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Trial registered on ANZCTR
Registration number
ACTRN12610000142033
Ethics application status
Approved
Date submitted
9/11/2009
Date registered
12/02/2010
Date last updated
5/05/2014
Type of registration
Retrospectively registered
Titles & IDs
Public title
Development of youth friendly family medicine services in Bosnia and Herzegovina: a cluster randomized controlled trial
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Scientific title
Transforming family medicine services into youth friendly services: a cluster randomised controlled trial evaluating family medicine team training and organisational restructuring in Bosnia and Herzegovina
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Secondary ID [1]
280070
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nil known
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Universal Trial Number (UTN)
U1111-1112-4542
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Youth friendly health services
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Condition category
Condition code
Public Health
252357
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0
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Health service research
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
training of the family medicine team and organisational changes in the family medicine services in order to transform them into youth friendly health services. Family medicine teams in the intervention arm will attend two one-day training sessions at 3 months interval and complete assignments between the two training sessions. Training will take place in interactive sessions involving 10 teams at a time. Three trainers experienced in adolescent medicine and family medicine will provide the training.
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Intervention code [1]
241524
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Other interventions
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Comparator / control treatment
Usual continuous medical education (CME) program and no organisational changes in the control family medicine services, wait list design. The CME program in Bosnia & Herzegovina does not usually include modules in adolescent health but the theme may be presented in lectures in paediatrics, which the family medicine are welcome to attend if they wish. There is no specific duration for the CME program but family doctors are required to acquire a certain number of points each year by attending lectures and training sessions
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Control group
Active
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Outcomes
Primary outcome [1]
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improved scores on the "Youth Friendly Health Services-World Health Organization Plus" (YFHS-WHO+) questionnaire, a validated questionnaire measuring youth friendliness in family medicine services
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Assessment method [1]
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Timepoint [1]
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at baseline and 3-4 months post intervention
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Secondary outcome [1]
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proportion of young people between the ages of 15 and 24 years consulting in these family medicine services, as extracted from the daily electronic list of patients consulting the service
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Assessment method [1]
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Timepoint [1]
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at baseline and 6 months post intervention
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Secondary outcome [2]
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proportion of young people between the ages of 10 and 14 years consulting in these family medicine services, as extracted from the daily electronic list of patients consulting the service. This will also be assessed as we expect the intervention to have effects on the consulting behaviour of younger adolescents as well.
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Assessment method [2]
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Timepoint [2]
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at baseline and 6 months post intervention
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Eligibility
Key inclusion criteria
Young people (15-24 years) consulting in participating family medicine services.
Only young people from the age of 15 years will be included for the evaluation of the services, although the aim is to provide services that are friendly also to younger adolescents. From the age of 15, young people are considered mature enough to provide consent on their own for participation in the study. The YFHS-WHO+ has been validated for completion by young people aged 15 years and older
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Minimum age
15
Years
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Maximum age
24
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
acute illness or injury requiring immediate attention of the physician, severe mental disorder such as psychosis or suicidal thoughts requiring treatment in a specialised setting, intellectual disability, inability to understand questions in the language of Bosnia & Herzegovina.
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Study design
Purpose of the study
Educational / counselling / training
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Family medicine services from 10 municipalities in the region of Zenica in Bosnia & Herzegovina will participate in the study. The unit of randomisation will be the municipalities. Patients will be recruited in the participating practices to complete the YFHS-WHO+ questionnaire shortly after their consultation. They will be blind to intervention allocation. The services however will not be blind to their allocation as they will be participating in specific CME activities as part of the intervention. Allocation involved contacting a stastician not involved in the study.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
computer generated stratified sequence (stratified by size of municipality, large and small) by a statistician not involed in the study
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
cluster randomized trial with municipalities as the unit of randomization, family medicine services as targets for the intervention and patients as subjects to measure the outcomes of the intervention
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/12/2009
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Actual
2/12/2009
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Date of last participant enrolment
Anticipated
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Actual
15/12/2010
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
600
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
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Bosnia and Herzegovina
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State/province [1]
2320
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Zenica canton
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Funding & Sponsors
Funding source category [1]
243998
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Hospital
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Name [1]
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Geneva University Hospitals
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Address [1]
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4 rue Gabrielle-Perret-Gentil
1211 GENEVE 14
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Country [1]
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Switzerland
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Primary sponsor type
University
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Name
University of Geneva
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Address
Dr Dagmar Haller
4 rue Gabrielle-Perret-Gentil
1211 GENEVE 14
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Country
Switzerland
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Secondary sponsor category [1]
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Charities/Societies/Foundations
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Name [1]
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Foundation fami
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Address [1]
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Dr Dejan Sredic
Nemanjina 18, 74000 Doboj
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Country [1]
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Bosnia and Herzegovina
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Secondary sponsor category [2]
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Government body
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Name [2]
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Public Health Institute
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Address [2]
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Doboj-Zenica canton
74000 Doboj
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Country [2]
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Bosnia and Herzegovina
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Other collaborator category [1]
952
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University
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Name [1]
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The University of Melbourne
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Address [1]
952
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Dr Lena Sanci
Department of General Practice,
200 Berkeley Street
Carlton 3053
Victoria
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Country [1]
952
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Comite departemental d'ethique de medecine interne et medecine communautaire, HUG
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Ethics committee address [1]
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Rue Gabrielle-Perret-Gentil 4 1211 GENEVE 14
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Ethics committee country [1]
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Switzerland
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Date submitted for ethics approval [1]
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25/08/2009
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Approval date [1]
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14/10/2009
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Ethics approval number [1]
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protocole 09-199
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Summary
Brief summary
Background: More evidence is needed on the effectiveness of developing youth-friendly services that address the barriers adolescents face in accessing care. Responding to the needs of young people is one of the priorities of Foundation fami, an organisation working in collaboration Geneva University Hospitals to rebuild family medicine services in post-war Bosnia & Herzegovina. Working hypothesis: Services exposed to an intervention to improve their youth-friendliness will be assessed as more youth-friendly by adolescent clients and will fulfil a higher number of youth-friendly standards as control services that are on a wait-list to receive the intervention. This will be a cluster randomised trial involving 10 municipalities and 60 health services of the canton of Zenica in Bosnia & Herzegovina: 5 municipalities will be randomised to the intervention arm and 5 to a wait-list control arm. Family medicine teams in the intervention arm will be invited to participate in an interactive training program about youth-friendly service principles and change processes within their service. The main outcome measures at baseline (before randomisation) and 6 months follow-up will be the score on the YFHS-WHO+ questionnaire, a recently validated tool which young people aged 15 to 24 years complete following a family medicine consultation. The results of this trial will provide much awaited evidence about the development of youth-friendly primary care services and inform their further development both in Bosnia & Herzegovina and worldwide.
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Trial website
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Trial related presentations / publications
1. Haller DM, Meynard A, Pejic D, et al. YFHS-WHO+ Questionnaire: validation of a measure of youth-friendly primary care services. J Adolesc Health 2012;51(5):422-30
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Public notes
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Contacts
Principal investigator
Name
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Dr Dagmar M Haller
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Address
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Primary Care Unit, Geneva University
9 avenue de Champel, 1211 GENEVE
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Country
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Switzerland
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Phone
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+41 22 372 96 79
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Dagmar M Haller
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Address
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Primary Care Unit, Geneva University
9 avenue de Champel, 1211 GENEVE
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Country
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Switzerland
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Phone
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+41 22 372 96 79
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Fax
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+41 22 372 96 00
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dagmar M Haller
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Address
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Primary Care Unit, Geneva University
9 avenue de Champel, 1211 GENEVE
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Country
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Switzerland
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Phone
4658
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+41 22 372 96 79
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Fax
4658
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+41 22 372 96 00
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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