E-Mental-Health aftercare for children and adolescents after partial or full inpatient psychiatric hospitalization: study protocol of the randomized controlled DigiPuR trial

Marlene Finkbeiner, Jan Kühnhausen, Johanna Schmid, Annette Conzelmann, Ute Dürrwächter, Lena-Marie Wahl, Augustin Kelava, Caterina Gawrilow, Tobias J Renner, Marlene Finkbeiner, Jan Kühnhausen, Johanna Schmid, Annette Conzelmann, Ute Dürrwächter, Lena-Marie Wahl, Augustin Kelava, Caterina Gawrilow, Tobias J Renner

Abstract

Background: During reintegration to daily school life following psychiatric hospitalization, children and adolescents are confronted with various challenges and are at risk for rehospitalization. Tailored post-discharge services could support a successful readjustment and accompany the high-risk transition period after discharge. The study DigiPuR ("Digital gestützte Psychotherapie und Reintegration," digitally supported psychotherapy and reintegration) aims to establish and to evaluate an innovative digital aftercare program to alleviate challenges during reintegration and improve cross-sectoral care.

Methods: DigiPuR is a randomized controlled trial comparing a digital aftercare service with regular aftercare (TAU) (planned N = 150, 25 children/adolescents, 25 parents, and 25 teachers in each group). In the intervention group, direct communication via secure and regular video calls until 8 weeks after discharge and a secure messenger system between the hospital, family, and school, as well as, if needed, external support systems, are established. A longitudinal pre-post-follow-up assessment at admission, discharge, and 8, 24, and 36 weeks after discharge takes place supplemented by a daily smartphone-based ambulatory assessment from a triadic perspective of patients, parents, and teachers. Primary outcomes include whether participants in the intervention group have fewer readmissions and higher treatment satisfaction and health-related quality of life as well as lower symptom severity than participants in the control group.

Discussion: The present study is essential to address the cross-sectoral challenges associated with reintegration into daily (school) life following child and adolescent psychiatric hospitalization and to determine possible needed adaptations in partial or full inpatient settings. If applicability and efficacy of the aftercare service can be demonstrated, integration into regular care will be sought.

Trial registration: ClinicalTrials.gov NCT04986228 . Registered on August 2, 2021.

Keywords: Aftercare; Child and adolescent psychiatric hospitalization; E-Mental Health; Preventing rehospitalization; Randomized controlled trial; School reintegration.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Recruitment process
Fig. 2
Fig. 2
Time schedule of the study for both groups. = video/phone call. = messenger = aftercare appointment at the hospital
Fig. 3
Fig. 3
Display of the app with one example item from the ambulatory assessment and with the identification figure PANDA
Fig. 4
Fig. 4
Sample excerpt from the weekly graphical evaluation of the ambulatory assessment data for the therapist. o data point. missing. Color coding for school attendance (green = yes, yellow = partial, red = no, gray = no school day)

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