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1. Improving alcohol and substance use screening in school-age children: translation, adaptation and psychometric evaluation of the CRAFFT tool for Lumasaaba, Uganda

Author

Joyce Sserunjogi Nalugya, Ingunn Marie Stadskleiv Engebretsen, Noeline Nakasujja, Grace Ndeezi, Juliet N. Babirye, Victoria Bakken, Ane-Marthe Solheim Skar, James K. Tumwine, and Norbert Skokauskas

Subjects
Alcohol, CRAFFT tool, Other substance use, Primary school-age children (6 to 13 years), Screening, Uganda, Medicine (General), R5-920, Social pathology. Social and public welfare. Criminology, HV1-9960
Abstract

Abstract Background Children at risk of substance use disorders (SUD) should be detected using brief structured tools for early intervention. This study sought to translate and adapt the Car, Relax, Alone, Forget, Family/Friends, Trouble (CRAFFT) tool to determine its diagnostic accuracy, and the optimum cut-point to identify substance use disorders (SUD) risk in Ugandan children aged 6 to 13 years. Methods This was a sequential mixed-methods study conducted in two phases. In the first qualitative phase, in Kampala and Mbale, the clinician-administered CRAFFT tool version 2.1 was translated into the local Lumasaaba dialect and culturally adapted through focus group discussions (FGDs) and in-depth interviews, in collaboration with the tool’s authors. Expert reviews and translations by bilingual experts provided insights on linguistic comprehensibility and cultural appropriateness, while pilot testing with the target population evaluated the tool’s preliminary effectiveness. In the second phase, the CRAFFT tool, adapted to Lumasaaba, was quantitatively validated against the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) for diagnosing SUD in Mbale district, through a survey. Participants, chosen randomly from schools stratified according to ownership, location, and school size, were assessed for the tool’s reliability and validity, including comparisons to the MINI KID as the Gold Standard for diagnosing SUD. Data were analyzed using STATA-15. Receiver-operating-characteristic analysis was performed to determine the sensitivity, specificity, and criterion validity of the CRAFFT with the MINI-KID. Results Of the 470 children enrolled, 2.1% (n = 10) had missing data on key variables, leaving 460 for analysis. The median age and interquartile range (IQR) was 11 (9–12) years and 56.6% were girls. A total of 116 (25.2%) children had consumed alcohol in the last twelve-month period and 7 (1.5%) had used other substances. The mean CRAFFT score for all the children (n = 460) was 0.32 (SD 0.95). The prevalence of any alcohol use disorder (2 or more positive answers on the MINI KID) in the last 12 months was 7.2% (n = 32). The Lumasaaba version of the CRAFFT tool demonstrated good internal consistency (Cronbach’s α = 0.86) and inter-item correlation (Spearman correlation coefficient of 0.84 (p 1. Conclusion The Lumasaaba version of the CRAFFT tool has sufficient sensitivity and specificity to identify school-age children at risk of SUD.

Published
2024
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2. Success Factors of an Early EHR System for Child and Adolescent Mental Health: Lessons Learned for Future Practice Data-Driven Decision Aids

Author

Kaban, Koochakpour, Øystein, Nytrø, Odd Sverre, Westbye, Bennett, Leventhal, Roman, Koposov, Victoria, Bakken, Carolyn, Clausen, Thomas Brox, Røst, and Norbert, Skokauskas

Subjects
Mental Health Services, Mental Health, Adolescent, Humans, Family, Child, Delivery of Health Care, Decision Support Techniques
Abstract

This paper recounts the successful BUPdata, a discontinued electronic health record (EHR) system for Child and Adolescent Mental Health Services (CAMHS) in Norway. It was developed and owned by the national association for CAMHS and fulfilled needs for collaborative care, practice insight, and service management. It aimed to unify the requirements of government, administration, clinicians, patients, and researchers alike, with the goal of providing uniform quality of care nationally. When CAMHS became integrated with specialist healthcare, BUPdata was replaced with more a general EHR system offering far less functionality and insight into CAMHS practice. We have studied BUPdata, and interviewed stakeholders in order to develop decision aids based on practice data analysis and give clinicians and patients insight into successful local practice, collaboration patterns, and overview of local resources.

Published
2022

3. Attitudes of Mental Health Service Users Toward Storage and Use of Electronic Health Records

Author

Victoria Bakken, Roman Koposov, Thomas Brox Røst, Carolyn Clausen, Øystein Nytrø, Bennett Leventhal, Odd Sverre Westbye, Kaban Koochakpour, Arthur Mandahl, Hege Hafstad, and Norbert Skokauskas

Subjects
Mental Health Services, Psychiatry and Mental health, Cross-Sectional Studies, Attitude, Privacy, Electronic Health Records, Humans
Abstract

Objective: Electronic health records (EHRs) are used for both clinical practice and research. Because mental health service users’ views are underrepresented in perspectives on EHR use, the authors examined service users’ awareness, attitudes, and opinions about EHR data storage and sharing. Methods: A mixed-methods, cross-sectional design was used to examine attitudes of 253 Norwegian mental health service users who were recruited online to complete a quantitative and qualitative (free-text) survey about EHR utilization. Results: Most participants were aware that EHRs were stored (95%) and shared (58%). Most thought that patients benefited from EHR storage (84%), trusted authorities with EHR sharing (71%), were willing to share their EHRs to help others (75%), felt they benefited from EHR sharing (75%), and thought EHR sharing was ethical for health care and research (71%). Fewer were aware of EHR sharing for research (36%), and 62% were aware that shared data were anonymized. Of the participants, 69% recognized privacy risks associated with sharing. Lack of transparency and skepticism about anonymization and misuse of EHR data were concerns and perceived risks. Mental health service users thought that EHRs should be shared for policy development (81%), education and training (85%), improving care quality (89%), research (91%), and clinical decision support (81%). Conclusions: Participants were aware of and supported EHR sharing for research and clinical care. They supported sharing to help others and were willing to fully participate in clinical care and research, as well as to share EHR information for their own care, research, and the care of others.

Published
2022

4. Success factors of an early EHR system for child and adolescent mental health: Lessons learned for future practice data-driven decision aids

Author

Kaban Koochakpour, Øystein Nytrø, Odd Sverre Westbye, Bennett Leventhal, Roman Koposov, Victoria Bakken, Carolyn Clausen, Thomas Brox Røst, and Norbert Skokauskas

Subjects
Informasjons- og kommunikasjonsvitenskap: 420 [VDP], Information and communication science: 420 [VDP]
Abstract

This paper recounts the successful BUPdata, a discontinued electronic health record (EHR) system for Child and Adolescent Mental Health Services (CAMHS) in Norway. It was developed and owned by the national association for CAMHS and fulfilled needs for collaborative care, practice insight, and service management. It aimed to unify the requirements of government, administration, clinicians, patients, and researchers alike, with the goal of providing uniform quality of care nationally. When CAMHS became integrated with specialist healthcare, BUPdata was replaced with more a general EHR system offering far less functionality and insight into CAMHS practice. We have studied BUPdata, and interviewed stakeholders in order to develop decision aids based on practice data analysis and give clinicians and patients insight into successful local practice, collaboration patterns, and overview of local resources.

Published
2022

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