Cody A Hostutler, Jeffrey D Shahidullah, Jennifer A Mautone, Tiffany M Rybak, Chimereodo Okoroji, Teryn Bruni, Kevin G Stephenson, Leah Vance Utset, Kurt A Freeman, Leah LaLonde, Andrew R Riley
{"title":"儿科综合初级保健对预防和治疗身体和行为健康状况的系统回顾和荟萃分析。","authors":"Cody A Hostutler, Jeffrey D Shahidullah, Jennifer A Mautone, Tiffany M Rybak, Chimereodo Okoroji, Teryn Bruni, Kevin G Stephenson, Leah Vance Utset, Kurt A Freeman, Leah LaLonde, Andrew R Riley","doi":"10.1093/jpepsy/jsae038","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effects of behavioral health interventions delivered within pediatric integrated primary care models on clinical outcomes.</p><p><strong>Methods: </strong>We searched Medline, EMBASE, CENTRAL, PsycINFO, and SCOPUS for studies published from January 1, 1998, to September 20, 2023. We included studies that evaluated onsite behavioral health integration in pediatric primary care using a comparator condition (usual, enhanced usual care, or waitlist). Outcome data on symptom change, impairment/quality of life, health indicator, and behavior change were extracted using Covidence software. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline was followed Risk of bias analysis was conducted using the Cochrane Risk of Bias tool. We used multilevel meta-analysis to synthesize multiple outcomes nested within studies. Open Science Foundation pre-registration: #10.17605/OSF.IO/WV7XP.</p><p><strong>Results: </strong>In total, 33 papers representing 27 studies involving 6,879 children and caregivers were included. Twenty-four studies were randomized controlled trials and three were quasi-experimental designs. Seventeen papers reported on treatment trials and 16 reported on prevention trials. We found a small overall effect size (SMD = 0.19, 95% confidence interval [0.11, 0.27]) supporting the superiority of integrated primary care to usual or enhanced usual care. Moderator analyses suggested similar effectiveness between co-located and integrated models and no statistically significant differences were found between treatment and prevention trials.</p><p><strong>Conclusions: </strong>Results suggest that integrated primary care is superior to usual and enhanced usual care at improving behavior, quality of life, and symptoms. Integrated primary care research needs improved standards for reporting to promote better synthesis and understanding of the literature.</p>","PeriodicalId":48372,"journal":{"name":"Journal of Pediatric Psychology","volume":null,"pages":null},"PeriodicalIF":2.7000,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A systematic review and meta-analysis of pediatric integrated primary care for the prevention and treatment of physical and behavioral health conditions.\",\"authors\":\"Cody A Hostutler, Jeffrey D Shahidullah, Jennifer A Mautone, Tiffany M Rybak, Chimereodo Okoroji, Teryn Bruni, Kevin G Stephenson, Leah Vance Utset, Kurt A Freeman, Leah LaLonde, Andrew R Riley\",\"doi\":\"10.1093/jpepsy/jsae038\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To evaluate the effects of behavioral health interventions delivered within pediatric integrated primary care models on clinical outcomes.</p><p><strong>Methods: </strong>We searched Medline, EMBASE, CENTRAL, PsycINFO, and SCOPUS for studies published from January 1, 1998, to September 20, 2023. We included studies that evaluated onsite behavioral health integration in pediatric primary care using a comparator condition (usual, enhanced usual care, or waitlist). Outcome data on symptom change, impairment/quality of life, health indicator, and behavior change were extracted using Covidence software. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline was followed Risk of bias analysis was conducted using the Cochrane Risk of Bias tool. We used multilevel meta-analysis to synthesize multiple outcomes nested within studies. Open Science Foundation pre-registration: #10.17605/OSF.IO/WV7XP.</p><p><strong>Results: </strong>In total, 33 papers representing 27 studies involving 6,879 children and caregivers were included. Twenty-four studies were randomized controlled trials and three were quasi-experimental designs. Seventeen papers reported on treatment trials and 16 reported on prevention trials. We found a small overall effect size (SMD = 0.19, 95% confidence interval [0.11, 0.27]) supporting the superiority of integrated primary care to usual or enhanced usual care. Moderator analyses suggested similar effectiveness between co-located and integrated models and no statistically significant differences were found between treatment and prevention trials.</p><p><strong>Conclusions: </strong>Results suggest that integrated primary care is superior to usual and enhanced usual care at improving behavior, quality of life, and symptoms. Integrated primary care research needs improved standards for reporting to promote better synthesis and understanding of the literature.</p>\",\"PeriodicalId\":48372,\"journal\":{\"name\":\"Journal of Pediatric Psychology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2024-06-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Pediatric Psychology\",\"FirstCategoryId\":\"102\",\"ListUrlMain\":\"https://doi.org/10.1093/jpepsy/jsae038\",\"RegionNum\":3,\"RegionCategory\":\"心理学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PSYCHOLOGY, DEVELOPMENTAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Pediatric Psychology","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.1093/jpepsy/jsae038","RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHOLOGY, DEVELOPMENTAL","Score":null,"Total":0}
A systematic review and meta-analysis of pediatric integrated primary care for the prevention and treatment of physical and behavioral health conditions.
Objective: To evaluate the effects of behavioral health interventions delivered within pediatric integrated primary care models on clinical outcomes.
Methods: We searched Medline, EMBASE, CENTRAL, PsycINFO, and SCOPUS for studies published from January 1, 1998, to September 20, 2023. We included studies that evaluated onsite behavioral health integration in pediatric primary care using a comparator condition (usual, enhanced usual care, or waitlist). Outcome data on symptom change, impairment/quality of life, health indicator, and behavior change were extracted using Covidence software. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline was followed Risk of bias analysis was conducted using the Cochrane Risk of Bias tool. We used multilevel meta-analysis to synthesize multiple outcomes nested within studies. Open Science Foundation pre-registration: #10.17605/OSF.IO/WV7XP.
Results: In total, 33 papers representing 27 studies involving 6,879 children and caregivers were included. Twenty-four studies were randomized controlled trials and three were quasi-experimental designs. Seventeen papers reported on treatment trials and 16 reported on prevention trials. We found a small overall effect size (SMD = 0.19, 95% confidence interval [0.11, 0.27]) supporting the superiority of integrated primary care to usual or enhanced usual care. Moderator analyses suggested similar effectiveness between co-located and integrated models and no statistically significant differences were found between treatment and prevention trials.
Conclusions: Results suggest that integrated primary care is superior to usual and enhanced usual care at improving behavior, quality of life, and symptoms. Integrated primary care research needs improved standards for reporting to promote better synthesis and understanding of the literature.
期刊介绍:
The Journal of Pediatric Psychology is the official journal of the Society of Pediatric Psychology, Division 54 of the American Psychological Association. The Journal of Pediatric Psychology publishes articles related to theory, research, and professional practice in pediatric psychology. Pediatric psychology is an integrated field of science and practice in which the principles of psychology are applied within the context of pediatric health. The field aims to promote the health and development of children, adolescents, and their families through use of evidence-based methods.