DSPPea34 (Shared Care Program for Children and Adolescents) is an experimental health program designed to provide rapid, guided care orientation for youth aged 6-18 when a first-line psychological follow-up is considered by a general practitioner or pediatrician. The program links hospital-based services and community providers by offering prompt contact and assessment by a registered nurse and/or psychiatrist, with structured feedback to the referring physician. Primary objective: To identify facilitators that support the engagement of all professionals involved in the care pathway of children and adolescents with psychological difficulties. Facilitators will be mapped across five stages of the pathway: (1) intake, (2) assessment, (3) orientation/referral, (4) inter-partner collaboration, and (5) discharge from the program. Results will be used to refine DSPPea34 specifications to inform broader implementation. Methods and study population (primary objective): A Delphi survey will be conducted with stakeholders directly interacting with families and youth within DSPPea34 (e.g., general practitioners (GP), pediatricians, program clinicians) as well as with program users. Secondary objectives and data sources: To describe (i) the sociodemographic and clinical characteristics of youth using DSPPea34 services and (ii) their care trajectories using quantitative methods. Data will be extracted from DSPPea34 records via the SPICO coordination file (the tool used to facilitate exchanges between the GP/pediatrician, DSPPea34, and the psychologist in charge of follow-up) and complemented by soliciting longitudinal outcome information from the referring physician based on DSPPea34 follow-up. Findings from this mixed-methods evaluation are expected to guide the optimization and potential scale-up of the DSPPea34 model.
Study Type
OBSERVATIONAL
Enrollment
30
A structured, online Delphi survey conducted in up to three iterative rounds to co-develop and refine proposals related to the DSPPea34 specifications. Questionnaires are developed by study facilitators based on the initial DSPPea34 specifications and new proposals arising from the interim evaluation. Content and Response Format: Each round includes closed-ended items rated on a 9-point Likert scale (1 = strongly disagree; 9 = strongly agree) assessing both the content and the wording of each proposal. Free-text fields allow participants to provide comments and suggested rewording. Iterative Adaptation Across Rounds: Based on prior-round results, items may be revised, added, or removed. Refinements aim to improve clarity and relevance, while preserving traceability of changes. Consensus Rule (Stopping/Exclusion Criterion for Items): If an item achieves ≥70% agreement (to retain or to remove the proposal) with concordant votes in both Round 1 and Round 2, the proposal is considered
Data collected from all users of the DSPPea34 program since its inception (approximately 1,200 cases) will include: * sociodemographic data (age, gender, living environment (urban, semi-urban, rural) * diagnosis at the end of the initial psychiatric assessment of the DSPPea34 program * referring physician * schooling (grade, mainstream or specialized environment) * existence of previous psychiatric or psychological follow-up * referrals by DSPPea34 staff and reasons (without collection of individual data for young people not included in DSPPea34 at the end of the staff meeting) * referrals at the end of the medical consultation and reasons * end-of-process referrals.
CHU Montpellier - Réseau DSPPea34 de l'Hérault
Montpellier, Hérault, France
Highlighting by the DELPHI method of the main facilitators of involvement in the DSPPea34 pathway, from successive rounds of proposal prioritization
These facilitators will be identified at different stages: 1) addressing, 2) evaluation, 3) orientation, 4) collaboration between partners, 5) exit from the device and will allow to evolve the specifications of DSPPea in view of its generalization. Each round includes closed-ended items rated on a 9-point Likert scale (1 = strongly disagree; 9 = strongly agree) assessing both the content and the wording of each proposal. Free-text fields allow participants to provide comments and suggested rewording. Iterative Adaptation Across Rounds: Based on prior-round results, items may be revised, added, or removed. Refinements aim to improve clarity and relevance, while preserving traceability of changes. Consensus Rule (Stopping/Exclusion Criterion for Items): If an item achieves ≥70% agreement (to retain or to remove the proposal) with concordant votes in both Round 1 and Round 2, the proposal is considered
Time frame: 3 months
Clinical Characterization at Baseline
Clinical profile including reason for referral, prior or ongoing mental-health follow-up, and functioning assessment coded as ICD-11 diagnostic categories and Children's Global Assessment
Time frame: At program entry (Baseline)
Reason for referral to the program
Proportion of patients according to broad categories of referral reasons Unit of Measure: % of participants.
Time frame: Baseline
Number of Requests and Referrals (DSPPea34 vs. Outside DSPPea34)
Count of requests and final referral directions (within DSPPea34 or redirected outside DSPPea34).
Time frame: Baseline
Number of Psychiatric Clinical Interviews within DSPPea34
Total number of psychiatric clinical interviews conducted as part of DSPPea34.
Time frame: At program entry (intake) to program completion (from 1 month to 12 months)
Number of Joint City-Hospital Follow-Ups
Count of joint follow-up episodes involving community (city) providers and hospital-based teams.
Time frame: At program entry (intake) to program completion (from 1 month to 12 months)
Number of Follow-Ups Coordinated by Primary Care
Count of follow-up episodes coordinated by primary care actors (e.g., GP or pediatrician).
Time frame: At program entry (intake) to program completion (from 1 month to 12 months)
Youth Status at Program Exit
Disposition at discharge (e.g., type of ongoing follow-up, referral destination) and youth outcome at exit
Time frame: At program entry (intake) to program completion (from 1 month to 12 months)
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