Barriers and Facilitators of Adverse Event Reporting by Adolescent Patients and Their Families.

OBJECTIVES: The objectives were (1) to describe barriers and facilitators of adverse event reporting by adolescent patients and parents in a pediatric hospital and (2) to identify characteristics the participants wished to have in a formal reporting system of adverse events. METHODS: We used a qualitative design in which 6 focus groups, 3 with parents and 3 with adolescents, were conducted. The transcripts of audio recordings, notes of team debriefings, and written field notes of group behaviors were analyzed using NVivo software for qualitative data analysis. RESULTS: Participants reported that the quality of the experience with the health care system, type of communication with health care providers, and degree of personal self-confidence in communication within the health care system were 3 interacting factors influencing willingness to report adverse events. Preferred reporting mechanisms were different for different participants and included face-to-face meetings with hospital representatives, Web sites, smart phone capability, phone calls from a human, and paper mail. Reporting systems should be easy to use, ensure confidentiality, and provide user feedback. CONCLUSIONS: Experience, communication, and confidence are 3 factors that can engage an adolescent patient and parents in their health care. Confident adolescent patients and parents in turn have a possibility of reporting an adverse safety event given an opportunity.

Predictors and outcomes of adolescent bariatric support group attendance.

BACKGROUND: Attending support groups connects adults undergoing bariatric surgery to peers and may improve weight loss efficacy. Predictors and outcomes of support group attendance of adolescents undergoing bariatric surgery are unknown. The objective of this cohort study was to determine the rate, predictors, and outcomes of support group attendance in a free-standing adolescent bariatric program. METHODS: Charts of 68 consecutive adolescents who underwent laparoscopic Roux-en-Y gastric bypass or vertical sleeve gastrectomy were retrospectively reviewed, and demographic and anthropometric variables and support group and clinic visit attendance were recorded. Prospectively collected vitamin adherence data were also analyzed. Univariate analyses evaluated characteristics and multivariate analyses evaluated predictors of support group attendance, clinic visit attendance, and vitamin adherence. RESULTS: Of the 68 patients, one third attended 1-3 support sessions, one third attended ≥ 4, and one third were nonattenders. Greater distance from clinical center (P = .01) and caregiver bariatric history (P = .05) were associated with decreased attendance. Only high preoperative body mass index (P<.01) and caregiver bariatric history (P<.01) were independently associated with decreased attendance. Increased attendance was associated with higher 6-month (P = .03) and 12-month (P<.01) clinic visit attendance but not with multivitamin adherence (P = .33). CONCLUSIONS: Caregiver bariatric history and higher preoperative body mass index were associated with decreasing attendance at an adolescent bariatric support group program. This highlights a need to encourage attendance in these patients, because adolescent attendance at support group sessions was positively associated with greater adherence to scheduled clinic visits postoperatively, which may positively influence long-term outcomes.