城市儿童初级保健的心理和行为健康及社区资源转诊特征。

IF 1.8 3区 医学 Q3 BEHAVIORAL SCIENCES
Nehaly S Patel, Alissa C Huth-Bocks, Kristin Cipolla, Kimberly Burkhart, Sarah Ronis
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引用次数: 0

摘要

目的:在城市/内城初级保健儿科实践中,检查与转诊到社会和行为健康资源相关的患者特征和实践过程。方法:对6个月至6岁的儿童进行健康检查,对每个孩子的安全环境(SEEK)筛查和临床医生对阳性筛查的即时和后期反应(由诊所的早期关系健康专家记录)进行回顾性图表审查。使用双变量和多变量分析来检查人口统计学、筛查结果和转诊接受度之间的关系。结果:在1104例SEEK筛查中,152例(13.8%)因筛查不完整而被排除,25例(2.3%)因重复护理者筛查而被排除。在纳入的927例患者中,286例(30.9%,“立即”)在筛查时进行了讨论,397例(42.8%,“稍后”,筛查和讨论之间的中位数为11天[四分位数范围6-19])试图在稍后的时间通过电话进行讨论;两种接触方式均有14例(1.5%);230个(24.8%)在任何时候都没有书面讨论。各群体的人口统计数据相似。如果看护者在屏幕上报告严厉的惩罚(p = 0.036)、看护者压力(p < 0.001)或看护者抑郁(p < 0.001),则临床医生更有可能进行讨论。经临床医生讨论后,697名护理人员中有225名(32.3%)提出转诊并接受转诊。每增加一个压力源,接受转诊的几率增加25%(95%可信区间,1.07-1.47)。68个被转介家庭中有33个(48.5%)完成了转介到育儿小组、社会需求导航支持和社会工作。结论:城市儿童初级保健机构“人人享有安全环境”筛查可识别家庭未满足的社会和行为卫生保健需求,为其提供支持。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Characterizing Referrals to Mental and Behavioral Health and Community Resources in Urban Pediatric Primary Care.

Objective: Examine patient characteristics and practice processes associated with referrals to social and behavioral health resources in an urban/inner-city primary care pediatric practice.

Method: Retrospective chart review was conducted on Safe Environment for Every Kid (SEEK) screening and immediate and later clinician responses to positive screens (documented by the practice's early relational health specialist) from well-child visits for children 6 months to 6 years. Bivariate and multivariate analyses were used to examine associations between demographics, screening results, and referral acceptance.

Results: Of 1104 SEEK screens, 152 (13.8%) were excluded for incomplete screens and 25 (2.3%) for duplicate caregiver screens. Of 927 included, responses were discussed at the time of screening for 286 (30.9%, "immediate") and/or attempted to be discussed at a later time by phone for 397 (42.8%, "later," median 11 days [interquartile range 6-19] between screen and discussion); 14 (1.5%) had both forms of contact; and 230 (24.8%) had no documented discussion at any time. Demographics were similar across groups. Clinician discussion was more likely if caregivers reported harsh punishment (p = 0.036), caregiver stress (p < 0.001), or caregiver depression (p < 0.001) on screen. After clinician discussion, referral was offered and subsequently accepted by 225 of 697 caregivers (32.3%). Each additional stressor endorsed increased odds of accepting referral by 25% (95% confidence interval, 1.07-1.47). Referrals to parenting groups, social needs navigation support, and social work were completed by 33 of 68 (48.5%) referred families.

Conclusion: Safe Environment for Every Kid screening in urban pediatric primary care can be used to identify families' unmet social and behavioral health care needs to provide support.

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来源期刊
CiteScore
3.10
自引率
8.30%
发文量
155
审稿时长
6-12 weeks
期刊介绍: Journal of Developmental & Behavioral Pediatrics (JDBP) is a leading resource for clinicians, teachers, and researchers involved in pediatric healthcare and child development. This important journal covers some of the most challenging issues affecting child development and behavior.
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