Department of Population Health Sciences, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA.
Departments of Psychiatry and Behavioral Sciences and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
J Child Health Care. 2024 Dec;28(4):700-714. doi: 10.1177/13674935231163362. Epub 2023 Mar 14.
We surveyed pediatric primary care clinicians working in Federally Qualified Health Centers about their perceptions of children's social-emotional wellbeing. We identified clinician's current methods for assessing social-emotional wellbeing in practices, perceived implementation barriers to providing behavioral health care, and interest in adopting a validated, low-burden developmentally sensitive parent-report instrument for screening for social-emotional wellbeing in young children. We surveyed 72 PCCs working in FQHCs from 9 US states. Analyses included examining central tendencies, correlations, analysis of variance, and group differences via t-tests. Average PCC perceptions of social-emotional wellbeing importance for overall health were statistically significantly higher than their confidence in providing care for common social-emotional wellbeing concerns (mean difference = 1.31, 95% CI = 1.13-1.49). PCCs expressed low satisfaction with currently available screening measures for identifying concerns in social-emotional wellbeing. Fewer than half of clinicians reported using any standardized parent-reported measure for identifying concerns in social-emotional wellbeing. Assessment methods and decision tools that improve clinician confidence concerning risk indications are needed, particularly at the critical early childhood period. Policymakers and payers ought to facilitate funding mechanisms that support pediatric PCCs in identifying early concerns in social-emotional wellbeing and providing referral guidance to evidence-based interventions to support parents and caregivers.
我们调查了在联邦合格健康中心工作的儿科初级保健临床医生,了解他们对儿童社会情感健康的看法。我们确定了临床医生在实践中评估社会情感健康的当前方法、提供行为保健的感知实施障碍,以及对采用经过验证的、低负担的、发展敏感的家长报告工具来筛查幼儿社会情感健康的兴趣。我们调查了来自 9 个美国州的 72 名在 FQHC 工作的 PCC。分析包括检查中心趋势、相关性、方差分析和通过 t 检验的组间差异。PCC 对社会情感健康对整体健康重要性的平均看法在统计学上明显高于他们对提供常见社会情感健康问题护理的信心(平均差异=1.31,95%置信区间=1.13-1.49)。PCC 对目前用于识别社会情感健康问题的筛选措施的满意度较低。不到一半的临床医生报告使用任何标准化的家长报告措施来识别社会情感健康方面的问题。需要评估方法和决策工具来提高临床医生对风险迹象的信心,特别是在关键的幼儿期。政策制定者和支付方应该为识别社会情感健康早期问题并为支持父母和照顾者的循证干预措施提供转介指导的儿科 PCC 提供资金机制支持。