DAWN
DAWN MIND
DAWN MIND Youth
BACKGROUND: ISPAD clinical practice consensus guidelines recommend that resources should be made available to include professionals with expertise in the mental and behavioral health of children and adolescents within the interdisciplinary diabetes healthcare team, including psychologists and social workers, with a goal to improve effective self-management and the psychosocial functioning of the whole family as a key objective of all pediatric diabetes care. Even with guidelines, a key foundation for securing comprehensive psychosocial care is the adequate use of valid, effective psychosocial evaluation methods. The study of de Wit et al. confirmed in a RCT that regular monitoring and discussion of health related quality of life improves the psychosocial well-being and satisfaction with care of adolescents with type 1 diabetes (de Wit et al. 2008). However, withdrawing the formal assessment of HRQoL resulted in the disappearance of those positive effects and a deterioration of glycaemic control (de Wit et al. 2009).
DAWN Youth can make a real and practical contribution to the pediatric diabetes community by supporting sharing of user friendly and well-validated psychosocial assessment tools. By providing easy access to simple psychosocial evaluation methods, DAWN Youth can support pediatric healthcare teams in prioritizing their education, motivation, and self-management resources to the needs of each individual patient and family in question.
AIMS: DAWN MIND - Youth aims to promote and simplify the use of a psychosocial assessment as part of routine pediatric diabetes care in all involved countries and make these available for coordinated and routine application and research in interested countries. Using a stepped care approach, the assessment and discussion of the patient's psychosocial needs is the first step. It has been shown that respectfully discussing psychosocial issues with the patient (and parent) in it self is helpful and appreciated. If the outcomes of the assessment so indicate, actions can be taken, e.g. referral to a psychologist for further evaluation of a specific problem, possibly therapy.
The DM-Y program includes:
" A newly developed, multi-dimensional, patient-friendly psychosocial assessment tool, suited for use at regular visits (at least once a year): the MIND Youth Questionnaire (MY-Q).
" A web-based software system for completion of the MY-Q and accessible for health care teams to access outcomes (report) for discussion in clinical practice.
" A manual will be made available for the paediatric diabetes team with instruction on scoring and strategies to enhance effective communication around psychosocial issues with the patient and his/her parent(s).
" Training will be offered prior to starting the DM-Y project to all participating diabetes teams, with detailed evidence-based instructions.
The DAWN MIND Youth program is expected to deliver HRQoL data from multiple centers across countries, also revealing the impact, if any, of HRQoL monitoring on psychological and glycemic outcomes and the impact of treatment (alterations).
In the Netherlands, the Dutch Diabetes Federation has taken on the DM-Y program and 13 centres have been trained and will start with the implementation from May 2010 onwards.
Training of centres across Europe will start from June onwards.
Publications: www.ncbi.nlm.nih.gov/pubmed www.ncbi.nlm.nih.gov/pubmed