TY - JOUR
AU - C. A. Hostutler
AU - J. D. Shahidullah
AU - J. A. Mautone
AU - T. M. Rybak
AU - C. Okoroji
AU - T. Bruni
AU - K. G. Stephenson
AU - L. V. Utset
AU - K. A. Freeman
AU - L. LaLonde
AU - A. R. Riley
A1 - 
AB - OBJECTIVE: To evaluate the effects of behavioral health interventions delivered within pediatric integrated primary care models on clinical outcomes. METHODS: We searched Medline, EMBASE, CENTRAL, PsycINFO, and SCOPUS for studies published from January 1, 1998, to September 20, 2023. We included studies that evaluated onsite behavioral health integration in pediatric primary care using a comparator condition (usual, enhanced usual care, or waitlist). Outcome data on symptom change, impairment/quality of life, health indicator, and behavior change were extracted using Covidence software. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline was followed Risk of bias analysis was conducted using the Cochrane Risk of Bias tool. We used multilevel meta-analysis to synthesize multiple outcomes nested within studies. Open Science Foundation pre-registration: #10.17605/OSF.IO/WV7XP. RESULTS: In total, 33 papers representing 27 studies involving 6,879 children and caregivers were included. Twenty-four studies were randomized controlled trials and three were quasi-experimental designs. Seventeen papers reported on treatment trials and 16 reported on prevention trials. We found a small overall effect size (SMD = 0.19, 95% confidence interval [0.11, 0.27]) supporting the superiority of integrated primary care to usual or enhanced usual care. Moderator analyses suggested similar effectiveness between co-located and integrated models and no statistically significant differences were found between treatment and prevention trials. CONCLUSIONS: Results suggest that integrated primary care is superior to usual and enhanced usual care at improving behavior, quality of life, and symptoms. Integrated primary care research needs improved standards for reporting to promote better synthesis and understanding of the literature.
AD - Pediatric Psychology and Neuropsychology, Nationwide Childrens Hospital, The Ohio State University, Columbus, OH, United States.; Department of Psychiatry and Behavioral Sciences, Dell Medical School, The University of Texas at Austin, Austin, TX, United States.; Department of Child & Adolescent Psychiatry & Behavioral Sciences, Children's Hospital of Philadelphia & Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.; Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States.; Department of Psychology, Algoma University, Marie, ON, Canada.; Institute on Development and Disability, Department of Pediatrics, Oregon Health & Science University, Portland, OR, United States.
AN - 38867311
BT - J Pediatr Psychol
C5 - Healthcare Disparities
DA - Jun 12
DO - 10.1093/jpepsy/jsae038
DP - NLM
ET - 20240612
JF - J Pediatr Psychol
LA - eng
N2 - OBJECTIVE: To evaluate the effects of behavioral health interventions delivered within pediatric integrated primary care models on clinical outcomes. METHODS: We searched Medline, EMBASE, CENTRAL, PsycINFO, and SCOPUS for studies published from January 1, 1998, to September 20, 2023. We included studies that evaluated onsite behavioral health integration in pediatric primary care using a comparator condition (usual, enhanced usual care, or waitlist). Outcome data on symptom change, impairment/quality of life, health indicator, and behavior change were extracted using Covidence software. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline was followed Risk of bias analysis was conducted using the Cochrane Risk of Bias tool. We used multilevel meta-analysis to synthesize multiple outcomes nested within studies. Open Science Foundation pre-registration: #10.17605/OSF.IO/WV7XP. RESULTS: In total, 33 papers representing 27 studies involving 6,879 children and caregivers were included. Twenty-four studies were randomized controlled trials and three were quasi-experimental designs. Seventeen papers reported on treatment trials and 16 reported on prevention trials. We found a small overall effect size (SMD = 0.19, 95% confidence interval [0.11, 0.27]) supporting the superiority of integrated primary care to usual or enhanced usual care. Moderator analyses suggested similar effectiveness between co-located and integrated models and no statistically significant differences were found between treatment and prevention trials. CONCLUSIONS: Results suggest that integrated primary care is superior to usual and enhanced usual care at improving behavior, quality of life, and symptoms. Integrated primary care research needs improved standards for reporting to promote better synthesis and understanding of the literature.
PY - 2024
SN - 0146-8693
ST - A systematic review and meta-analysis of pediatric integrated primary care for the prevention and treatment of physical and behavioral health conditions
T1 - A systematic review and meta-analysis of pediatric integrated primary care for the prevention and treatment of physical and behavioral health conditions
T2 - J Pediatr Psychol
TI - A systematic review and meta-analysis of pediatric integrated primary care for the prevention and treatment of physical and behavioral health conditions
U1 - Healthcare Disparities
U3 - 10.1093/jpepsy/jsae038
VO - 0146-8693
Y1 - 2024
ER -