Connors Elizabeth H, Arora Prerna, Blizzard Angela M, Bower Kelly, Coble Kelly, Harrison Joyce, Pruitt David, Steinberg Janna, Wissow Lawrence
University of Maryland School of Medicine, 737 West Lombard Street, Baltimore, MD, 21201, USA.
Pace University, One Pace Plaza, New York, NY, 10038, USA.
J Behav Health Serv Res. 2018 Jul;45(3):340-355. doi: 10.1007/s11414-017-9580-9.
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.
初级保健提供者（PCP）在其儿科患者中经常遇到行为健康（BH）需求。然而，PCP报告称他们在BH方面接受的培训参差不齐，对BH的熟悉程度也各不相同，关于PCP如何以及何时满足儿科BH需求的问题依然存在。现有关于PCP决定在诊所处理儿科BH需求还是转介至专科BH服务的文献有限，研究结果也参差不齐。因此，本研究旨在探讨影响PCP与BH护理相关决策和实践的参数及背景因素。对马里兰州21名PCP进行的定性访谈结果表明，关于如何以及何时处理儿科BH问题的决策受到所需BH服务类型、患者特征、社区中BH服务的可获得性，以及PCP对BH护理作为一个独特专科的认知等因素的影响。研究结果表明，在努力支持个体PCP在初级保健中处理BH问题能力的同时，必须通过扩大专科BH劳动力的努力来实现平衡。
