Referral to digital parent training in primary care: Facilitators and barriers.

Fehrenbacher, Caitlin; Schoeny, Michael; Reed, Monique; Shattell, Mona; Breitenstein, Susan M.

doi:10.1037/cpp0000367

Cited by 5 publications

(5 citation statements)

References 31 publications

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“…In an earlier study that used clinician referrals for recruitment to a parent training behavioral trial, clinicians and clinic staff also noted some major barriers to referrals. 75 Clinicians reported being too busy or forgetting to refer patients or not initiating referrals due to personal opinions regarding intervention (ie, clinicians would not refer if they did not like the digital intervention delivery vs an in-person delivery). When referring patients to behavioral trials, clinicians could make unintentional assumptions regarding current health behaviors, health history, or patient preferences (ie, clinicians assuming patients would not have time, interest, or ability to participate) that may lead to unintentional and premature exclusion before recruitment.…”

Section: Discussionmentioning

confidence: 99%

“…Yet, we found that engaging all clinic clinicians was challenging, so we relied on a few clinician champions for patient referrals. In an earlier study that used clinician referrals for recruitment to a parent training behavioral trial, clinicians and clinic staff also noted some major barriers to referrals 75 . Clinicians reported being too busy or forgetting to refer patients or not initiating referrals due to personal opinions regarding intervention (ie, clinicians would not refer if they did not like the digital intervention delivery vs an in-person delivery).…”

Section: Discussionmentioning

confidence: 99%

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Overcoming Pandemic-Related Challenges in Recruitment and Screening

et al. 2023

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Background: Recruiting participants with cardiovascular disease into research during the COVID-19 pandemic was challenging, particularly those at risk of health disparities. Objective: During the pandemic, 12 cohorts of older women with cardiovascular disease were recruited from cardiology clinics into a lifestyle intervention trial to prevent cognitive decline. Objectives were to (a) describe the results of modified recruitment/screening strategies to overcome pandemic-related challenges and (b) evaluate differences in age, race, and ethnicity between patients recruited/ randomized, recruited/not randomized (entered recruitment but not randomized because of being ineligible or not interested), and not recruited (clinic patients who met preliminary criteria but did not enter recruitment). Methods: This was a cross-sectional descriptive analysis. In-person study strategies proposed before the COVID-19 pandemic were modified before study onset (September 2020). Women 65 years or older with cardiovascular disease were recruited from cardiology clinics by clinicians, posted flyers, and letters mailed to patients randomly selected from electronic health record data extractions. Patients were classified as recruited/randomized, recruited/not randomized, and not recruited. Results: Of 5719 patients potentially eligible, 1689 patients entered recruitment via referral (49.1%), posted flyers (0.5%), or mailed letters (50.3%), and 253 patients were successfully recruited/randomized. Recruited/ randomized participants were, on average, 72.4 years old (range, 65-90 years old), non-Hispanic White (54.2%), non-Hispanic Black (38.3%), Hispanic/Latinx (1.6%), and other/not reported (5.1%). The recruited/randomized group was significantly younger with fewer patients of Hispanic/Latinx ethnicity compared with those not recruited.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Overcoming Pandemic-Related Challenges in Recruitment and Screening

et al. 2023

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“…Emerging research indicates that most caregivers desire behavioral guidance in PPC; however, preferences for behavioral health content and delivery vary by socioeconomic, child, and parenting risk factors (Riley et al, 2019). Studies suggest the need to move beyond integrating or colocating BPT services, instead moving toward designing interventions to address disparities in initiation and engagement (Fehrenbacher et al, 2020).…”

Section: Public Significance Statementmentioning

confidence: 99%

Adapting a preschool disruptive behavior group for the underserved in pediatric primary care practice.

Bignall¹,

Herbst²,

McClure³

et al. 2023

Families, Systems, & Health

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Introduction: While behavioral parent training (BPT) is the first line treatment for preschool aged children with disruptive behavior, only a fraction of families receive these therapies. The integration of BPT within the pediatric primary care (PPC) setting is a promising way to address this need, as the PPC setting is the first and only point of contact for most children diagnosed with mental health disorders. We piloted a clinical innovation by implementing an adapted BPT group in an urban, academic, PPC practice, serving a low-income, predominantly Black population. Method: Using a formative program development approach and a cultural adaptation framework, structural and cultural adaptations to the program were implemented to increase engagement and adaptability of the group to meet the needs of our PPC population. Results: Learnings indicated that these adaptations were feasible and acceptable to families. Specifically, they were effective in engaging families and transforming the practice of primary care providers. Discussion: Our work offers a case example to guide efforts to thoughtfully and effectively adapt evidence-based interventions for disruptive behavior in primary care settings. These processes provide one strategy to ameliorate behavioral health disparities in diverse, racial/ethnic minority populations.

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“…As part of a type I effectiveness-implementation hybrid trial, Fehrenbacher, Schoeny, Reed, Shattell, and Breitenstein (2020) conducted a qualitative analysis of facilitators and barriers to referrals to ezParent, a self-administered, digital parent training program, using the Consolidated Framework for Implementation Research. Semistructured interviews with clinical stakeholders revealed perceived barriers related to time pressures, providers’ perceptions of the intervention, and organizational factors.…”

Section: Understanding and Increasing Engagementmentioning

confidence: 99%

Introduction to the special issue on integrated pediatric primary care: Placing “how” in the context of now.

Lines

Riley²

2020

Clinical Practice in Pediatric Psychology

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The integration of behavioral health services into pediatric primary care settings has expanded rapidly in recent years, and pediatric psychologists have played a prominent role in this development. As integrated care becomes mainstream, there is a growing need to develop and disseminate pragmatic strategies for maximizing the reach and impact of behavioral services in primary care. This special issue in includes papers focused on 4 central themes: understanding and increasing engagement with integrated primary care services, identifying barriers and facilitators to implementation, reducing health disparities, and workforce development. In this introduction to the special issue, we preview each of these contributions and consider their implications in the context of the 2 great pandemics of our time: COVID-19 and systemic racial injustice. The work included in this special issue provides clear examples of strategies clinicians can use to analyze and improve their clinical services, articulates methods of adapting interventions to particular patient populations, and sets a roadmap for the future of integrated primary care psychology. Implications for Impact StatementThis special issue depicts the current state of the field of integrated primary care psychology (IPC). Themes include understanding and increasing engagement with IPC services, exploring barriers and facilitators to implementation, and building culturally informed service models to reduce disparities in care. The aim of this special issue is to contribute to the growing evidence for how pediatric psychologists can more effectively contribute to pediatric population health in the IPC setting.

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Referral to digital parent training in primary care: Facilitators and barriers.

Cited by 5 publications

References 31 publications

Overcoming Pandemic-Related Challenges in Recruitment and Screening

Overcoming Pandemic-Related Challenges in Recruitment and Screening

Adapting a preschool disruptive behavior group for the underserved in pediatric primary care practice.

Introduction to the special issue on integrated pediatric primary care: Placing “how” in the context of now.

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