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The journal of behavioral health services & research
07, 2018;45 (3): 340-355.

When Behavioral Health Concerns Present in Pediatric Primary Care: Factors Influencing Provider Decision-Making.

Elizabeth H Connors, Prerna Arora, Angela M Blizzard, Kelly Bower, Kelly Coble, Joyce Harrison, David Pruitt, Janna Steinberg, Lawrence Wissow
Author Information
  1. Elizabeth H Connors: University of Maryland School of Medicine, 737 West Lombard Street, Baltimore, MD, 21201, USA. econnors@som.umaryland.edu.
  2. Prerna Arora: Pace University, One Pace Plaza, New York, NY, 10038, USA.
  3. Angela M Blizzard: Florida International University, 11200 S.W. 8th Street, Miami, FL, 33199, USA.
  4. Kelly Bower: Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD, 21205, USA.
  5. Kelly Coble: University of Maryland School of Medicine, 737 West Lombard Street, Baltimore, MD, 21201, USA.
  6. Joyce Harrison: Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD, 21205, USA.
  7. David Pruitt: University of Maryland School of Medicine, 737 West Lombard Street, Baltimore, MD, 21201, USA.
  8. Janna Steinberg: Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD, 21205, USA.
  9. Lawrence Wissow: Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD, 21205, USA.
PMID: 29209899 DOI: 10.1007/s11414-017-9580-9

Abstract

Primary care providers (PCPs) frequently encounter behavioral health (BH) needs among their pediatric patients. However, PCPs report variable training in and comfort with BH, and questions remain about how and when PCPs address pediatric BH needs. Existing literature on PCP decisions to address pediatric BH in-office versus referring to subspecialty BH is limited and findings are mixed. Accordingly, this study sought to examine parameters and contextual factors influencing PCP decisions and practices related to BH care. Qualitative interview results with 21 PCPs in Maryland indicated that decisions about how and when to address pediatric BH concerns are influenced by the type BH service needed, patient characteristics, the availability of BH services in the community, and possibly PCPs' perceptions of BH care as a distinct subspecialty. Findings suggest that efforts to support individual PCPs' capacity to address BH within primary care must be balanced by efforts to expand the subspecialty BH workforce.

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MeSH Term

Adolescent
Attitude of Health Personnel
Child
Decision Making
Female
Health Knowledge, Attitudes, Practice
Health Personnel
Humans
Interviews as Topic
Male
Maryland
Mental Disorders
Nurses
Pediatric Nurse Practitioners
Pediatricians
Pediatrics
Physicians, Primary Care
Practice Patterns, Physicians'
Primary Health Care
Referral and Consultation
Rural Health Services
Urban Health Services
Journal Article Research Support, Non-U.S. Gov't
Article has an altmetric score of 1

Word Cloud

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