Preparedness of Pediatric Subspecialty Fellows to Address Emotional and Mental Health Needs Among Children With Chronic Medical Conditions

Green, Cori M.; Leyenaar, JoAnna K; Tucker, Ashley; Leslie, Laurel K.

doi:10.1001/jamapediatrics.2022.3451

Cited by 9 publications

(3 citation statements)

References 6 publications

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“…This highlights an important interprofessional opportunity for psychosocial providers to partner and build relationships with HCPs in order to model psychosocial care and identify occasions for cotreatment. Participants in this study also reported often educating their medical trainees about the role of psychosocial care in pediatric IBD, which has been identified as an educational area of need based on work showing that 64% of GI fellows feeling interested to support psychosocial needs of their patients, while only 25% endorsing feeling competency to do so ( 13 ).…”

Section: Discussionmentioning

confidence: 99%

Pediatric GI Health Care Professionals’ Perceptions of and Engagement With Psychosocial Providers in Pediatric IBD Care

et al. 2023

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Objectives: Multidisciplinary care is recommended for optimal pediatric inflammatory bowel disease (IBD) care, including psychosocial providers (eg, psychologists). However, health care professionals’ (HCPs) perceptions of and engagement with psychosocial providers in pediatric IBD is lacking. Methods: Cross-sectional REDCap surveys were completed by HCPs (eg, gastroenterologists) across American ImproveCareNow (ICN) centers. Demographics and self-reported perceptions of and engagement with psychosocial providers were collected. Data were analyzed at participant and site levels through descriptives, frequencies, an independent t test, and exploratory analyses of variance. Results: A total of 101 participants from 52% of ICN sites participated. Participants were 88% gastrointestinal physicians, 49% identifying as female, 94% non-Hispanic, and 76% Caucasian. Of ICN sites, 75% and 94% of sites reported outpatient and inpatient psychosocial care, respectively. Participants referred for various clinical reasons to psychosocial providers (eg, illness adjustment). At the participant level, 92% of HCPs reported psychosocial care was very important and 64% reported their clinical thresholds shifted to engage psychosocial providers earlier in care. Barriers to psychosocial care included limited psychosocial providers (92%), psychosocial providers availability (87%), and IBD patients’ lack of openness to psychosocial care (85%). One-way analyses of variance by HCP length of experiences were not statistically significant on perceived understanding of psychosocial providers or perceived changes in clinical threshold over time. Conclusion: HCPs overall reported positive perceptions of and frequent engagement with psychosocial providers in pediatric IBD. Limited psychosocial providers and other notable barriers are discussed. Future work should continue interprofessional education of HCPs and trainees and efforts to improve access to psychosocial care in pediatric IBD.

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Section: Discussionmentioning

confidence: 99%

Pediatric GI Health Care Professionals’ Perceptions of and Engagement With Psychosocial Providers in Pediatric IBD Care

et al. 2023

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“…Pediatric professional societies are increasingly embracing mental health skills training. This is relevant because while 76% of pediatric rheumatology fellows ( n = 82) were interested in providing mental health care, only 25% (95% confidence intervals 14.7–34.3) felt competent to do so exemplifying the need to train the future generations explicitly in behavioral care ( 46 ). One of the added benefits of our EBHC model is the capacity to provide interdisciplinary training to rheumatology or other pediatric subspecialty fellows.…”

Section: Discussionmentioning

confidence: 99%

Implementation of an embedded behavioral health care model in a pediatric rheumatology subspecialty juvenile myositis clinic

Shenoi,

Edison,

Haynes

et al. 2023

Front. Psychiatry

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Youth with chronic medical illness, such as juvenile myositis (JM), require specialized behavioral health care. However, access to such care is challenging due to the youth mental health crisis, which impacts accessibility of mental health services in the community, as well as challenges accessing behavioral health care above and beyond the demands of care related to their JM management. In this paper we describe an embedded behavioral health care model, including the establishment and implementation of such a model, at a pediatric hospital where youth with JM receive medical care in a Center of Excellence (CoE). We describe a unique partnership with a philanthropic organization; the challenges and benefits of delivering care within this model; as well as recommendations for maximizing its effectiveness. Ultimately, we provide an example of a successful embedded behavioral health care program for youth with rare disease, which may be applied to other institutions providing similar care.

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“…Many paediatricians in the United States lack the training, confidence and competence to address emotional health in children 10,11 . In addition, studies of paediatric subspecialty fellows reported interest in addressing emotional health in their patients with chronic conditions, but respondents overwhelmingly felt underprepared to do so 12 . Addressing unmet emotional health needs will require practice change amongst our clinical teams caring for children with chronic medical conditions, and additional education to ensure paediatric trainees graduate competent to address these needs.…”

Section: Introductionmentioning

confidence: 99%

Integrating education for clinical practice change

Chawla,

Schuler,

Barnhardt

et al. 2024

The Clinical Teacher

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BackgroundChildren with chronic medical conditions and their families have significant emotional health concerns, yet paediatricians are often ill‐equipped to address these needs. The American Board of Pediatrics launched the Roadmap Project to better support emotional health as part of routine care. We present pilot work in paediatric training programmes to test educational approaches and explore lessons learned.ApproachFour institutions implemented Roadmap tools into their paediatric training programmes, either incorporating them into existing educational structures or embedding them into the clinical workplace. One programme utilised an existing longitudinal curriculum, and another incorporated into a block rotation. Two programmes embedded training for residents into a larger programme for the healthcare team within the clinical space, one in outpatient clinics and one in an inpatient service.EvaluationEvaluation strategies at each site matched the intended outcomes. Sites working within education programmes evaluated learners, demonstrating increases in resident skills and confidence on pre‐/post‐self‐assessments. Sites embedding tools into the practice context measured changes in the clinical practice of the healthcare team. Despite variability in implementation, all approaches improved trainee skills; sites embedding education into a clinical setting saw greater changes in clinical practice.ImplicationsOur pilot provided structure yet allowed for flexibility, and all sites improved trainee skills. Engaging the entire healthcare team within practice settings appears advantageous, thus embedding education into clinical practice may be preferable to a separate education programme. Similar to outcomes found in interprofessional education (IPE), educating clinical teams together may be more impactful for cultural shifts needed for changing clinical practice.

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Preparedness of Pediatric Subspecialty Fellows to Address Emotional and Mental Health Needs Among Children With Chronic Medical Conditions

Abstract: This survey study investigates pediatric subspecialty fellows’ attitudes about and perceived competence in addressing emotional and mental health needs of pediatric patients with chronic medical conditions.

Cited by 9 publications

References 6 publications

Pediatric GI Health Care Professionals’ Perceptions of and Engagement With Psychosocial Providers in Pediatric IBD Care

Pediatric GI Health Care Professionals’ Perceptions of and Engagement With Psychosocial Providers in Pediatric IBD Care

Implementation of an embedded behavioral health care model in a pediatric rheumatology subspecialty juvenile myositis clinic

Integrating education for clinical practice change

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