this study was to develop and implement a community-based program aiming for smoking, alcohol, and substance use prevention based on multiple disciplinary literacy strategies. A one-group pretest-and-posttest comparison design was used to test the feasibility of the new substance use prevention program. Thirty-two adolescents, most from families with minority and low-socioeconomic status backgrounds, participated. The group met for a 1-hour session once a week for 10 weeks. The program was implemented in a suburban setting in a southeastern state in the United States.

Intervention Results: The results of the study indicated that the community-based youth substance use prevention program using disciplinary literacy strategies was well-received by the participants, with high levels of satisfaction reported. Significant positive changes were observed in participants' knowledge, skills, assets related to substance use, intention not to smoke, perception of the unhealthiness of tobacco, perceived benefits of remaining tobacco-free, and attitudes toward smoking.

Conclusion: The study found that the community-based youth substance use prevention program was effective in improving participants' knowledge, skills, assets related to substance use, intention not to smoke, perception of the unhealthiness of tobacco, perceived benefits of remaining tobacco-free, and attitudes toward smoking.

Study Design: Pre/post intervention design

Setting: Suburban community in a southeastern USA state

Population of Focus: Practitioners of community-based youth substance prevention programs

Sample Size: 32 adolescents

Age Range: No age range given, only that "adolescents" were study participants

Intervention Components (click on component to see a list of all articles that use that intervention): Education on Disease/Condition, YOUTH, Planning for Transition, Pediatric to Adult Transfer Assistance, Integration into Adult Care, Care Coordination, HEALTH_CARE_PROVIDER_PRACTICE

Intervention Description: Children's hospitals must provide developmentally appropriate care to increasing numbers of young adults with complex healthcare needs as they transition to adult-oriented care. This article describes the patients, service, and short-term outcomes of an interprofessional healthcare transition (HCT) consult team comprised of nurses, social workers, a community health worker, and physicians. The Adult Consult Team's tiered population framework stratifies patients by medical complexity. The team coordinates HCT services for patients with the highest complexity. Patients at least 18 years old are eligible if they have at least two specialists or an intellectual or developmental disability (IDD). Through a comprehensive medical and psychosocial assessment, the team prepares patients/families for adult-oriented healthcare.

Intervention Results: The Adult Consult Team received 197 referrals from July 2017 to June 2018. Patients had at least two specialists (73%), IDD (71%), technology dependence (e.g., gastrostomy tube, 37%) and Medicaid insurance (57%). The team assisted patients seen in its outpatient clinic with navigating mental health services (39%), insurance issues (13%), IDD services (15%), and the guardianship process (37%) and creating comprehensive care plans.

Conclusion: The Adult Consult Team transferred 30 patients with medical complexity to adult primary and specialty care, significantly improving pediatric inpatient and outpatient capacity for pediatric-aged patients. A broad range of young adult medical, psychosocial, legal, educational, and vocational needs were addressed.

Study Design: Cohort pilot evaluation

Setting: Hospital/clinicbased (Large tertiary-care children’s hospital and ambulatory) network located in an East Coast urban community

Population of Focus: Patients aged 18 and older who had not transitioned from pediatric to adult care who need specialty care from at least two specialties and/or had an intellectual or developmental disability

Data Source: Medical records

Sample Size: 197 patient referrals; at analysis, 97 were seen in consultation

Age Range: Mean age 20.4 years

Intervention Components (click on component to see a list of all articles that use that intervention): Educational Material (Provider), Consultation (Parent/Family), Education on Disease/Condition,

Intervention Description: The intervention consisted of a five-component toolkit aimed at improving healthcare providers' communication skills about HPV vaccination. The components included: (1) making presumptive and strong recommendations, (2) using motivational interviewing techniques, (3) providing a fact sheet, (4) showing disease images, and (5) using a website.

Intervention Results: - Providers in the intervention group reported higher use of the intervention components, including making presumptive and strong recommendations and using motivational interviewing techniques. - Use of the fact sheet was significantly correlated with high parental acceptance of the HPV vaccine. - Providers in the intervention group did not report spending more time discussing the vaccine with hesitant parents than control providers. - Providers in the intervention group reported greater improvement in parental HPV vaccine acceptance than control providers. The study found that the intervention resulted in substantial improved HPV vaccine series initiation and completion among adolescents in the intervention arm compared to controls. Providers in the intervention group reported greater improvement in parental HPV vaccine acceptance than control providers. However, the change in parental vaccine acceptance over time was not statistically significant between groups.

Conclusion: Communication-based interventions, such as the five-component toolkit used in this study, have the potential to increase HPV vaccination rates among adolescents. - Future research should examine the effectiveness of a streamlined version of the intervention, focusing on communication skills training and fact sheets.

Study Design: The study used a randomized controlled trial design.

Setting: The study was conducted in a central Colorado practice-based research network.

Population of Focus: Healthcare providers who work with adolescent patients.

Sample Size: The study included 187 providers from 16 practices (8 intervention, 8 control).

Age Range: The study focused on adolescent patients who were eligible for HPV vaccination.

Intervention Components (click on component to see a list of all articles that use that intervention): Education on Disease/Condition, Planning for Transition, YOUTH, HEALTH_CARE_PROVIDER_PRACTICE

Intervention Description: We assessed the efficacy of our transition clinic on patient education and empowerment and identified correlates of successful transition.

Intervention Results: Overall, 592 patients were seen at least once in our transition service between 2015 and 2022 (age 15.2 ± 1.8 years, 47.5% female). Most adolescents (53%) had moderate CHD, followed by simple (27.9%) and severe (19.1%) CHD. Learning disability (LD) was present in 18.9% and physical disability (PD) in 4.7%. In patients without LD, knowledge of their cardiac condition improved significantly from the first to the second visit (naming their condition: from 20 to 52.3%, P < 0.0001; describing: 14.4-42.7%, P < 0.0001; understanding: 26.1-60.7%, P < 0.0001), and from the second to the third (naming: 67.4%, P = 0.004, describing: 61.4%, P < 0.001, understanding: 71.1%, P = 0.02;). Patients with LD did not improve their disease knowledge over time (all P > 0.05). Treatment adherence and management involvement, self-reported anxiety, and dental care awareness did not change over time. Successful transition (attendance of ≥ 2 clinics) was achieved in 49.3%. Younger age at the first visit, simpler CHD, and absence of PD were associated with successful transition.

Conclusion: A transition service positively impacts on patient education and empowerment in most CHD adolescents transitioning to adult care. Strategies to promote a tailored support for patients with LD should be sought, and earlier engagement should be encouraged to minimize follow-up losses.

Intervention Components (click on component to see a list of all articles that use that intervention): Technology-Based Support, Education on Disease/Condition, Assessment (patient/consumer),

Intervention Description: Youth account for half of new sexually transmitted infections (STIs) in the United States annually. Barriers to STI prevention include a lack of accurate sexual and reproductive health (SRH) education and low STI testing. We sought to obtain youth feedback on a digital health platform prototype designed to address these barriers. The platform prototype included SRH content, free STI testing and treatment, and anonymous question submission. Five focus group discussions, each lasting 45-60 minutes with 5-6 youth living in a high-prevalence STI region (Baltimore, Maryland), were conducted. Thematic analysis was conducted.

Intervention Results: There were 28 participants with a mean age of 15.9 years (range 14-19), among whom 89% self-identified as female, 57% Black/African American, 29% Asian American, 14% White, and 7% Hispanic/Latino. Youth felt that the prototype platform was comprehensive and understandable. They suggested adding peer reviews to increase trustworthiness.

Conclusion: Youth reported that the platform (violetproject.org) was an acceptable tool for SRH education and STI testing. Participants expressed enthusiasm and willingness to use the platform as a reliable SRH educational tool to combat medical misinformation on the Internet and a non-clinic-based source of STI testing. This platform could fill gaps in access to SRH care and education for youth.

Study Design: Qualitative study

Setting: Public high schools and community colleges in Baltimore, Maryland

Population of Focus: Adolescents and young adults living in Baltimore, Maryland

Sample Size: 28 adolescents and youth

Age Range: Adolescents and youth 14-19 years of age

Intervention Components (click on component to see a list of all articles that use that intervention): Peer-led Mentoring/Support Counseling, Adult-led Support/Counseling/Remediation, Education on Disease/Condition,

Intervention Description: The headspace Brief Interventions Clinic (BIC) aims to provide quick access to evidence-based interventions for young people presenting with early signs of mental disorders. The treatment package includes skill-building and behavioral intervention modules.

Intervention Results: Allocation to the BIC occurred within 2 to 3 weeks of initial referral. Most young people (73%) completed their treatment, attending on average four sessions. Significant reductions in overall psychological distress, depressive symptomatology and anxiety severity ratings were observed at completion of treatment, as well as significant improvements in social and occupational functioning. About 91% of young people stated that their outcome expectations had been entirely met and 95% were entirely satisfied with their treatment experience. A strong therapeutic relationship, specific strategies for managing emotions, coping and problem-solving and a choice of engaging in flexible and modularised content were identified as the most valued experiences by young people.

Conclusion: The BIC might be ideally suited for health care settings aiming to promote timely access to treatments for young people with early signs of mental disorders.

Study Design: Clinical intervention study

Setting: The headspace Brief Interventions Clinic (BIC) in Australia

Population of Focus: Young people with early signs of mental health problems

Sample Size: 4172

Age Range: School students (aged 15 ± 0.9 years)

Intervention Components (click on component to see a list of all articles that use that intervention): Education on Disease/Condition, Online Material/Education/Blogging, Online Games

Intervention Description: ...we developed the mobile game intervention HitnRun. A two-armed randomized controlled trial (RCT; n = 144) was conducted and young smokers (Mage = 19.39; SDage = 2.52) were randomly assigned to either play HitnRun or read a psychoeducational brochure. Prior to, directly following the intervention period, and after three-month follow-up, weekly smoking behavior, abstinence rates, intervention dose, and peer- and engagement-related factors were assessed.

Intervention Results: Results indicated similar reductions in weekly smoking levels and similar abstinence rates for both groups. Yet, we found a dose effect with HitnRun only: The longer participants played HitnRun, the lower their weekly smoking levels were. In the brochure group, a higher dose was related to higher weekly smoking levels at all measurement moments. Exploratory analyses showed the most powerful effects of HitnRun for participants who connected with and were engaged by the intervention.

Conclusion: Future work should build on the promising potential of HitnRun by increasing personalization efforts and strengthening peer influence components.

Study Design: Randomized controlled trial

Setting: Radbound University, Nijmegan, Netherlands

Population of Focus: Researchers, policy makers, health practitioners

Sample Size: 144 young people

Age Range: ages 16-27

Intervention Components (click on component to see a list of all articles that use that intervention): Care Coordination, Integration into Adult Care, Pediatric to Adult Transfer Assistance, Planning for Transition, Nurse/Nurse Practitioner, YOUTH, Education on Disease/Condition, HEALTH_CARE_PROVIDER_PRACTICE

Intervention Description: We compared the clinical long-term course of 24 patients with and 11 patients without structured transition care within 24 months before and 24 months after transfer from paediatric to adult health care. Socio-economic parameters and quality of life were assessed by IBD Questionnaire (IBDQ-32) and additional items. Treatment costs were calculated for medication, surgery and hospitalisation.

Intervention Results: The percentage of transfer group patients with an IBD-related intestinal complication was higher compared to the transition group (64% vs. 21%, p = 0.022). We also found a tendency towards a higher number of IBD-related surgery in the transfer group compared to the transition group (46% vs. 13%, p = 0.077). Transfer group patients received higher mean cumulated doses of radiation compared with the transition group (4.2 ± 5.3 mSv vs. 0.01 ± 0.01 mSv, p = 0.036). Delayed puberty was only noted in the transfer group (27%, p = 0.025). Mean expenditures for surgeries and hospitalisation tended to be lower in the transition group compared to transfer group patients (744 ± 630€ vs. 2,691 ± 4,150€, p = 0.050). Sexual life satisfaction was significantly higher (p = 0.023) and rates of loose bowel movements tended to be lower (p = 0.053) in the transition group.

Conclusion: Structured transition of adolescents with IBD from paediatric into adult health care can lead to important clinical and economic benefits.

Study Design: Retrospective study design

Setting: Clinic-based (Pediatric department of a health clinic)

Population of Focus: Patients with IBD transferring to adult care

Data Source: Medical records, patient questionnaires

Sample Size: 24 patients with transition care

Age Range: 17-22 years of age

Intervention Components (click on component to see a list of all articles that use that intervention): Education on Disease/Condition, Planning for Transition, HEALTH_CARE_PROVIDER_PRACTICE, YOUTH

Intervention Description: The objective of this study was to design, implement and evaluate a novel transitions program for adolescents with Inflammatory Bowel Disease and their parents, and to assess the impact of this program on transition readiness skills, self-efficacy and participant satisfaction.

Intervention Results: Over 60% of participants found the workshop helpful and 92% would recommend it to other teens with IBD. The average adolescent transition readiness score (TRAQ) significantly increased by 5.00 points following the workshop (SD = 7.49, p = 0.04), while total parent scores increased by 10.55 points (SD = 11.15, p = 0.011). As was expected, this demonstrates increased transition readiness skills. The average total adolescent IBD-SES score decreased by 6.75 (SD = 8.95, p = 0.024).

Conclusion: This novel transition program resulted in increased participant transition readiness, as reported by adolescent and parents, indicating the workshop's utility in promoting tangible skill development. Self-efficacy scores did not increase; self-efficacy is a delayed measure of program success and is tied to disease status and other stressors which also changed across time points. Practice implications: Future directions include continuing the virtual program for increased participation and dissemination, integrating feedback and increasing interdisciplinary involvement.

Intervention Components (click on component to see a list of all articles that use that intervention): Peer-led Mentoring/Support Counseling, Assessment, Education on Disease/Condition,

Intervention Description: Project Amp, a four-session one-on-one manualized intervention delivered by young adults with lived experience of substance use recovery (mentors or peers) to enhance SBIRT for moderate-risk youth

Intervention Results: 71 practitioners completed training in SBIRT, 30 mentors were hired and trained for the study, and 20 completed sessions with adolescent participants. Of the 1192 adolescents screened, 139 were eligible, and 51 eligible youth enrolled in the study, and 28 enrolled youth completed the intervention. Five of the six sites were successfully able to integrate the SBIRT-based Project Amp model into their workflow.

Conclusion: The Project Amp intervention can be conducted successfully in school and healthcare settings in conjunction with SBIRT, adding capacity to expand access to screening and early intervention in a developmentally appropriate way. However, the study yielded insights into adaptations for future implementation, such as a more streamlined model and centralized staff roles such as integrated roles for young peer mentors.

Study Design: Project Amp, a four-session one-on-one manualized intervention delivered by young adults with lived experience of substance use recovery (mentors or peers) to enhance SBIRT for moderate-risk youth

Setting: Three school-based programs and three health clinics

Population of Focus: Adolescents ages 13-17 who are at moderate risk for substance use disorder

Sample Size: 51 eligible youth enrolled in the study, and 28 enrolled youth completed the intervention

Age Range: 13-17 years old

Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH, Education on Disease/Condition, Counseling (Parent/Family), Planning for Transition, Pediatric to Adult Transfer Assistance, PARENT_FAMILY, HEALTH_CARE_PROVIDER_PRACTICE

Intervention Description: There is no model for the process of transition of adolescents with inflammatory bowel diseases (IBD) to the adult care protocol. We recently established a transition clinic where 17-year-old to 18-year-old IBD patients are seen by a multidisciplinary team including pediatric and adult gastroenterologists with expertise in IBD treatments, an IBD nurse, and a psychologist. We quantitatively describe this model and its benefits, and correlate demographic and transition parameters to self-efficacy in IBD adolescent patients before and after transition. All adolescent IBD patients enrolled in our transition clinic between January 2013 and December 2015 were included. They completed a self-efficacy questionnaire ('IBD-yourself') before and after the transition. The scores were correlated to demographic, disease, and transition parameters.

Intervention Results: Thirty of the 36 enrolled patients (mean age: 19±1.8 years, range: 17-27) had Crohn's disease. Twenty-seven patients completed the transition protocol, which included an average of 3-4 meetings (range: 2-8) over 6.9±3.5 months. Self-efficacy scores in all domains of the questionnaire were significantly higher after completion of the transition. The weighted average score of the questionnaire's domains was 1.85±0.3 before and 1.41±0.21 after transition (P<0.0001). Age, sex, disease duration, duration of transition, and the number of meetings in the clinic correlated with the questionnaire's scores in the domains of coping with IBD, knowledge of the transition process, and medication use.

Conclusion: A well-planned adolescent IBD transition clinic contributes significantly toward improved self-efficacy in IBD. We recommend its implementation in IBD centers to enable a personalized transition program tailored to the needs of adolescents with IBD in specific domains.

Study Design: Quasi- experimental pre post

Setting: Hospital-based (Pediatric and adult IBD centers in a hospital)

Population of Focus: 36 IBD patients who started the transition process (January 2013-December 2015) in the adolescent transition clinic in the institute/hospital

Data Source: Questionnaires

Sample Size: 36 patients

Age Range: 17-27 years of age (median: 18.5)