Adolescent Health Posters 100 – 106

Adolescent Health Posters 100 – 106

100 Identification and support of young carers with a view to widening participation and developing the future NHS workforce

Samantha Wong, Health Education England Yorkshire and the Humber

Background Up to one in twelve school aged children in England are young carers, many of whom are unrecognised and unsupported. Their additional responsibilities can restrict their educational attainment and result in lower rates of higher education, employment and training between ages sixteen and nineteen. Caring can lead to significant long term physical and mental health problems. However, young carers rarely make themselves known to their GP and often avoid seeking help.These young people have identified potential learning and career opportunities arising from their skills built up in this role. Although not previously documented, this unique cohort are likely to offer high value to the future NHS workforce.

Aims & Method Work with the local young carers charity to run assemblies in order to raise awareness and identification of this group in secondary schools.Hold focus groups with the young carers exploring how they could be better supported, which will will be acted on where possible. Encourage identification and engagement with their GP.Promote healthcare careers by offering basic life support training and work experience within the NHS.

Findings Entry and exit questionnaires (including PANOC-YC20) will be used to evaluate the impact of the programme on the wellbeing of the young carers and future career choice (to complete in July 2016).

Desired significance Improve recognition, support and wellbeing of young carers within secondary schools and with their GP. Widen participation into multidisciplinary healthcare careers, representing the population it seeks to serve, appearance satisfaction, social anxiety, fear of negative evaluation and self-esteem at 3 months. Outcomes were positively correlated with number of sessions completed. Six-month outcome data will be reported.

Discussion These findings indicate that that YPF improves psychosocial outcomes and justify a definitive randomised controlled trial.

101 Supporting adolescents struggling with appearance-altering conditions: the feasibility of using an online psychosocial intervention (YP Face IT) in primary care

Heidi Williamson, Centre for Appearance Research, University of the West of England

Aims/Objectives To assess the feasibility of a large randomised controlled trial of YP Face IT (YPF), a 7-session online psychosocial intervention for adolescents experiencing low self-esteem, social anxiety and/or bullying as a result of a visible difference. This trial set out to determine whether using YPF was a viable, potentially cost effective option for vulnerable individuals that can be used successfully in primary care.

Content 47 adolescents (aged 12-17) were recruited via GP practices and randomised to complete YPF (n=23) or receive treatment as usual (n=24). Participants completed self-report measures online at baseline, 3 and 6 months. Adolescents, parents and GPs were interviewed about the study design and their experiences of taking part. Relevance Appearance concerns have a significant impact on social function and well-being. Adolescents experiencing challenges associated with ‘looking different’ are often unable to access limited psychological services. Parents want appropriate support for their children however GPs report a lack of rigorously evaluated appearance-specific interventions.

Outcomes Recruitment, randomisation and safeguarding protocols were feasible and acceptable to participants and practice staff, as were outcome measures and health economic data collection procedures. Participant retention was 98% at 3 months and 52% completed the full intervention. Those completing YPF had statistically significant improvements in appearance satisfaction, social anxiety, fear of negative evaluation and self-esteem at 3 months. Outcomes were positively correlated with number of sessions completed. Six-month outcome data will be reported.

Discussion These findings indicate that that YPF improves psychosocial outcomes and justify a definitive randomised controlled trial.

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102 Young HIMMS (human papillomavirus vaccination in men-who-have-sex-with-men study)

Sam Merriel, Centre for academic primary care, University of Bristol

Aim & Objectives This project aims to understand adolescent and young adult (AYA) men-who-have-sex-with-men (MSM)’s knowledge and attitude towards human papillomavirus (HPV) and the HPV vaccination; and to determine GP’s level of knowledge, perception and attitudes towards AYA MSM HPV vaccination and to identify appropriate strategies to support this vaccination programme.

Content of presentation An interactive discussion of the importance of HPV in AYA MSM will be delivered. Key theoretical and methodological concepts will be discussed, as will the preliminary findings from surveys and interviews of young men and GPs.

Relevance/Impact HPV is one of the most common sexually transmitted infections worldwide. HPV infection is recognised as a causative agent in cervical cancer, but it is also associated with other anogenital tumours, oropharyngeal cancers, and genital warts, meaning that it also has serious health consequences in males. The UK Joint Committee on Vaccination and Immunisation (JCVI) recently recommended extension of the HPV vaccination programme to MSM. It is known that many MSM do not disclose their sexual orientation until after sexual debut, and the vaccine is most efficacious before exposure to HPV.

Outcomes The findings will assist policy makers and public health authorities better understand the knowledge and attitudes of AYA MSM regarding HPV vaccination. It may highlight potential difficulties with a targeted MSM programme, and possibly serve as a catalyst for change to a universal HPV vaccination programme for all adolescents.

Discussion Preliminary results from the surveys, interviews and focus groups of GPs and AYA MSM will be presented.

103 Management of co-morbid anxiety/depression in adolescents with high-functioning autistic spectrum disorder

Isabella Piper, Manchester Medical School

Autistic Spectrum disorder has been on the rise in past decade and is now prevalent in approximately 1% of the youth population in the UK. 70% of this population will develop at least one psychiatric co-morbid diagnosis with depression and/or anxiety being most common. Effective management of these conditions is therefore crucial. This audit aims to review the management offered to 20 adolescents diagnosed with a dual diagnosis of high functioning autism and anxiety, depression or both. This audit reviews whether these patients are being managed in accordance with NICE guidelines. However there is a lack of evidence base for the management methods in this area meaning there is limited guidance. The relevant NICE guidelines are currently being met in this patient group, with 72% being offered CBT and of those offered 69% were having their CBT personally adapted. SSRI medication is being offered to the majority of patients, 19/20, their management however was being well monitored and adjusted where needed. The main recommendation from this audit is that functional development monitoring needs to occur pre and post treatment to measure efficacy. Secondly effective methods of adapting CBT can be reviewed, potentially offering group CBT where possible in order to both further social development and for cost effectiveness. This audit highlights the crucial need for more guidance in this area.

104 Contraception continuation rates in adolescents Contraception continuation rates in adolescents

Katie Lawton, NHS

Aims/Objectives England has one of the highest teenage pregnancy rates in Europe. Although there is a wide selection of available contraceptives, they must be used consistently and correctly to prevent pregnancy. There is limited data on contraception continuation rates in teenagers in the UK. This audit aims to establish baseline continuation rates of the contraceptive pill/injection in <18’s within a sexual health service.

Content of Presentation A retrospective audit on all 305 <18’s started on the contraceptive pill/injection between Jan-March 2014. Continuation rates at 6 and 12 months were compared to the 2002 National Survey of Family Growth in the United States, standards cited by FSRH guidance.

Outcomes The continuation rates of the combined oral contraceptive pill (COC) at 6 and 12 months were 59% and 44.9% respectively, the progesterone only pill (POP) were 37.3% and 23.6% respectively and the injection were 60% and 22.9% respectively.

Discussion and Relevance The continuation rates were lower than the standard when compared to women of all ages. However, using age-adjusted rates, the COC continuation rate exceeded the standard by 3%, and the POP and injection rates were closer to the standard. The COC had the highest continuation rate, suggesting the COC should be the method of choice in <18’s. Continuation rates dropped off more sharply in the first 6 months, suggesting this is the crucial time to remind, educate and engage with teenagers, for example with text reminder services or a dedicated vulnerable young persons’ worker.

105 ECG checklist for assessing cardiac causes of syncope in children

Jacky Wong, University Hospital Southampton NHS Foundation Trust, Abbeywell Surgery

Relevance and AimsElectrocardiography (ECG) is an important part of ruling out possible cardiac diseases in children attending the emergency department (ED) following syncope. Numerous studies on the accuracy of paediatric ECG interpretation by ED doctors have shown a high discordance rate particularly in ECGs showing significant pathology. Paediatric and GP trainees working in ED also lacked knowledge and confidence when dealing with paediatric ECGs. The aim of my project was to design a checklist that will both educate doctors in what to look for in paediatric ECGs and provide a simple yet thorough process in ruling out cardiac causes of syncope in children.

Content and method A checklist for assessing the history, examination findings, and ECG was made in collaboration with a consultant paediatric cardiologist and a consultant in paediatric emergency medicine. A 10-question survey was conducted on trainee doctors working in the paediatric ED assessing their current knowledge on paediatric ECGs and level of training. The checklist was subsequently introduced for 1-2 months and a second survey was conducted at the end of the study period.

Outcome and Discussion Survey scores assessing knowledge rose from 68% to 84%. Trainee doctors found that the checklist was a useful tool for assessing children attending ED for syncope rating it at 4.8/5.0 in usefulness. Overall, this checklist proved to be useful as both a training tool for new trainees or as a memory aid for those already working in the department. This tool could potentially be adapted into general practice.

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106 Analysis of Primary Care Resources for Depression in Adolescents

Sarah Mills, University of Dundee

Aims/Objectives To explore what telephone and online resources are available to GPs in managing mild-to-moderate depression in adolescents, and to categorise these resources thematically.

Content of Presentation This poster presents a thematic analysis and visual presentation of the web-based and telephone resources for supporting young patients with depression. Its aim is to increase awareness in GPs of the availability of these resources and to present them in ways that enable GPs to quickly decide which support tools would be most appropriate given their wide range of contact mode, sub-specialisms and theme, and target audiences.

Relevance/Impact Depression affects 3-5% of adolescents, making it the most common psychiatric disorder in young people. With over-stretched secondary care services, GP referrals are increasingly refused, and over half result in no treatment. It is imperative that GPs are aware of all the resources at their disposal to support and manage depression in youths. OutcomesEighteen telephone and internet-based resources were identified which aim to support youths with depression and which are endorsed by the RCGP or RCPsych. The resources were analysed thematically and grouped by focus, age, access medium and targeted intervention.

Discussion GPs can support a child or young person with mild depression through guided self-help and on-line CBT resources, online fora and portals and telephone support services. It is important for GPs to be aware of the wide range of resources available to clinicians, parents and youths, and for them to signpost patients and their families appropriately.