The prevalence of emotional and behavior problems in pediatric primary care serving rural children.

Objectives: To examine the prevalence of parent-reported emotional and behavior problems in pediatric primary care clinics serving rural Appalachia using methods commensurate with studies of broader samples.

Methods: Parents presenting to pediatric primary care clinics completed a rating scale (Pediatric Symptom Checklist) of psychosocial problems for their child.

Results: Approximately 21% of all rating scales were in the clinically significant range. Across all parents, 63% identified the child's physician as their most common source of help. In contrast, mental health professionals had been sought out by only 24% of the sample.

Conclusions: These data replicate previous findings showing high rates of parent-rated psychosocial problems in pediatric primary care. Given the prevalence of these problems in primary care and parents' frequent help seeking in this setting, more research is needed on innovative approaches to integrated care in rural settings.