What Caregivers Want: Preferences for Behavioral Health Screening Implementation Procedures in Pediatric Primary Care
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What Caregivers Want: Preferences for Behavioral Health Screening Implementation Procedures in Pediatric Primary Care Mallory Schneider1 · Krista Mehari1 · Jennifer Langhinrichsen‑Rohling2 Accepted: 25 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract There has been a national push for universal psychosocial prevention screening in pediatric primary care. Implementation science highlights the importance of considering patients’ perspectives when developing such procedures; however, minimal studies have examined this. The present study employed a mixed-methods design to examine caregivers of pediatric patients’ (n = 149) preferences and comfort with psychosocial screening procedures. A subset of participants (n = 20) were interviewed to better understand reasons for responses. Results indicated that caregivers rated screening for physical health, development, emotion and behavior, caregiver adverse childhood experiences (ACEs), and child ACEs within primary care as important or very important. The majority of caregivers were not comfortable completing screenings in the waiting room and preferred the exam room. Caregivers primarily preferred the primary care provider to administer screenings and communicate results and recommendations. Parents also preferred the behavioral health provider to provide recommendations on emotion and behavior, parent ACEs, and child ACEs. Qualitative reasons for responses included relationship quality, knowledge of child, expertise, and desire for direct communication. Findings have implications for developing family-centered, trauma-informed practices within primary care, particularly among those within under-resourced rural communities. Keywords Behavioral health · Prevention screening · Adverse childhood experiences · Implementation science
Introduction Childhood developmental, behavioral, and psychological problems are prevalent and predict physical, mental, and social well-being across the lifespan (Weitzman & Wegner, 2015). In fact, the top five most common chronically impairing problems among children and adolescents are related to mental or behavioral health (MBH; i.e., speech delays, learning problems, attention-deficit/hyperactivity disorder, emotional/behavioral difficulties, developmental concerns), not physical health (Slomski, 2012). Typically, caregivers of children with MBH concerns first present to their child’s primary care provider (PCP), making primary care an ideal setting for early identification and intervention (Sheldrick, * Mallory Schneider [email protected] 1
Department of Psychology, University of South Alabama, 307 N University Blvd, UCOM 1000, Mobile, AL 36606, USA
Department of Psychological Science, University of North Carolina at Charlotte, Charlotte, NC, USA
2
Merchant, & Perrin, 2011; Weitzman & Wegner, 2015). There has been a national push to implement universal developmental, psychosocial, and behavioral screenings in pediatric primary care to reduce the time lapse between the expre
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