51.5 PEER COACHING FOR YOUTH WITH PHYSICAL ILLNESS

• Published in: Journal of the American Academy of Child and Adolescent Psychiatry Vol. 55; no. 10; p. S78
• Main Author: Brotkin, Samuel, BA
• Format: Journal Article
• Language: English
• Published: Baltimore Elsevier Inc 01.10.2016; Elsevier BV
• Subjects: Accountability; Adolescents; Adults; Approaches; Asthma; Cancer; Child & adolescent psychiatry; Children; Clinical outcomes; Clinics; Coaching; Coaching (Performance); Diabetes; Diabetes mellitus; Disease management; Evidence based; First year; Health insurance; Health promotion; Health status; Inflammatory bowel diseases; Insurance; Intervention; Interviews; Intestine; Leadership; Management; Medical Services; Motivational interviewing; Navigation; Patient-centered care; Pediatrics; Psychiatry; Risk assessment; Self Management; Selfmanagement; Sickle cell disease; Specialists; Stages of change; Survival; Telephone service
• ISSN: 0890-8567; 1527-5418
• DOI: 10.1016/j.jaac.2016.07.745

Objectives: Youth struggle to acquire the skills necessary to transition to independent self-management and navigate through the healthcare system, yet few evidence-based approaches address the adaptive challenges associated with these barriers. This presentation will describe a population health approach to providing youth, cared for by pediatric specialists, an intervention to promote the development of self-management and healthcare navigation skills. Methods: Peer support and health coaching have been shown to be effective methods in promoting positive outcomes for adults with diabetes, asthma, and other conditions. This presentation will describe a process for implementing a population health approach by deploying peer coaches to assist with the healthcare transition in five pediatric specialty clinics for adolescents with cancer, diabetes, inflammatory bowel disease, lupus, and sickle cell disease at a large academic medical center. The presentation will include a description of data from the first year of the program, as well as a focus case discussion of peer coaching for youth with cancer as they move into a long-term survivorship clinic. Results: The transition coach program at Duke Children's Hospital is a telephone-based peer coaching program for youth aged 18-21 years. The goal is to support a smooth transition from pediatric to adult/long-term follow-up clinics. A novel population health management tool was developed to effectively identify all eligible pediatric patients at highest risk for poorly transitioning to adult care. Peer coaches are trained and supervised by the leadership staff to learn motivational interviewing techniques and the stages of change model in order to incorporate a patient-centered approach. Coaches and mentees communicate via phone and text message through Mentor 1 to 1TM, a Health Insurance Portability and Accountability Act-compliant, peer-support interface. The coach, who is paired with a mentee of the same illness, focuses on health goals specific to the illness. In the long-term survivorship clinic, for instance, coaches focus on the transfer from acute illness to survivorship care and follow-up, with the medical care plan outlined by the mentee's physician. Conclusions: Participants will gain an understanding of a population health approach to promoting positive health and self-management outcomes for youth with physical illness.