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

5 Scopus citations

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

Keywords

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

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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