geKuJu: The health and care situation of children and young people in Schleswig-Holstein in times of crisis

Research question
This study will provide a better picture of the care situation for children and adolescents in Schleswig-Holstein, enabling the care needs and proportion of children and adolescents requiring care in Schleswig-Holstein to be identified and quantified in order to support regional planning for needs-based care.

Background
The COVID-19 pandemic has led to changes worldwide. These changes have also affected medical care for children and adolescents in Germany. Many facilities were temporarily closed or unable to offer services as usual, while psychosocial and health burdens on children and adolescents increased. The results of preliminary studies (subproject A3 of the ABCDEF-COOP study, CorJu_1 and CorJu_2) conducted by the University of Lübeck indicate that medical care for children and adolescents in northern Germany will be limited from autumn 2020 to autumn 2022, with regional differences also likely.

Methods
As part of the research project, commissioned by the state of Schleswig-Holstein, 15,000 parents from all districts of Schleswig-Holstein will be contacted and surveyed on health issues, the paediatric care situation in 2023, the use of medical services, care needs, health behaviour and health literacy. To this end, representative samples were taken from the registers of the residents' registration offices of the independent cities and districts in Schleswig-Holstein, so that statements about any existing regional differences and comparative statements about the preliminary studies on the care situation and needs of children and adolescents can be made. Descriptive analyses of the variables relating to the care situation as well as exploratory univariate and multivariate association analyses are planned.

The surveys include the following standardised questionnaire instruments: Health status of children and adolescents in Schleswig-Holstein (KIDSCREEN-10), need for and use of defined paediatric care (CHC-SUN), degree of difficulty in meeting care needs (CHC-SUN Part 1), Satisfaction with doctor consultations (based on ZuF-8), Health literacy of parents (HLS-EU-Q16), Health behaviour (exercise, nutrition, smoking, alcohol consumption as in KIDA), Computer gaming behaviour of the child (Gaming Disorder Scale for Adolescents (GADIS-A), parents' quality of life and general health status (Global Health-Related Quality of Life Score (subscale from EORTc-QLQ30)), indications of depression and anxiety in parents (PHQ-4), parents' perceived social support (OSSS-3) and sociodemographic data: age, gender, migration background of the parents and child, as well as the parents' level of education and weekly working hours, and the everyday language spoken in the family.

Of the 15,000 parents, 13,000 will receive study information and a link or QR code by post with a request to participate in the online survey. A further 1,000 parents will be sent study information and a paper questionnaire with a stamped envelope by post, with a request to complete it and return it by post. In addition, 1,000 parents will be given the choice of filling out the paper questionnaire or participating online. This approach is intended to determine the response rates depending on the type of survey and reminder letters. In addition, reasons for non-participation will be collected.

Durch diese Studie wird es möglich werden, ein besseres Bild von der Versorgungssituation von Kindern und Jugendlichen in Schleswig-Holstein zu erlangen und somit Versorgungsbedarfe und den Anteil an versorgungsbedürftigen Kindern und Jugendlichen in Schleswig-Holstein identifizieren und quantifizieren zu können, um die regionale Planung einer bedarfsgerechten Versorgung zu unterstützen.

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