Ask: a health advocacy program for adolescents with an intellectual disability: a cluster randomised controlled trial

被引:30
|
作者
Lennox, Nicholas [1 ]
Ware, Robert [1 ,2 ]
Carrington, Suzanne [3 ]
O'Callaghan, Michael [1 ]
Williams, Gail [2 ]
McPherson, Lyn [1 ]
Bain, Chris [1 ,4 ]
机构
[1] Univ Queensland, Mater Hosp, Queensland Ctr Intellectual & Dev Disabil, Brisbane, Qld 4101, Australia
[2] Univ Queensland, Sch Populat Hlth, Herston, Qld 4006, Australia
[3] Queensland Univ Technol, Sch Learning & Profess Studies, Kelvin Grove, Qld 4059, Australia
[4] Queensland Inst Med Res, Genet & Populat Hlth Div, Brisbane, Qld 4006, Australia
基金
英国医学研究理事会;
关键词
Intellectual disability; Health advocacy; Adolescent; School-based intervention; Doctor patient relations; Primary health care; General Practitioner; Health diary; Health check; IMPROVE HEALTH; PEOPLE; ADULTS; CARE; COMMUNICATION; INTERVENTIONS; PARTICIPATE; STRATEGIES; DISORDERS; BARRIERS;
D O I
10.1186/1471-2458-12-750
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: Adolescents with intellectual disability often have poor health and healthcare. This is partly as a consequence of poor communication and recall difficulties, and the possible loss of specialised paediatric services. Methods/Design: A cluster randomised trial was conducted with adolescents with intellectual disability to investigate a health intervention package to enhance interactions among adolescents with intellectual disability, their parents/carers, and general practitioners (GPs). The trial took place in Queensland, Australia, between February 2007 and September 2010. The intervention package was designed to improve communication with health professionals and families' organisation of health information, and to increase clinical activities beneficial to improved health outcomes. It consisted of the Comprehensive Health Assessment Program (CHAP), a one-off health check, and the Ask Health Diary, designed for on-going use. Participants were drawn from Special Education Schools and Special Education Units. The education component of the intervention was delivered as part of the school curriculum. Educators were surveyed at baseline and followed-up four months later. Carers were surveyed at baseline and after 26 months. Evidence of health promotion, disease prevention and case-finding activities were extracted from GPs clinical records. Qualitative interviews of educators occurred after completion of the educational component of the intervention and with adolescents and carers after the CHAP. Discussion: Adolescents with intellectual disability have difficulty obtaining many health services and often find it difficult to become empowered to improve and protect their health. The health intervention package proposed may aid them by augmenting communication, improving documentation of health encounters, and improving access to, and quality of, GP care. Recruitment strategies to consider for future studies in this population include ensuring potential participants can identify themselves with the individuals used in promotional study material, making direct contact with their families at the start of the study, and closely monitoring the implementation of the educational intervention.
引用
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页数:12
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