Bielefeld School of Public Health

Duration
04/2018 bis 03/2021

Project management and coordination
Prof. Dr. Petra Kolip

Project team members
Britta Kelch

Cooperation partner
Evangelisches Klinikum Bethel (EvKB) gGmbH, Klinik für Psychiatrie und Psychotherapie

Project funding
Stiftung Wohlfahrtspflege NRW

Background
Attention deficit hyperactivity disorder (ADHD) is one of the most common chronic mental disorders in youth: in Germany, the prevalence is estimated at about 5% in the 3-17 age group. ADHD causes a high burden of disease and goes hand in hand with health inequalities in affected youths. Adolescents with ADHD exhibit less health literacy and self-management competencies – the promotion of which is critical to improving appropriate handling of this disorder as well as to empowering affected youths to shape their lives in an autonomously and subjectively satisfactory manner despite the restrictions caused by ADHD. This is even more important, as until a few years ago it was assumed that ADHD symptoms disappear in later adolescence. In the meantime, however, it has become evident that in many cases ADHD symptoms can persist into adulthood(even into old age). Many adolescents therefore have a need for persisting medical-therapeutic and psychosocial care. Owing to the high persistence of the disorder, the health care system is faced with specific challenges, because a change from paediatric to adult health care is necessary. Due to a lack of orientation towards the needs and demands of users, this transition goes hand in hand with a high risk of discontinuation of treatment. In addition, it is often not realized that adolescents and young adults with ADHD and insufficient health literacy live with a high risk of not receiving appropriate care, because they are less capable of participating in care processes. Despite relevant requests, for example of the Sachverständigenrat Gesundheit (Advisory Council on the Assessment of Developments in the Health Care System), sustainable concepts of coordinated procedures for facilitating the transition of ADHD patients still remain to be developed.

Objectives
The aim of the project is

1. To pursue the question, how transitional consultation-hours for ADHD patients in late adolescence should be arranged and conducted, in order to better adapt the transition from paediatric to adult health care to the demands and needs of the target group. 
2. On the basis of information obtained, an intervention will be developed and tested, which aims to improved users’ orientation within the health care system, provides support in handling day-to-day life and promotes autonomy and participation of ADHD patients. The focus will be placed on providing information and know-how regarding the disorder as well as the (health) care provision.

These objectives define the place of the subproject within the overall project. By concentrating on the important target group of older adolescents it also focuses on a relatively early life stage and the challenges arising when realising user-orientated health care.

Approach

1. Systematic review of international literature regarding concepts and models of transitional consultation-hours. Particular emphasis is put on practical examples for adolescents with ADHD as well as on models/concepts, in which nursing/nurses plays a key role. 
2. Carrying out 10-15 expert interviews with medical-therapeutic and psychosocial care professionals and conducting an expert workshop to reflect the results obtained.
3. Planning and designing of an intervention concept “Transitional consultation-hour” on the basis of Steps 1 and 2.
4. Testing and validation of the intervention.
5. Review and distribution of the results in presentations, publications and a joint project volume of the research network förges.

This project is part of the research network förges.