Literature Collection

Behavioral parenting interventions can enhance positive parenting practice, which is crucial in preventing maltreatment and promoting child well-being. Primary care has been increasingly recognized as an underutilized platform to widely disseminate evidence-based parenting interventions, given parents' ongoing access to primary care without stigma and the perceptions toward health-care providers as a trustworthy source of information about positive parenting. This study sought to explore the effects of primary care-based parenting interventions on parenting practice and child behavioral outcomes while examining the types of and the theories of change underlying these interventions. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Randomized controlled trials or quasi-experimental studies of interventions targeting caregivers of children aged between 1 and 17 were included in the review. Information sources included electronic databases, relevant government and private organizational websites, and expert consultations. The final sample included 17 studies focusing on 10 interventions. Positive results were found in knowledge gain, locus of control, monitoring, parent-child interactions, and negative discipline. Child behavior outcomes were inconsistent as most studies reported nonsignificant changes while one study reported significant intervention effects on various externalizing behaviors. A limited number of studies described the process of adapting, installing, and implementing the interventions in primary care. Future studies should examine the types, dosages, and delivery formats that are most suitable and sustainable in the context of primary care to maximize its utility in promoting child well-being while preventing maltreatment through integrated behavioral parenting interventions.

Children with complex health and behavioral health conditions face challenges accessing coordinated health and community-based services. Adverse childhood experiences (ACEs), social determinants of health, and care delivery silos can lead to negative long-term outcomes. This paper provides an update on the Integrated Care for Kids (InCK) model from the Centers for Medicare &Medicaid Services' Innovation Center and discusses barriers and facilitators to program implementation in the seven communities. The three core InCK activities-supported by flexible alternative payment models-are early identification, risk stratification, and service integration. Challenges include obtaining the appropriate Medicaid and Children's Health Insurance Program (CHIP) authorities, sharing data across non-traditional partners, assessing impact in non-clinical domains, and evaluating the program's impact on child health. InCK enables innovation in value-based purchasing by creating a guiding framework that allows states to design and implement a service delivery and payment model that accounts for the heterogeneity of Medicaid programs.