The Influence of Project ECHO and Integrated Behavioral Health in Primary Care on Emergency Department Visits Among Youth Diagnosed with Depression.

Rates of depression among youth and emergency department (ED) visits for un- or under-treated symptoms are on the rise. Early identification and treatment of depression is imperative at the patient, program, system, and population levels. This paper examines the individual and cumulative impact of Project ECHO and the inclusion of IBH services in pediatric primary care practices on mental health-related ED rates among youth diagnosed with depression for those practices.

Integrated Behavioral Health: A Guide to Practical Implementation.

Integrating behavioral health providers in primary care settings is an effective model for increasing access to mental and behavioral health services for youth. Resources and subject matter experts can be leveraged by pediatric practices to identify the components of a successful model and to support implementation in community practices. Integrated behavioral health approaches vary in scope and components of the models can be selected and implemented to meet the needs of each practice and the patient population served.

Integrated Behavioral Health Prevention for Infants in Pediatric Primary Care: A Mixed-Methods Pilot Study.

Objective: Pediatric primary care is a promising setting in which to deliver preventive behavioral health services to young children and their families. Integrated behavioral health care models typically emphasize treatment rather than prevention. This pilot study examined the efficacy of an integrated behavioral health preventive (IBH-P) intervention delivered by psychologists and focused on supporting parenting in low-income mothers of infants as part of well-child visits in the first 6 months of life.

Behavior Problems in Low-Income Young Children Screened in Pediatric Primary Care.

Importance: Screening of behavior problems in young children in pediatric primary care is essential to timely intervention and optimizing trajectories for social-emotional development. Identifying differential behavior problem trajectories provides guidance for tailoring prevention and treatment.

Objective: To identify trajectories of behavior problems in children 2 to 6 years of age screened in pediatric primary care.

Provider Perspectives on an Integrated Behavioral Health Prevention Approach in Pediatric Primary Care.

The purpose of this study was to use qualitative interviews to ascertain the perspective of pediatric primary care providers on the implementation of Integrated Behavioral Health (IBH) as provided by psychologists within an expanded HealthySteps™ model, and with a particular focus on prevention of behavioral health symptoms in the first five years. A semi-structured interview guide was used to assess medical providers' perceptions of behavioral health integration into their primary care clinics. A conventional qualitative content analysis approach was utilized to identify patterns of meaning across qualitative interviews.

Adapting a preschool disruptive behavior group for the underserved in pediatric primary care practice.

Introduction: While behavioral parent training (BPT) is the first line treatment for preschool aged children with disruptive behavior, only a fraction of families receive these therapies. The integration of BPT within the pediatric primary care (PPC) setting is a promising way to address this need, as the PPC setting is the first and only point of contact for most children diagnosed with mental health disorders. We piloted a clinical innovation by implementing an adapted BPT group in an urban, academic, PPC practice, serving a low-income, predominantly Black population.

Integrated Behavioral Health Increases Well-Child Visits and Immunizations in the First Year.

Objective: To assess whether integrated behavioral health (IBH) prevention encounters provided during well-child visits (WCVs) is associated with increased adherence to WCVs and timely immunizations in the first year.

Methods: Data were collected in an urban pediatric primary care clinic serving a low-income population and using the HealthySteps model. Subjects were 813 children who attended a newborn well-child visit between January 13, 2016 and August 8, 2017.

A novel behavioral health program for family caregivers of children admitted to a transitional chronic ventilator unit.

Background: The care of mechanically ventilated pediatric patients is complex and burdensome. It is essential to adequately support the family caregivers of these children to optimize outcomes; however, there is no literature describing interventions for caregivers in this population.

Research Question: This study described a novel behavioral health program and examined its impact on family caregiver engagement and psychological distress on a pediatric inpatient chronic ventilator unit.

Four innovations: A robust integrated behavioral health program in pediatric primary care.

The increase in behavioral health problems presenting in pediatric primary care (PPC) has led to a greater focus on the prevention and treatment of mental health concerns. As a result, care has shifted from colocation to integrated PPC models. However, the literature provides limited guidance on the development and implementation of integrated PPC models that aim to transform both PPC and the larger health care system.