J03 – Examining Community Practice Readiness for Pediatric Primary Care Behavioral Health Services

Summary

This presentation examines the process of developing, implementing, and evaluating a community-based pediatric primary care behavioral health (PCBH) program. Structural limitations imposed as precautions for COVID-19 are presented in relation to the launch of this new program. In addition to discussing program development and implementation, cross-sectional study data is presented examining the process of introducing an integrated behavioral health model within a well-established community pediatric primary care organization. Participants included both clinical and administrative staff (N=91) of a pediatric primary care “supergroup,” comprised of 4 community clinic settings and central business office. A descriptive analysis of practice needs is provided, followed by multivariate analysis of clinicians’ ratings of their practice readiness for behavioral health integration. The majority of clinicians reported seeing 21-25 patients per day. The most frequent behavioral health concerns encountered were Anxiety/Mood (53%), Disruptive Behavior and ADHD (51%), Speech/Language Problems, Sleep Issues (27%), and Autism Spectrum and Developmental Disorders (23%). However, when rating the most difficult behavioral health concerns, clinicians reported Anxiety/Mood (43%), Disruptive Behavior and ADHD (34%), Suicidality (26%), and Family Problems (25%), Autism Spectrum and Developmental Disorders (25%). Collaboration Satisfaction (CS) and Integration Readiness (IR) displayed a moderate, positive correlation, r(87) = .51, p = .001. Participant ratings suggest generally positive Collaboration Satisfaction with an average raw score of 5.04 (out of 9). Integration Readiness ratings were also positive overall with an average raw score of 6.28 (out of 10). There were no significant differences in the variability of ratings Collaboration Satisfaction or Integration Readiness when controlling for clinic site or participant role (clinician or administrator). Results highlight significant interests and needs expressed by clinic staff for behavioral health services, but with a relatively limited level of practice readiness for incorporating these services into their current workflows. Areas for program development and growth are discussed, including key areas identified for improving program integration.