Inflammatory bowel disease at a young age – implications for achieving upper secondary education

Abstract Background The incidence of inflammatory bowel disease (IBD) among children and adolescence is increasing worldwide. Having a chronic condition at a young age may affect educational achievement and later employment and self-support. The study aims to examine the impact of being diagnosed with IBD before 18 years of age on achieving an upper secondary education before 25 years of age. Methods Using the Danish National Patient Register (1980-2018) all patients (born 1970-1994) diagnosed with IBD at a young age (<18 years) were identified. The IBD-patients were matched on age and sex with 10 references without IBD at the index date (date of diagnosis of IBD). The outcome was achieving an upper secondary education using data from Danish Education Registers. The association between IBD diagnosis and achieving an upper secondary education was analyzed using Cox regression with robust variance estimation adjusting for parents’ highest educational level. Furthermore, stratified analyses were performed on parental socioeconomic status (education and income). Results We identified 3,178 patients with IBD: Crohn’s disease (CD) n = 1,344, Ulcerative colitis (UC) n = 1,834. Reference n = 28,220. The median age at diagnosis was 15.3 years (IQR: [13.0;16.9]). At the age of 25 74.0% (CI: 71.6-76.4) for CD, 75.8% (CI: 73.8-77.8) for UC, and 69.7% (CI: 69.2-70.3) for references had achieved an upper secondary education. The adjusted Hazard ratio (HR) of achieving an upper secondary education was 1.05 (CI: 1.00 -1.11) for CD and 1.09 (CI: 1.04 -1.15) for UC. When stratifying the IBD-patient with the lowest socioeconomic status performed better than their peers. Conclusions Being diagnosed with IBD before 18 years of age did not reduce the chance of achieving an upper secondary education. Patients with low socioeconomic status performed better than their peers, however the study gives no explanation of this. Key messages • Children diagnosed with IBD before 18 years of age had at least the same chance of achieving an upper secondary education compared to references. • IBD patients with low social economic status performed better than their peers.


Background:
The overall aim of the Bloom Trial is to develop and test a program promoting healthy weight development during infancy within the community health nurse setting in Denmark.Many interventions are poorly implemented, and to ensure adequate implementation support, previous studies have suggested to assess barriers and organizational readiness before intervention start.The aim of the present study is to assess barriers for implementing and sustaining the Bloom Trial among program adopters and implementers.

Methods:
Telephone interviews with managing health nurses (adopters) and health nurses (implementors) from twenty Danish municipalities were carried out (n = 22) in 2017.Moreover, two workshops with health nurses, and continuously meetings with implementation science experts were conducted in 2021-2022.

Results:
Barriers were identified on different levels.Organizational barriers within the work of health nurses included lack of time, economic resources, project fatigue, and political priority.Furthermore, health nurses lacked relevant tools to guide parents about promoting healthy weight development.Interpersonal barriers between health nurses and parents were identified as the difficulties of having conversations about healthy weight development, especially if the parents or health nurses were overweight themselves.Cultural differences including language barriers and different perceptions of for example healthy food choices were also found.

Conclusions:
The findings are central for ensuring that the Bloom Trial is relevant and applicable to the setting of health nurses in Danish municipalities.This is crucial for ensuring successful

Background:
The incidence of inflammatory bowel disease (IBD) among children and adolescence is increasing worldwide.Having a chronic condition at a young age may affect educational achievement and later employment and self-support.The study aims to examine the impact of being diagnosed with IBD before 18 years of age on achieving an upper secondary education before 25 years of age.

Methods:
Using the Danish National Patient Register  all patients (born 1970-1994) diagnosed with IBD at a young age (<18 years) were identified.The IBD-patients were matched on age and sex with 10 references without IBD at the index date (date of diagnosis of IBD).The outcome was achieving an upper secondary education using data from Danish Education Registers.The association between IBD diagnosis and achieving an upper secondary education was analyzed using Cox regression with robust variance estimation adjusting for parents' highest educational level.Furthermore, stratified analyses were performed on parental socioeconomic status (education and income).

Conclusions:
Being diagnosed with IBD before 18 years of age did not reduce the chance of achieving an upper secondary education.Patients with low socioeconomic status performed better than their peers, however the study gives no explanation of this.

Key messages:
Children diagnosed with IBD before 18 years of age had at least the same chance of achieving an upper secondary education compared to references.IBD patients with low social economic status performed better than their peers.
Abstract citation ID: ckac131.445Forced migrant women's Mental Health in the perinatal period in Germany-A mixed-method study