15581-m-nanninga

CHAPTER 6 114 Outcomes after three and twelve months referred to problem solution with resolved problems and change in severity per type of problem (internalizing, externalizing, parenting and family problems). Resolved problems referred to a change from a ‘problem’ score at T1 to a ‘no problems’ score at T2 and T3, respectively. Change in problem severity referred to a change between T1, T2 and T3, respectively. Background characteristics included age, gender, ethnicity, psychosocial care use in the past six months, parental educational level, and family composition (T1). Age was categorized as 4-11, and 12-19, as in the Dutch educational system the primary school age includes ages 4 to 11; and secondary school age is from 12 years onwards; the child psychosocial care system is focused on children up to 18 years old. Ethnicity was defined as either Dutch or non-Dutch (the child and/or one of the parents was foreign-born). Psychosocial care use in the past six months was measured with the Questionnaire Intensive Care for Youth (QUINCY) [27-30]. Parents and adolescents reported whether they had used care because of the child’s psychosocial problems, and if so, which type(s) and by which professional. Past use of care was defined as the use of professional care for psychosocial problems of the child during the past six months. Parental educational level was based on the highest educational level achieved by either one of the parents/caregivers [31]. Family composition was assessed by asking the parent and the adolescent with whom the child lived. This was categorized into ‘biological two-parent family’ and ‘other’ (e.g., living with one parent, a foster family or living in a residential care facility). Analyses First, we described the characteristics of the cohorts. Second, we assessed the types of problems of children being enroled, as compared to children not enroled, in psychosocial care, per type of care enroled in. Third, we assessed duration of care and problem solution (removal and reduction of severity of problems) between the types of care, per type of problem. We performed the analyses on the reduction of severity of problems using Generalized Linear Mixed Modelling in SAS (www.sas.com ), taking into account the hierarchical nature of the pre-post data. We repeated all analyses after exclusion of those receiving psychosocial care before T2 or T3 from the group of children and adolescents not enroled in care.