Pre-implementation determinants for digital mental health integration in Chicago pediatric primary care.

Autor:	Stiles-Shields C; Institute for Juvenile Research, Department of Psychiatry, College of Medicine, University of Illinois Chicago, Chicago, IL, United States.; AI.Health4All Center for Health Equity using ML/AI, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States., Gustafson EL; Institute for Juvenile Research, Department of Psychiatry, College of Medicine, University of Illinois Chicago, Chicago, IL, United States., Lim PS; UCI Center on Stress and Health, University of California, Irvine School of Medicine, Irvine, CA, United States., Bobadilla G; Institute for Juvenile Research, Department of Psychiatry, College of Medicine, University of Illinois Chicago, Chicago, IL, United States., Thorpe D; Institute for Juvenile Research, Department of Psychiatry, College of Medicine, University of Illinois Chicago, Chicago, IL, United States., Summersett Williams FC; Department of Pediatrics (Adolescent and Young Adult Medicine), Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States., Donenberg GR; Center for Dissemination and Implementation Science, Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States., Julion WA; Department of Women, Children and Family Nursing, Rush University College of Nursing, Chicago, IL, United States., Karnik NS; Institute for Juvenile Research, Department of Psychiatry, College of Medicine, University of Illinois Chicago, Chicago, IL, United States.; AI.Health4All Center for Health Equity using ML/AI, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States.
Jazyk:	angličtina
Zdroj:	Journal of pediatric psychology [J Pediatr Psychol] 2024 Aug 05. Date of Electronic Publication: 2024 Aug 05.
DOI:	10.1093/jpepsy/jsae058
Abstrakt:	Objective: Pediatric primary care (PPC) is a common treatment site for pediatric mental health, but it is currently unable to meet the needs of all teen patients, particularly those with minoritized identities and/or marginalized experiences. Digital mental health (DMH) low-intensity treatments (LITs) can increase mental health screening and care capacity in PPC, but how this is done successfully without burdening providers, patients, or families is unclear. This paper presents a pre-implementation study aimed at understanding the implementation context (PPCs in Chicago, IL) for a specific DMH LIT. Method: Using a mixed-methods design, quantitative data from an online survey of providers assessed current DMH practices in PPC, and qualitative interviews with Pediatricians and Pediatric Psychologists examined implementation determinants for a specific DMH LIT. Quantitative data were analyzed using descriptive statistics, and interviews were analyzed using rapid qualitative assessment. Results: Survey reports (n = 105) and interviews (n = 6) indicated low current use of DMH. Providers in PPC clinics voiced multiple reasons for low usage and low perceived feasibility, including: Consolidated Framework for Implementation Research (CFIR) Inner Setting Domain (PPC clinic workflow, responsibility and ethical considerations, patient privacy and confidentiality), CFIR Outer Setting Domain (hospital and healthcare system factors), CFIR Innovation Domain (DMH design), and a cross-cutting theme of safety. Conclusions: Provider-reported low feasibility for integrating DMH in PPC is a call to action to partner with interdisciplinary colleagues and identify how such settings can ethically and seamlessly deliver digital evidence-based and accessible screening and care prior to implementation. (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society of Pediatric Psychology.)
Databáze:	MEDLINE
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