Peskin Abigail, Rothenberg William Andrew, Perez Camille, Sobalvarro Cindy, Davis Eileen, Mansoor Elana, Jent Jason, Garcia Dainelys
University of Miami, Miami, Florida, USA.
J Community Psychol. 2025 Jul;53(5):e70019. doi: 10.1002/jcop.70019.
Behavior problems in young children, especially among families from disadvantaged backgrounds (e.g., facing greater risk of poverty, social exclusion, discrimination, and violence), often result in referrals to mental health clinics. However, low-income families from historically marginalized racial and ethnic backgrounds disproportionately experience barriers to accessing, engaging, and completing treatment. This study examined the recruitment and referral network of a parenting program providing Parent-Child Interaction Therapy (PCIT) in a large urban academic medical center and affiliated community-embedded clinics, as well as the impact of recruitment/referral sources on screening paperwork completion, intake attendance, and treatment completion. Data from 2510 families referred between 2018 and 2022 were analyzed, considering demographic factors and recruitment adaptations during COVID-19. Referral sources included but were not limited to community agencies, social media, and healthcare providers. Logistic regression analyses determined the likelihood of completing the screening paperwork, attending intake, and completing treatment based on recruitment/referral sources. Every recruitment/referral source increased the likelihood of screening paperwork completion (except community outreach). Every source increased the likelihood of attending intake (except previously enrolled families). Treatment completion was significantly more likely for those referred from pediatricians, friends, behavioral health, and Google. After COVID-19 (post March 2020), families were more likely to complete the screening paperwork, attend intake, and complete treatment compared to families screened before COVID-19. Effective recruitment and retention strategies are crucial for engaging families in mental health services. Findings emphasize the role of community and healthcare providers, word-of-mouth, and Google and the benefits of telehealth (indicated by post-COVID-19 results), in improving treatment access and retention, highlighting the need for flexible service delivery methods.
幼儿的行为问题，尤其是来自弱势背景家庭（例如面临更高贫困、社会排斥、歧视和暴力风险的家庭）的幼儿行为问题，常常导致他们被转介到心理健康诊所。然而，来自历史上被边缘化的种族和族裔背景的低收入家庭在获得、参与和完成治疗方面面临的障碍不成比例地更多。本研究调查了一家大型城市学术医疗中心及其附属社区诊所中提供亲子互动疗法（PCIT）的育儿项目的招募和转介网络，以及招募/转介来源对筛查文书完成情况、入院登记出席率和治疗完成情况的影响。分析了2018年至2022年间被转介的2510个家庭的数据，同时考虑了人口统计学因素以及新冠疫情期间的招募调整情况。转介来源包括但不限于社区机构、社交媒体和医疗服务提供者。逻辑回归分析确定了基于招募/转介来源完成筛查文书、参加入院登记和完成治疗的可能性。每个招募/转介来源都增加了完成筛查文书的可能性（社区外展除外）。每个来源都增加了参加入院登记的可能性（之前已登记的家庭除外）。由儿科医生、朋友、行为健康机构和谷歌转介的家庭完成治疗的可能性显著更高。在新冠疫情之后（2020年3月之后），与疫情之前接受筛查的家庭相比，家庭更有可能完成筛查文书、参加入院登记并完成治疗。有效的招募和留用策略对于让家庭参与心理健康服务至关重要。研究结果强调了社区和医疗服务提供者、口碑以及谷歌的作用，以及远程医疗的益处（由新冠疫情后的结果表明），有助于改善治疗机会和留用率，突出了灵活服务提供方式的必要性。
