Evaluation of computer-tailored health education (‘E-health4Uth’) combined with personal counselling (‘E-health4Uth + counselling’) on adolescents’ behaviours and mental health status: design of a three-armed cluster randomised controlled trial

BMC Public Health

Hein Raat³  Els van As²  Petra van de Looij - Jansen⁴  Evelien Joosten - van Zwanenburg¹  Rienke Bannink³ 

[1] Municipal Public Health Service South-Holland South, Karel Lotsyweg 40, 3318 AL, Dordrecht, the Netherlands;Department of Youth Health Care, Rivas zorggroep, P.O. Box 90, 4200 AB, Gorichem, the Netherlands;Department of Public Health, Erasmus MC University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands;Municipal Public Health Service Rotterdam area, Schiedamsedijk 95, 3011 EN, Rotterdam, the Netherlands

关键词: Tailored counselling;    Counselling;    Tailored health education;    E-health4Uth;    Well-being;    Mental health;    Psychosocial problems;    Health behaviour (alcohol, drugs, smoking, safe sex);    Youth;    Adolescents;   

Others  :  1162725
DOI  :  10.1186/1471-2458-12-1083

 received in 2012-11-22, accepted in 2012-12-11,  发布年份 2012

【 摘 要 】

Background

About 15% of adolescents in the Netherlands have mental health problems and many also have health risk behaviours such as excessive alcohol consumption, cigarette smoking, use of drugs, and having unsafe sex. Mental health problems and health risk behaviours may have adverse effects on the short and longer term. Therefore, in the Netherlands there is a considerable support for an additional public health examination at age 15–16 years. The study evaluates the effect of two options for such an additional examination. Adolescents in the ‘E-health4Uth’ group receive internet-based tailored health messages on their health behaviour and well-being. Adolescents in the ‘E-health4Uth + counselling’ group receive the computer-tailored messages combined with personal counselling for adolescents at risk of mental health problems.

Methods and design

A three-arm cluster randomised controlled trial will be conducted in the Netherlands among fourth-grade secondary school students. School classes are the unit of randomisation. Both intervention groups complete the computer-tailored program during one class session; the program focuses on nine topics related on health behaviour and well-being. For each topic a score is computed that can be compared with the Dutch health norms for adolescents. Based on the score, a message is presented that reflects the person’s current behaviour or well-being, the Dutch health norm, and offers advise to change unhealthy behaviour or to talk to a person they trust. Adolescents in the ‘E-health4Uth + counselling’ group are also invited for an appointment to see the nurse when they are at risk of mental health problems. The control group receives ‘care as usual’.

The primary outcome measures are health behaviour (alcohol, drugs, smoking, safe sex) and mental health status. The secondary outcome measure is health-related quality of life. Data will be collected with a questionnaire at baseline and at 4-months follow-up. A process evaluation will also be conducted.

Discussion

It is hypothesized that at follow-up adolescents in the ‘E-health4Uth’ group and adolescents in the ‘E-health4Uth + counselling’ group will show fewer mental health problems and less risky behaviour compared to the control group.

Trial registration

Current Controlled Trials NTR3596

【 授权许可】

   
2012 Bannink et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]van Dorsselaer S, de Looze M, Vermeulen-Smit E, de Roos S, Verdurmen J, ter Bogt T, Vollebergh W: Gezondheid, welzijn en opvoeding van jongeren in Nederland. Utrecht: Trimbos-instituut, Universiteit Utrecht, Sociaal en cultureel planbureau; 2009.
• [2]Vollebergh WA, van Dorsselaer S, Monshouwer K, Verdurmen J, van der Ende J, ter Bogt T: Mental health problems in early adolescents in the Netherlands: differences between school and household surveys. Soc Psychiatry Psychiatr Epidemiol 2006, 41(2):156-163.
• [3]Fergusson DM, Woodward LJ: Mental health, educational, and social role outcomes of adolescents with depression. Arch Gen Psychiatry 2002, 59(3):225-231.
• [4]Pine DS, Cohen P, Gurley D, Brook J, Ma Y: The risk for early-adulthood anxiety and depressive disorders in adolescents with anxiety and depressive disorders. Arch Gen Psychiatry 1998, 55(1):56-64.
• [5]Kim-Cohen J, Caspi A, Moffitt TE, Harrington H, Milne BJ, Poulton R: Prior juvenile diagnoses in adults with mental disorder: developmental follow-back of a prospective-longitudinal cohort. Arch Gen Psychiatry 2003, 60(7):709-717.
• [6]Hofstra MB, van der Ende J, Verhulst FC: Child and adolescent problems predict DSM-IV disorders in adulthood: a 14-year follow-up of a Dutch epidemiological sample. J Am Acad Child Adolesc Psychiatry 2002, 41(2):182-189.
• [7]Schrijvers C, Schoemaker C: Spelen met gezondheid. Leefstijl en psychische gezondheid van de Nederlandse jeugd. Volume RIVM Rapport nr. 270232001/2008. Bilthoven: RIVM; 2008.
• [8]de Wit DJ, Adlaf EM, Offord DR, Ogborne AC: Age at first alcohol use: a risk factor for the development of alcohol disorders. Am J Psychiatry 2000, 157:745-750.
• [9]Koivusilta L, Rimpela A, Rimpela M: Health related lifestyle in adolescence predicts adult educational level: a longitudinal study from Finland. J Epidemiol Community Health 1998, 52(12):794-801.
• [10]Monshouwer K, van Dorsselaer S, Verdurmen J, ter Bogt T, de Graaf R, Vollebergh W: Cannabis use and mental health in secondary school children. Findings from a Dutch survey. Br J Psychiatry 2006, 188:148-153.
• [11]Verdurmen J, Monshouwer K, van Dorsselaer S, ter Bogt TWV: Alcohol use and mental health in adolescents: interactions with age and gender. Findings from the Dutch 2001 Health Behaviour in School-aged Children Survey. J Stud Alcohol 2005, 66:605-609.
• [12]Verdurmen J, Monshouwer K, van Dorsselaer S, Vollebergh W: Cannabisgebruik onder adolescenten: gebruikspatronen, achtergrondfactoren en psychosociale problemen. Utrecht: Trimbos-Instituut; 2005.
• [13]Ministerie van VWS: Basistakenpakket jeugdgezondheidszorg 0–19 jaar. Den Haag: Ministerie van Volksgezondheid, Welzijn en Sport; 2002.
• [14]Dunnink G: Advies Extra contactmoment in de leeftijdsperiode 12–19 jaar. Volume Rapport 295001007/2009. Bilthoven: RIVM; 2009.
• [15]Kreuter MW, Farell D, Olevitch L, Brennan L: Tailoring health messages. Customizing communication with computer technology. London: Lawrence Erlbaum Associates; 2000.
• [16]Kroeze W, Werkman A, Brug J: A systematic review of randomized trials on the effectiveness of computer-tailored education on physical activity and dietary behaviors. Ann Behav Med 2006, 31(3):205-223.
• [17]Brug J, Oenema A, Campbell M: Past, present, and future of computer-tailored nutrition education. Am J Clin Nutr 2003, 77(4 Suppl):1028S-1034S.
• [18]de Vries H, Brug J: Computer-tailored interventions motivating people to adopt health promoting behaviours: introduction to a new approach. Patient Educ Couns 1999, 36(2):99-105.
• [19]Durlak JA, Wells AM: Evaluation of indicated preventive intervention (secondary prevention) mental health programs for children and adolescents. Am J Community Psychol 1998, 26(5):775-802.
• [20]de Nooijer J, de Vries NK: Monitoring health risk behavior of Dutch adolescents and the development of health promoting policies and activities: the E-MOVO project. Health Promot Int 2007, 22(1):5-10.
• [21]de Nooijer J, Veling ML, Ton A, de Vries H, de Vries NK: Electronic monitoring and health promotion: an evaluation of the E-MOVO Web site by adolescents. Health Educ Res 2008, 23(3):382-391.
• [22]Campbell MK, Elbourne DR, Altman DG: CONSORT statement: extension to cluster randomised trials. BMJ (Clinical research ed) 2004, 320(7244):1240-1243.
• [23]Lokale en nationale monitor gezondheid. http://www.monitorgezondheid.nl webcite
• [24]Joosten-van Zwanenburg E: Veilig opgroeien en gezondheid van jongeren in Dordrecht. http://www.ggdzhz.nl/pool/1/documents/Veilig%20opgroeien%20en%20gezondheid%20van%20jongeren%20in%20Dordrecht%202008.pdf webcite
• [25]Goodman R, Ford T, Simmons H, Gatward R, Meltzer H: Using the Strengths and Difficulties Questionnaire (SDQ) to screen for child psychiatric disorders in a community sample. Br J Psychiatry 2000, 177:534-539.
• [26]Goodman R, Meltzer H, Bailey V: The Strengths and Difficulties Questionnaire: a pilot study on the validity of the self-report version. Eur Child Adolesc Psychiatry 1998, 7(3):125-130.
• [27]Muris P, Meesters C, van den Berg F: The Strengths and Difficulties Questionnaire (SDQ)–further evidence for its reliability and validity in a community sample of Dutch children and adolescents. Eur Child Adolesc Psychiatry 2003, 12(1):1-8.
• [28]van Widenfelt BM, Goedhart AW, Treffers PD, Goodman R: Dutch version of the Strengths and Difficulties Questionnaire (SDQ). Eur Child Adolesc Psychiatry 2003, 12(6):281-289.
• [29]Janssens A, Deboutte D: Screening for psychopathology in child welfare: the Strengths and Difficulties Questionnaire (SDQ) compared with the Achenbach System of Empirically Based Assessment (ASEBA). Eur Child Adolesc Psychiatry 2009, 18(11):691-700.
• [30]Achenbach TM, Rescorla LA: Manual for the ASEBA School-Age Forms & Profiles. Burlington: VT: University of Vermont, Research Center for Childeren, Youth, & Families; 2001.
• [31]Raat H, Landgraf JM, Bonsel GJ, Gemke RJ, Essink-Bot ML: Reliability and validity of the child health questionnaire-child form (CHQ-CF87) in a Dutch adolescent population. Qual Life Res 2002, 11(6):575-581.
• [32]Currie CE, Elton RA, Todd J, Platt S: Indicators of socioeconomic status for adolescents: the WHO Health Behaviour in School-aged Children Survey. Health Educ Res 1997, 12(3):385-397.
• [33]Currie C, Molcho M, Boyce W, Holstein B, Torsheim T, Richter M: Researching health inequalities in adolescents: the development of the Health Behaviour in School-Aged Children (HBSC) family affluence scale. Soc Sci Med 2008, 66(6):1429-1436.
• [34]Hollis S, Campbell F: What is meant by intention to treat analysis? Survey of published randomised controlled trials. BMJ (Clinical research ed) 1999, 319(7211):670-674.
• [35]Twisk JW: Applied multilevel analysis: A Practical Guide for Medical Researchers (Practical Guides to Biostatistics and Epidemiology). Cambridge: Cambridge University Press; 2006.