Which Pediatricians Comanage Mental Health Conditions?

Cori Green, Amy Storfer-Isser, Ruth E. K. Stein, Andrew S. Garner, Bonnie D. Kerker, Moira Szilagyi, Karen G. O'Connor, Kimberly E. Hoagwood, Sarah M. Horwitz

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
JournalAcademic Pediatrics
DOIs
StateAccepted/In press - Jun 4 2016

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Mental Health
Confidence Intervals
Pediatrics
Education
Pediatricians
Logistic Models
Regression Analysis
Physicians
Therapeutics

Keywords

  • Behavior problems
  • Comanagement mental health
  • Developmental behavioral pediatrics
  • Pediatric education learning problems

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Green, C., Storfer-Isser, A., Stein, R. E. K., Garner, A. S., Kerker, B. D., Szilagyi, M., ... Horwitz, S. M. (Accepted/In press). Which Pediatricians Comanage Mental Health Conditions? Academic Pediatrics. https://doi.org/10.1016/j.acap.2016.10.014

Which Pediatricians Comanage Mental Health Conditions? / Green, Cori; Storfer-Isser, Amy; Stein, Ruth E. K.; Garner, Andrew S.; Kerker, Bonnie D.; Szilagyi, Moira; O'Connor, Karen G.; Hoagwood, Kimberly E.; Horwitz, Sarah M.

In: Academic Pediatrics, 04.06.2016.

Research output: Contribution to journalArticle

Green, C, Storfer-Isser, A, Stein, REK, Garner, AS, Kerker, BD, Szilagyi, M, O'Connor, KG, Hoagwood, KE & Horwitz, SM 2016, 'Which Pediatricians Comanage Mental Health Conditions?', Academic Pediatrics. https://doi.org/10.1016/j.acap.2016.10.014
Green, Cori ; Storfer-Isser, Amy ; Stein, Ruth E. K. ; Garner, Andrew S. ; Kerker, Bonnie D. ; Szilagyi, Moira ; O'Connor, Karen G. ; Hoagwood, Kimberly E. ; Horwitz, Sarah M. / Which Pediatricians Comanage Mental Health Conditions?. In: Academic Pediatrics. 2016.
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title = "Which Pediatricians Comanage Mental Health Conditions?",
abstract = "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.",
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author = "Cori Green and Amy Storfer-Isser and Stein, {Ruth E. K.} and Garner, {Andrew S.} and Kerker, {Bonnie D.} and Moira Szilagyi and O'Connor, {Karen G.} and Hoagwood, {Kimberly E.} and Horwitz, {Sarah M.}",
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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.

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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.

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KW - Pediatric education learning problems

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