Effects of Primary Care Provider Characteristics on Changes in Behavioral Health Delivery During a Collaborative Care Trial.
behavioral health
collaborative care
pediatrics
Journal
Academic pediatrics
ISSN: 1876-2867
Titre abrégé: Acad Pediatr
Pays: United States
ID NLM: 101499145
Informations de publication
Date de publication:
04 2020
04 2020
Historique:
received:
24
06
2019
revised:
13
11
2019
accepted:
16
11
2019
pubmed:
25
11
2019
medline:
18
3
2021
entrez:
25
11
2019
Statut:
ppublish
Résumé
Pediatric primary care providers (PCPs) are increasingly expected to deliver behavioral health (BH) services, yet PCP characteristics that facilitate or hinder BH service delivery are poorly understood. This study examined how PCP characteristics and collaborative care participation influenced changes in BH-related effort and competency over time. Pediatric PCPs (N = 74) participating in a cluster randomized trial (8 practices) of a collaborative care intervention for disruptive behavior problems completed self-report measures at 0, 6, 12, and 18 months. Latent growth curve models tested the impact of PCP characteristics (ie, age, gender, negative BH beliefs, BH burden, BH competency) on changes in identification/treatment of disruptive behavior disorders and competency over the course of the trial. Participation in collaborative care was associated with increases in identification/treatment, with no evidence that PCP characteristics moderated changes in identification/treatment. For competency, however, older PCPs (>50 years) in collaborative care exhibited steep increases over time, while older PCPs in the comparison condition exhibited steep decreases, suggesting differential benefits of collaborative care participation by PCP age. In both conditions, PCPs with more negative BH beliefs reported less identification/treatment over time. Baseline competency was positively associated with identification/treatment and associations weakened over time. Gender and perceived burden had little impact. PCP characteristics are associated with changes in PCPs' BH-related effort and competency over time. Participation in a collaborative care model appears to be especially beneficial for older PCPs. Implementation of collaborative care can promote growth in BH-related effort and competency for PCPs.
Identifiants
pubmed: 31760174
pii: S1876-2859(19)30460-7
doi: 10.1016/j.acap.2019.11.008
pmc: PMC7138708
mid: NIHMS1545588
pii:
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
399-404Subventions
Organisme : NIMH NIH HHS
ID : R01 MH063272
Pays : United States
Organisme : NIMH NIH HHS
ID : R25 MH054318
Pays : United States
Organisme : NCATS NIH HHS
ID : TL1 TR001858
Pays : United States
Organisme : NIGMS NIH HHS
ID : U54 GM104942
Pays : United States
Organisme : NIMH NIH HHS
ID : P50 MH115838
Pays : United States
Organisme : NIMH NIH HHS
ID : T32 MH018951
Pays : United States
Informations de copyright
Copyright © 2019 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
Références
Psychiatr Serv. 2017 Jun 1;68(6):531-534
pubmed: 28502240
Pediatrics. 2014 Apr;133(4):e981-92
pubmed: 24664093
Ambul Pediatr. 2001 Mar-Apr;1(2):91-8
pubmed: 11888379
Clin Pediatr (Phila). 2007 Nov;46(9):812-20
pubmed: 17641120
Ambul Pediatr. 2003 Jul-Aug;3(4):191-5
pubmed: 12882596
Adm Policy Ment Health. 2012 Nov;39(6):489-502
pubmed: 21915748
Can J Psychiatry. 2018 Jul;63(7):432-438
pubmed: 29673268
Clin Pediatr (Phila). 2004 May;43(4):355-65
pubmed: 15118779
Pediatr Clin North Am. 2016 Feb;63(1):97-113
pubmed: 26613691
Arch Pediatr Adolesc Med. 2002 Jun;156(6):592-8
pubmed: 12038893
Arch Fam Med. 1993 Oct;2(10):1061-6
pubmed: 8111487
J Dev Behav Pediatr. 2014 Jan;35(1):28-37
pubmed: 24336091
Pediatrics. 2006 Jul;118(1):e132-8
pubmed: 16818528
Arch Pediatr Adolesc Med. 1998 Aug;152(8):774-80
pubmed: 9701137
Curr Psychiatry Rep. 2014 Nov;16(11):506
pubmed: 25218604
Adm Policy Ment Health. 2007 May;34(3):269-81
pubmed: 17226090
J Behav Health Serv Res. 2018 Jul;45(3):340-355
pubmed: 29209899
JAMA Pediatr. 2015 Oct;169(10):929-37
pubmed: 26259143
J Dev Behav Pediatr. 1999 Feb;20(1):24-30
pubmed: 10071942
Acad Pediatr. 2015 Nov-Dec;15(6):613-20
pubmed: 26409303
Arch Fam Med. 1994 Oct;3(10):899-907
pubmed: 8000562
J Clin Child Adolesc Psychol. 2014;43(2):216-28
pubmed: 24588366