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Using telehealth to deliver developmental, behavioral, and mental health services in primary care settings for children in underserved areas
Investigator (PI): Coker, Tumaini
Performing Organization (PO): (Current): Seattle Children's Hospital, Seattle Children's Research Institute, Center for Child Health, Behavior and Development / (206) 884-8269
(Past): UCLA/RAND Center for Adolescent Health Promotion / (310) 794-3569
Supporting Agency (SA): Patient-Centered Outcomes Research Institute (PCORI)
Initial Year: 2013
Final Year: 2018
Record Source/Award ID: PCORI/IH-12-11-4168-IC ; PCORI/IH-12-11-4168
Funding: Total Award Amount: $1,715,453
Award Type: Contract
Award Information: PCORI: More information and project results (when completed)
Abstract: Background: Primary care clinicians should provide comprehensive, family-centered care that addresses unmet developmental, behavioral, and mental health (DB/MH) needs. However, data indicate that most children who need DB/MH services do not receive them. Access to DB/MH services is often severely limited, while a lack of communication and coordination between specialty and primary care providers often prevents optimal outcomes even for those with DB/MH access. A patient-centered model for telehealth has the potential to transform DB/MH services by integrating them into primary care. If DB/MH specialty providers are able to deliver services remotely to many sites from a central location, large numbers of children across multiple small, but conveniently located, primary care clinics can gain ready and sustainable access to DB/MH providers. Objective: The objective of this study is to integrate developmental, behavioral, and mental health services into pediatric primary care using a telehealth model that will be tested with children in low-income, urban communities. Methods: In partnership with a multisite, Los Angeles-area community clinic consortium, North East Valley Health Corporation (NEVHC), we will use telehealth to integrate DB/MH services into primary care for low-income, publicly insured children. During project year 1, we will conduct and analyze interviews with parents, clinicians, and staff at NEVHC to assess their perspectives on the delivery of child DB/MH services and on a potential telehealth-based system for providing DB/MH specialty care in primary care settings to children ages 5-12. These data will be used in a stakeholder-engaged process to customize a telehealth-based delivery system for child DB/MH services that can be integrated into primary care settings. During project years 2-3, we will compare this customized telehealth-based system to the usual in-person referral system at NEVHC in 400 children ages 5-12 who require DB/MH specialty referral. This study will examine whether a telehealth DB/MH delivery model can be an effective, efficient, and family-centered way to provide integrated DB/MH services to children in low-income communities. Patient outcomes: Patient outcomes are (1) access; (2) quality (timeliness, family-centeredness, coordination, parent experiences of care); (3) parent satisfaction; (4) child DB/MH clinical outcomes; and (5) child's quality of life.
MeSH Terms:
  • Child
  • Child Guidance /*organization & administration
  • Child, Preschool
  • Health Services Accessibility
  • Humans
  • Los Angeles
  • Medically Underserved Area
  • Multicenter Studies as Topic
  • Outcome Assessment, Health Care
  • Parents
  • Patient Satisfaction
  • Primary Health Care /*organization & administration
  • Quality of Life
  • Telemedicine /*organization & administration
Country: United States || United States
State: Washington || California
Zip Code: 90024 / 98121
UI: 20143009
CTgovId: NCT02396576
Project Status: Completed
Record History: ('2017: Project extended to 2018, and changed PO and PI email address.',) ('Start date changed to 2016 per PCORI due to institutional change, 2/14/2020',)