TY - JOUR
T1 - Which Pediatricians Comanage Mental Health Conditions?
AU - Green, Cori
AU - Storfer-Isser, Amy
AU - Stein, Ruth E.K.
AU - Garner, Andrew S.
AU - Kerker, Bonnie D.
AU - Szilagyi, Moira
AU - O'Connor, Karen G.
AU - Hoagwood, Kimberly E.
AU - Horwitz, Sarah M.
N1 - Publisher Copyright:
© 2016 Academic Pediatric Association
PY - 2017/7
Y1 - 2017/7
N2 - Objective Given the prevalence of mental health (MH) conditions (MHC) in children, pediatricians should initiate treatment alone or in collaboration with a specialist for children with MHC. However, the majority of pediatricians do not manage or comanage common MHC even with an on-site MH provider. We examined which physician, practice, and training characteristics are associated with pediatricians' comanaging at least half of their patients with MHC. Methods We analyzed responses of general pediatricians (n = 305) from the American Academy of Pediatrics 2013 Periodic Survey. Practice characteristics include presence of an on-site MH provider and perceived access to services. Independent variables included sociodemographics, training experiences, and interest in further training. The outcome was comanagement of ≥50% of patients with MHC. Weighted univariate, bivariate, and multivariable analyses were performed. Results Of the pediatricians who reported comanaging ≥50% of their patients with MHC, logistic regression analysis showed that pediatricians who completed ≥4 weeks of developmental behavioral pediatrics training had 1.8 increased odds (95% confidence interval 1.06, 3.08, P =.03) of comanagement, those very interested in further education in managing/treating MHC had 2.75 increased odds (95% confidence interval 1.63, 3.08, P <.001), and those with more training in MH treatment with medications had 1.4 increased odds (95% confidence interval 1.12, 1.75, P =.004) of comanaging children with MHC. Conclusions Specific educational experiences and interest in further education in managing or treating MHC were significantly associated with comanaging ≥50% of patients, suggesting that enhanced MH training among pediatricians could increase the comanagement of children with MHC.
AB - Objective Given the prevalence of mental health (MH) conditions (MHC) in children, pediatricians should initiate treatment alone or in collaboration with a specialist for children with MHC. However, the majority of pediatricians do not manage or comanage common MHC even with an on-site MH provider. We examined which physician, practice, and training characteristics are associated with pediatricians' comanaging at least half of their patients with MHC. Methods We analyzed responses of general pediatricians (n = 305) from the American Academy of Pediatrics 2013 Periodic Survey. Practice characteristics include presence of an on-site MH provider and perceived access to services. Independent variables included sociodemographics, training experiences, and interest in further training. The outcome was comanagement of ≥50% of patients with MHC. Weighted univariate, bivariate, and multivariable analyses were performed. Results Of the pediatricians who reported comanaging ≥50% of their patients with MHC, logistic regression analysis showed that pediatricians who completed ≥4 weeks of developmental behavioral pediatrics training had 1.8 increased odds (95% confidence interval 1.06, 3.08, P =.03) of comanagement, those very interested in further education in managing/treating MHC had 2.75 increased odds (95% confidence interval 1.63, 3.08, P <.001), and those with more training in MH treatment with medications had 1.4 increased odds (95% confidence interval 1.12, 1.75, P =.004) of comanaging children with MHC. Conclusions Specific educational experiences and interest in further education in managing or treating MHC were significantly associated with comanaging ≥50% of patients, suggesting that enhanced MH training among pediatricians could increase the comanagement of children with MHC.
KW - behavior problems
KW - comanagement mental health
KW - developmental behavioral pediatrics
KW - pediatric education learning problems
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U2 - 10.1016/j.acap.2016.10.014
DO - 10.1016/j.acap.2016.10.014
M3 - Article
C2 - 28279638
AN - SCOPUS:85014460858
SN - 1876-2859
VL - 17
SP - 479
EP - 486
JO - Academic Pediatrics
JF - Academic Pediatrics
IS - 5
ER -