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时间变化:在联邦合格健康中心接受综合心理健康保健的学龄儿童和家长的结果

Changes Over Time in Outcomes of School-Age Children and Parents Receiving Integrated Mental Health Care in Federally Qualified Health Centers.

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV.

Department of Pediatrics, Boston Medical Center, Boston, MA.

出版信息

J Dev Behav Pediatr. 2023 Sep 1;44(7):e493-e500. doi: 10.1097/DBP.0000000000001203. Epub 2023 Aug 11.

Abstract

OBJECTIVE

The purpose of this study is to understand change in parent-reported outcomes of mental health symptoms, health-related quality of life (QoL), and school-related functioning among children receiving mental health care at 3 federally qualified health centers engaging in a comprehensive pediatric mental health integration model.

METHODS

Trained personnel enrolled English- or Spanish-speaking families of 6- to 12-year-old children who had recently started receiving integrated mental health care and surveyed their parent/caregiver at 3 time points: entry into the cohort, 6-month follow-up, and 12-month follow-up (unique N = 51). Primary outcomes included validated measures of child symptoms, child health-related QoL, and child school-related functioning. Secondary outcomes focused on parental functioning and included validated measures of parental stress and depressive and internalizing symptoms. A multilevel mixed-effects generalized linear model was used to estimate the change in parent-reported outcomes over time, with inverse probability weights used to address attrition. Additional analyses were conducted to determine the degree to which changes in symptoms over time were associated with improvements in school-related functioning.

RESULTS

Over 12 months, children's mental health symptoms, health-related QoL, and school-related functional outcomes significantly improved. No changes in parental functioning were observed. In addition, improvements in mental health symptoms and health-related QoL were associated with improvements in school-related functional outcomes over time.

CONCLUSION

Findings demonstrate that outcomes of children who received integrated mental health care improved over time, both in regard to mental health and school functioning.

摘要

目的

本研究旨在了解在参与综合儿童心理健康整合模式的 3 家联邦合格健康中心接受心理健康护理的儿童中,家长报告的心理健康症状、健康相关生活质量(QoL)和与学校相关的功能变化情况。

方法

训练有素的人员招募了最近开始接受综合心理健康护理的 6 至 12 岁儿童的英语或西班牙语家庭,并在 3 个时间点对其家长/照顾者进行了调查:进入队列、6 个月随访和 12 个月随访(独特的 N=51)。主要结果包括儿童症状、儿童健康相关 QoL 和儿童与学校相关功能的验证措施。次要结果侧重于父母的功能,包括验证的父母压力和抑郁和内化症状的措施。使用多级混合效应广义线性模型来估计随着时间的推移,父母报告的结果的变化,使用逆概率权重来解决流失问题。还进行了额外的分析,以确定随着时间的推移症状的变化与学校相关功能的改善程度之间的关系。

结果

在 12 个月内,儿童的心理健康症状、健康相关 QoL 和与学校相关的功能结果显著改善。未观察到父母功能的变化。此外,随着时间的推移,心理健康症状和健康相关 QoL 的改善与学校相关功能的改善相关。

结论

研究结果表明,接受综合心理健康护理的儿童的结果随着时间的推移而改善,无论是在心理健康还是学校功能方面。

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