Pajer Kathleen, Gardner William, Ouellette Carley, Cheng Michael, Bissex Sarah, MacKay Roxanne, MacLaurin Tracey, Gandy Hazen
Department of Psychiatry, University of Ottawa, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.
Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.
Clin Pediatr (Phila). 2025 Mar;64(3):382-390. doi: 10.1177/00099228241270035. Epub 2024 Aug 25.
Primary care providers (PCPs) report insufficient capacity for child and youth mental health care (CYMH). The telementoring program Project ECHO (Extension for Community Healthcare Outcomes) can build capacity, but 75- to 120-minute sessions are a participation barrier. Using a Lean health care paradigm, we designed a 60-minute session, and compared self-reported CYMH capacity strengthening (10 constructs) and satisfaction between 60- and 90-minute sessions. Pre-post (n = 139) and post-cycle (n = 146) survey data were analyzed using generalized linear mixed-effects logistic regression. Capacity strengthening was demonstrated when analyzing both groups together (all ≤ .002). Session duration did not affect capacity strengthening for 9/10 constructs (all > .05), but medication management development was higher with 90-minute sessions ( = .002). Satisfaction was high in both groups. The 60-minute ECHO CYMH sessions can be used without negative learning outcomes, but more mentoring may be needed to build capacity for psychopharmacologic treatment.
初级保健提供者（PCP）报告称，儿童和青少年心理健康护理（CYMH）的能力不足。远程指导项目“社区医疗成果扩展计划”（Project ECHO）可以提高能力，但75至120分钟的课程是一个参与障碍。我们采用精益医疗模式设计了一个60分钟的课程，并比较了60分钟和90分钟课程之间自我报告的CYMH能力增强情况（10个指标）以及满意度。使用广义线性混合效应逻辑回归分析了前后测（n = 139）和周期后（n = 146）的调查数据。将两组数据一起分析时显示出能力增强（所有P≤.002）。课程时长对9/10个指标的能力增强没有影响（所有P>.05），但90分钟课程的药物管理能力提升更高（P =.002）。两组的满意度都很高。60分钟的ECHO CYMH课程可以使用且不会产生负面学习结果，但可能需要更多的指导来增强心理药物治疗的能力。
