Practices to support co-design processes: A case-study of co-designing a program for children with parents with a mental health problem in the Austrian region of Tyrol

Forms of collaborative knowledge production, such as community-academic partnerships (CAP), have been increasingly used in health care. However, instructions on how to deliver such processes are lacking. We aim to identify practice ingredients for one element within a CAP, a 6-month co-design process, during which 26 community- and 13 research-partners collaboratively designed an intervention programme for children whose parent have a mental illness. Using 22 published facilitating and hindering factors for CAP as the analytical framework, eight community-partners reflected on the activities which took place during the co-design process. From a qualitative content analysis of the data, we distilled essential practices for each CAP factor. Ten community- and eight research-partners revised the results and co-authored this article. We identified 36 practices across the 22 CAP facilitating or hindering factors. Most practices address more than one factor. Many practices relate to workshop design, facilitation methods, and relationship building. Most practices were identified for facilitating ‘trust among partners’, ‘shared visions, goals and/or missions’, ‘effective/frequent communication’, and ‘well-structured meetings’. Fewer practices were observed for ‘effective conflict resolution’, ‘positive community impact’ and for avoiding ‘excessive funding pressure/control struggles’ and ‘high burden of activities’. Co-designing a programme for mental healthcare is a challenging process that requires skills in process management and communication. We provide practice steps for delivering co-design activities. However, practitioners may have to adapt them to different cultural contexts. Further research is needed to analyse whether co-writing with community-partners results in a better research output and benefits for participants.     

The Duodenal–Jejunal Bypass Liner for the Treatment of Type 2 Diabetes Mellitus and/or Obesity: a Systematic Review

This systematic literature review applies the GRADE approach to evaluate the efficacy and safety of the duodenal–jejunal bypass liner (DJBL) for the treatment of (a) patients with obesity?≥?grade II (with comorbidities) and (b) patients with type 2 diabetes mellitus?+?obesity?≥?grade I. We included ten studies with a total of 342 patients that primarily investigated a prototype of the DJBL. In high-grade obese patients, short-term excess weight loss was observed. For the remaining patient-relevant endpoints and patient populations, evidence was either not available or ambiguous. Complications (mostly minor) occurred in 64–100 % of DJBL patients compared to 0–27 % in the control groups. Gastrointestinal bleeding was observed in 4 % of patients. We do not yet recommend the device for routine use.     

Reaching families where a parent has a mental disorder: Using big data to plan early interventions

neuropsychiatrie - Children who grow up with a parent who has a mental health problem (25%) are at increased risk of developing (health) problems themselves. One approach to reach...     

Towards a re-orientation of the Austrian ‘Parent–child preventive care programme’

Aim

In 1974, a preventive care programme for expectant mothers and children was introduced in Austria: the ‘mother-child-pass’. The aim of this study was to provide the Austrian Ministry of Health with a decision support for adapting the parent–child screening policy regarding contemporary medical and social health threats.

Subjects and methods

We gathered epidemiological data mainly via searching websites and reference lists by hand. In terms of ante- and postnatal screening practices, nine European experts provided information via a survey. With regard to financing, we conducted interviews with national experts and analysed policy documents.

Results

Our analysis showed a lack of epidemiological data on health threats affecting pregnant women and children from Austria. However, we identified four populations of women at risk, depending on age, socioeconomic situation, pre-existing chronic diseases or addictive disorders, and multiple pregnancies and preterm births. Unlike Austria, several European countries offer additional parent–child screenings focussing on sociomedical risk factors. Regarding financing, several publicly financed in-kind services and monetary transfers exist during pregnancy and early childhood with little coordination between them. Public expenditure is highest for hospital care and monetary benefits.

Conclusion

A parent–child preventive care programme which is primarily ‘medically oriented’ fails to identify particular populations at high risk of sociomedical health threats. Furthermore, the re-orientation of the Austrian ‘mother-child-pass’ may require the consideration of health visiting programmes to provide ‘easy-to-access’ services. From an economic perspective, the evidence suggests that a re-allocation of resources, i.e., from monetary transfers to in-kind services, is preferable.