Category: Primary Care
Keywords: Integrated Care | Hispanic Americans | Cross Cultural / Cultural Differences
Presentation Type: Symposium
As many as 80% of youth needing mental health services do not receive them (Kataoka et al., 2002), and this problem is exacerbated in cultural and linguistic minorities (Satcher, 2001). Primary care has increasingly become the de facto mental health system in the US, particularly for underserved populations (Kessler & Stafford, 2008). As such, the integration of psychological services into primary care has potential promise for reaching underserved youth. This study examines the efficacy of utilizing behavioral health interventions with English and Spanish-speaking youth in a primary care setting.
Participants were 56 child and adolescent patients seen for at least two behavioral health visits at one of two primary care clinics in northwest Arkansas. In terms of language proficiency, 50.8% received services in English while 49.2% received services in Spanish. Of the Spanish language patients, 22.2% received services from a bilingual therapist and 77.8% utilized a trained interpreter. In terms of age range, 65.1% of patients were under 12 and 34.9% were 12-17 years old. During visits with primary care physicians (PCPs), if the PCP identified a behavioral health problem, the patient was referred to a Behavioral Health Consultant (BHC) for an immediate, same day appointment, typically of 30 minute duration. Patients were seen for an average of 2.30 visits (SD = .60, range 2-4). Caregivers completed A Collaborative Outcome Research Network (ACORN) questionnaires measuring global distress (0-4 scale) at the first and last session. A mixed between-within subjects analysis of variance assessed the impact of patient preferred language (Spanish, English) and session number (first, last) on ACORN global distress scores. There was no significant interaction between time and language, p = .65, partial eta squared = .004. There was a significant main effect for time, p = < .001, partial eta squared = .32, with global distress scores declining significantly between first and last sessions (Mpre = 1.41, SDpre = 0.74; Mpost = 1.02, SDpost = 0.75). The main effect of language was not significant, p = .11, partial eta squared = .046. Both Spanish (M = 3.59, SD = .91) and English (M = 3.56, SD = .87) speaking caregivers reported comparable and high satisfaction with behavioral health services. These findings are encouraging and suggest that IBHC interventions delivered in primary care settings might be a viable solution to reducing health disparities in underserved pediatric populations.
University of Arkansas
Friday, November 17
1:45 PM – 3:15 PM
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