Evidence-based prevention programs targeting youth mental and behavioral health in primary care: A systematic review

Rojas, Lourdes; Bahamón, Mónica; Wagstaff, Rachel; Ferre, Isabella; Perrino, Tatiana; Estrada, Yannine; George, Sara M. St.; Pantín, Hilda; Prado, Guillermo

doi:10.1016/j.ypmed.2018.12.009

Cited by 19 publications

(5 citation statements)

References 65 publications

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“…This may be a more feasible and acceptable method for providers to use existing infrastructure to reach all parents in the practice. This aligns with findings that primary care may be a critical point of entry for prevention interventions but not the sole intervention site (Rojas et al, 2019).…”

Section: Discussionsupporting

confidence: 85%

Implementation findings from an effectiveness-implementation trial of tablet-based parent training in pediatric primary care.

Breitenstein

Laurent

Pabalan

et al. 2019

Families, Systems, & Health

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The use of mobile delivery to deliver parent training can address barriers to access and improve the translation of interventions in existing settings like pediatric primary care. Studying implementation provides critical information to identify and address barriers and facilitators and inform sustainability efforts. Method: This study was a descriptive evaluation using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework as part of a Hybrid Type I Effectiveness-Implementation trial of the ezParent Program within 4 pediatric primary care clinics. We collected data before, during, and after implementation to evaluate provider implementation and their perspectives on program benefits and barriers to implementation. Results: On average, 14% of eligible parents were introduced to the study. Of these parents, 78% expressed interest in participating and 37% enrolled in the study. Seventy-eight percent of staff providers (n ϭ 36) implemented the procedures at least once, and among those who implemented 3 or more times (n ϭ 24), 79% maintained implementation for 6 months. Barriers to implementation include limited time, lack of information, and full practice buy-in and engagement. Discussion: Implementation fidelity may improve with additional education and training of the interdisciplinary team, clear messaging regarding the purpose and content of the ezParent program, defining roles within the care team, identifying practice champions, and use of the electronic health record. Findings from this evaluation, including data from the randomized controlled trial and literature to support intervention effectiveness and implementation, will be used to develop an implementation toolkit to include specific strategies for implementation and ideas for local adaptations.

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Section: Discussionsupporting

confidence: 85%

Implementation findings from an effectiveness-implementation trial of tablet-based parent training in pediatric primary care.

Breitenstein

Laurent

Pabalan

et al. 2019

Families, Systems, & Health

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“…Thus, now more than ever, we must seek prevention efforts that are easily accessible and effective across this developmental stage. In addition, clinicians need to start focusing on understanding youth suicide, mental health, and what is happening in urban communities, specifically among Black youths (Healthy People 2030; Lindsey et al, 2019; Rojas et al, 2019). This project has provided a valuable and accessible tool (in addition to the American Academy of Pediatrics recommendations) that may quickly and efficiently identify and manage positive screens for medical personnel who interact with Black youth, parents, and the community in urban settings (Coleman et al, 2020; Horowitz et al, 2021).…”

Section: Implications For Practicementioning

confidence: 99%

Feasibility of a universal suicidality tool for adolescents

Abaddi

Pickens²,

Burns

et al. 2023

J Am Assoc Nurse Pract

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Background:The suicide rate among adolescents has been increasing rapidly over the past several years.Local problem:Adequate screening for suicide risk in this population, particularly youth of color, is lacking.Methods:The Ask Suicide-Screening Questions (ASQ) tool was implemented at two adolescent-focused health clinics in a large U.S. city.Interventions:This project followed the Ottawa Model of Research Use. Participating clinicians were surveyed before and after receiving an educational module on suicide risk screening, the ASQ tool, and clinical pathways. Clinicians were also asked about the feasibility and acceptability of the ASQ tool in their practice. An electronic medical records software was used to gather data on patients newly screened for suicide risk using the ASQ tool.Results:Among eligible patients, 40.2% were screened using the ASQ tool during the 4-month duration of the project. Most clinicians reported that using the tool was feasible within their practice (66%) and 100% endorsed its acceptability (i.e., reporting that they were comfortable screening for suicide and that the ASQ was easy to use).Conclusions:The ASQ may be a promising screening tool for clinicians to use to address the mental health needs of at-risk youth. This project supports the universal acceptability and feasibility of its use in inner-city primary care clinics.

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“…Many had a parenting outcome but were not necessarily a formal parenting program. Rojas et al 43 identified 19 preventive interventions for child and adolescent mental and behavioral health problems, 10 of which were considered parenting programs. Studies were focused mostly on school-aged children (n = 6) and adolescents (n = 8) compared with earlier ages (infancy: n = 2; preschool age: n = 3).…”

Section: Effectiveness Of Behavioral Health Interventions In Pediatric Primary Carementioning

confidence: 99%

Parenting Interventions in Pediatric Primary Care: A Systematic Review

Smith¹,

Cruden²,

Rojas³

et al. 2020

Pediatrics

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CONTEXT: More than 4 decades of research indicate that parenting interventions are effective at preventing and treating mental, emotional, and behavioral disorders in children and adolescents. Pediatric primary care is a viable setting for delivery of these interventions.OBJECTIVE: Previous meta-analyses have shown that behavioral interventions in primary care can improve clinical outcomes, but few reviews have been focused specifically on the implementation of parenting interventions in primary care. We aimed to fill this gap.DATA SOURCES: We reviewed 6532 unique peer-reviewed articles published in PubMed, the Cumulative Index to Nursing and Allied Health Literature, and PsycInfo.STUDY SELECTION: Articles were included if at least part of the intervention was delivered in or through primary care; parenting was targeted; and child-specific mental, emotional, and behavioral health outcomes were reported.DATA EXTRACTION: Articles were reviewed in Covidence by 2 trained coders, with a third coder arbitrating discrepancies.RESULTS: In our review of 40 studies, most studies were coded as a primary. Few researchers collected implementation outcomes, particularly those at the service delivery system level.LIMITATIONS: Including only published articles could have resulted in underrepresentation of implementation-related data.CONCLUSIONS: Parenting interventions delivered and implemented with fidelity in pediatric primary care could result in positive and equitable impacts on mental, emotional, and behavioral health outcomes for both parents and their children. Future research on the implementation strategies that can support adoption and sustained delivery of parenting interventions in primary care is needed if the field is to achieve population-level impact.

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Evidence-based prevention programs targeting youth mental and behavioral health in primary care: A systematic review

Cited by 19 publications

References 65 publications

Implementation findings from an effectiveness-implementation trial of tablet-based parent training in pediatric primary care.

Implementation findings from an effectiveness-implementation trial of tablet-based parent training in pediatric primary care.

Feasibility of a universal suicidality tool for adolescents

Parenting Interventions in Pediatric Primary Care: A Systematic Review

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