Support Groups For Adolescents Research Articles

Rediscovering life after being diagnosed with HIV: A qualitative analysis of lived experiences of youth living with HIV in rural Rwanda.

In sub-Saharan Africa, youth living with HIV, especially those who have lost one or both parents, face economic, socially and psychological challenges that hinder adherence to ART, ultimately leading to poor health outcomes. Partners In Health/Inshuti Mu Buzima implemented an Adolescent Support Group (ASG) to support HIV-positive youth aged 15-25 years. During the evaluation of the ASG program, we sought to better understand youths' lived experiences to improve our delivery of HIV care. We conducted qualitative in-depth, semi-structured individual interviews with youth enrolled in the ASG program. All interviews were conducted in-person or by telephone. Thematic analysis applying the framework approach with parallel inductive coding in Kinyarwanda and English was used. We interviewed 35 youth who ranged in age from 16 to 29 years. The main themes related to the lived experiences of youth were (a) Experiences living with HIV, including disclosure, stigma, interactions with the health care system, and medication adherence; (b) external challenges, defined as challenges that were not related to the implementation of the ASG program; and (c) personal vision. Almost all youth reported acquiring HIV from their mothers and disclosure of HIV status occurred around the age of 10. Disclosure was often unintentional and followed by internalized and enacted stigma. Many reported poor past medication adherence which improved following enhanced counselling. External challenges were overwhelmingly economic in nature, and orphanhood was a root cause of other challenges such as difficulty accessing education, lack of transport to health facility, and lack of insurance fees. Despite these challenges, youth have an optimistic view of the future with dreams of health, economic attainment, marriage, and children. Healthcare providers should empower caregivers to support HIV disclosure. Supporting youth as they face many economic challenges could help address socio-economic barriers to good health and promote holistic well-being.

Receipt of a combined economic and peer support intervention and clinical outcomes among HIV-positive youth in rural Rwanda: A retrospective cohort.

To combat poor clinical outcomes among HIV-positive youth, Partners In Health/Inshuti Mu Buzima (PIH/IMB) implemented Adolescent Support Groups (ASGs), which combined peer support and group-based economic incentives to promote treatment adherence, economic empowerment, and viral suppression. This study assesses the association between ASG membership and clinical outcomes among HIV-positive youth living in rural Rwanda. We constructed a retrospective cohort using PIH/IMB's electronic medical record (EMR) system. ASG members were matched to control youth within strata defined by health facility, year of birth, and whether the patient had enrolled in HIV services as a pediatric patient, as a PMTCT mother, or through another route. Our 12-month outcomes of interest were a) death-free retention in care, b) death-free retention with active follow-up, c) ≥80% adherence to appointment keeping, and d) viral load suppression (<20 copies/ml). We used generalized linear mixed models to estimate odds ratios for the association between ASG participation and each outcome. To mitigate possible unmeasured confounding, we additionally included participant data from the previous year and conducted a difference-in-difference analysis for each outcome to assess whether ASG members experienced greater changes compared to control youth over a similar period. Two-hundred sixty ASG members were identified in the EMR and matched to 209 control youth for analysis. After 12 months of follow-up, ASG members had similar outcomes to the control youth in terms of death-free retention (93% vs. 94%), death-free retention with active follow-up (79% vs. 78%), ≥80% adherence to appointment keeping (42% vs. 43%), and viral suppression (48% vs. 51%). We did not observe any significant associations between ASG participation and clinical outcomes in crude or adjusted models, nor did ASG members experience greater improvements than control youth in our difference-in-difference analysis. The ASG program did not improve retention, appointment adherence, or viral suppression among HIV positive youth in rural Rwanda. Challenges implementing the intervention as designed underscore the importance of incorporating implementation strategies and youth perspectives in program design. This population remains vulnerable to poor clinical outcomes, and additional research is needed to better serve youth living with HIV.

Implementation and Adaptation of a Combined Economic Empowerment and Peer Support Program Among Youth Living With HIV in Rural Rwanda.

Background: Youth living with HIV in rural Rwanda experience poor clinical outcomes. In 2017, we implemented Adolescent Support Groups (ASGs), which provided economic incentives and peer support to youth aged 15-25. Methods: We assessed the ASG program using programmatic and electronic medical records. We described group composition and achievement on three indicators used to determine economic incentive levels: (1) quarterly pharmacy visit attendance, (2) biannual savings target achievement, and (3) annual viral suppression. Results: In total, 324 members enrolled in 34 ASGs. Group size and member ages varied more than anticipated. Groups performed well on pharmacy visit attendance (median quarterly group attendance range 91-100%) and on achieving savings targets (median biannual achievement range 80–83%). The viral suppression indicator could not be implemented as planned. Conclusion: To reflect contextual realities, adaptations in enrollment, indicator evaluation, and awarding of incentives occurred during implementation. Future research should assess whether these adaptations affected results.

274: Creating a virtual CF support group for adolescents during the COVID-19 pandemic

274: Creating a virtual CF support group for adolescents during the COVID-19 pandemic

Genderdysforie en ASS

There is a growing interest in the co-occurrence of autism spectrum disorder (ASD) and gender dysphoria (GD). Research has shown that people with ASD show more gender variance than people without ASD. Due to the difficulties associated with ASD (limited social skills, problems in information processing and difficulty with change), regular GD treatment does not seem to be adequately equipped for this specific group. In this study we want to gain insight into the clinical needs of adolescents with ASD and GD and their parents. We are conducting a pilot study to the effects of a specific peer support group for adolescents with ASD and GD on quality of life. A pre-posttest design is used. Prior to the start of the support group, during each meeting and at the end of the support group, the adolescents fill out several short questionnaires. The ASD and Gender support group consists of nine monthly meetings for the adolescents, covering topics such as autism and gender-related needs, psychoeducation on medical interventions, environmental factors, gender expression and practicing gender presentation skills. Simultaneously, parents can follow the parent meetings. Currently, three rounds of the peer support group have started (each round with about 10-12 adolescents).

Implementation of a Peer Support Group for Adolescents with Persistent Pain

Implementation of a Peer Support Group for Adolescents with Persistent Pain

205 Challenges to Pediatric Adherence to ART Treatment and Strategies to Improve Adherence Among a Large Cohort of Uganda Children

ISSUES: Perfect adherence (>95%) to highly active antiretroviral treatment(HAART) is critical to treatment success, yet little is known about adherence rates to HAART and strategies to improve adherence among children in resource – limited settings. DESCRIPTION: Mama's Club Uganda has 2,800 HIV – positive children.1, 200 of these are on HAART, after a rapid scale-up of HIV care and treatment services during the last year. Statistics show that 90% of patients on HAART for 12-15 months have = 95% adherence rates. LESSONS LEARNED: To support adherence, PIDC a partner organization Mama's Club works with developed an interdisciplinary strategy and several innovative adherence tools that were rolled out with the scale-up of HAART. All cadres of clinic staff play a critical role in reinforcing and promoting adherence to drugs and refill appointments. An adherence nurse visit, home-based adherence assessment and counseling services.Additional adherence tools developed include pictorial aids and cue cards on the principles of HAART; a patient handout on key guidelines for pediatric HAART administration translated in the local language; a standardized psychosocial pre- HAART assessment form incorporation checklists of “high risk” psychosocial situations, disclosure,and common barriers to adherence; and support groups for adolescents and caretakers. An overview of the above tools will be shared, with an in-depth description of the challenges and successes of adherence in this large, urban pediatric cohort. RECOMMENDATIONS: Home-based unannounced assessments of adherence are necessary to obtain an accurate picture of true adherence rates among patients on HAART.Adherence support of children and adolescents should involve an interdisciplinary team approach using innovative facility and community-based interventions. Research regarding the effectiveness of these interventions is needed.

I'm Gone When You're Gone: How a Group Can Survive When Its Leader Takes a Leave of Absence

SUMMARY As the roles and demands on social workers increase in their agencies and their personal lives, there is a greater chance that they will need to take a leave of absence. This is also true for social workers who lead groups. This article presents a process to allow the primary worker to take a leave of absence while the group continues with an interim worker. The author's personal experience of a leave of absence from a HIV+ adolescent support group will be used to illustrate this transfer process. In providing ample time and a thoughtful process of transfer, this leave of absence was successful in maintaining group attendance and participation.

School‐based support groups for adolescents with an addicted parent: Using principles of solution focused therapy

There are four to six children with chemically dependent parents in an average classroom. Only 5% of these children receive any supportive services. Children of substance abusers attend school less often, are often late for school, and have a higher incidence of learning disabilities. In an effort to address the needs of this vulnerable population, many school districts offer school‐based support groups (SBSG). Consistent with the principles of solution‐focused therapy, the SBSG focuses on the strengths and resiliency of these youth and helps them develop problem‐solving strategies and find solutions. This study was a qualitative evaluation of SBSG for adolescents with an addicted parent.

Development of a support network for adolescents with endometriosis

Background Endometriosis is a chronic disease that can cause severe pelvic pain in adolescents. We sought to develop a support network to educate adolescents, their families, schools, and peers. In addition, we aimed to develop a network to assist adolescents coping with this chronic disease, that could then be adapted for use by other local and national chapters of the Endometriosis Association (EA). Methods Patients were informally surveyed by their health care provider to inquire if they thought that they would benefit from an “Endometriosis Teen Support Group”; if they answered affirmatively they were asked if they would like to be contacted by the Boston Chapter of the EA. The EA was contacted with the names of those patients who were interested. A support group for adolescents was established with in the EA which provided information to patients, parents, health care providers, and schools by supplying periodic newsletters, literature, and book lists. In addition members of the EA contacted the adolescents by telephone to periodically offer advice for coping with specific endometriosis problems that arose, and for effective communication with doctors, teachers, or parents. Monthly Sunday afternoon meetings were established addressing subjects of interest to the adolescent with endometriosis and her parents. After one year of existence the EA contacted the adolescent members by telephone to assess their perspective of the support group in order to improve services. Results 30 adolescents with endometriosis were identified who desired contact by the EA. The mean age at the time of referral was 17 years (range: 14–21). The mean number of months of association with the EA was 7 (range: 1–12). The adolescents selected “TEEN: Teen Endometriosis Education Network” as the name for the support group. They reported that the “best” day for meetings was Sunday, and preferred that the meeting be held at a hospital (70%) as compared to a school (30%). They preferred that the meetings occur monthly as opposed to bi-monthly. 100% wanted to receive a newsletter. 900% wanted to be contacted by other adolescents by phone at the time of their diagnosis. 900% wanted to be a contact person for newly diagnosed individuals with endometriosis. 60% wanted to have a designated “big sister” with endometriosis. 60% of the young women wanted information about endometriosis distributed to schools: 90% of those in high school, 20% of those in college. 100% stated that they found the TEEN to be helpful. Conclusions Adolescents with endometriosis feel that they benefit from an age specific support system. We present “TEEN - Teen Endometriosis Education Network” as a model for other chapters of the EA to establish proven support and education for adolescents, their families, and schools.

Newfound Friends: A support group for adolescents with cancer

Adolescence is a developmental period greatly characterized be change. The experience of cancer at this life stage often impacts on normal development of body image and self-concept, relationships with others, autonomy and sense of identity and life direction. Newfound Friends is a support group for adolescents with cancer and/or those who have survived cancer. The purpose of the group is to promote positive psychological and social health. The article describes the goals, membership and format, as well as the activities of Newfound Friends. This group could be easily organized in other provinces by nurses who work with adolescents or young adults coping with cancer.