Email UpdatesLiterature Collection
Collection Insights
10K+
References
9K+
Articles
1400+
Grey Literature
4500+
Opioids & SU
The Literature Collection contains over 10,000 references for published and grey literature on the integration of behavioral health and primary care. Learn More
Use the Search feature below to find references for your terms across the entire Literature Collection, or limit your searches by Authors, Keywords, or Titles and by Year, Type, or Topic. View your search results as displayed, or use the options to: Show more references per page; Sort references by Title or Date; and Refine your search criteria. Expand an individual reference to View Details. Full-text access to the literature may be available through a link to PubMed, a DOI, or a URL. References may also be exported for use in bibliographic software (e.g., EndNote, RefWorks, Zotero).
457 Results
61
Association of Psychiatric Comorbidity With Opioid Prescriptions and Long-term Opioid Therapy Among US Adolescents
Type: Journal Article
Year: 2018
Abstract: Opioid use, opioid misuse, and long-term opioid therapy (LTOT) have captured the nation’s attention, raising questions regarding pain management and concerns about who is most at risk for the use of nonmedical prescribed opioids (NMPOs). In 2015, opioid overdoses accounted for 33?091 US deaths.1 During this same year, more than 276 000 adolescents were current NMPO users, placing these adolescents at serious health risk.2 Physicians therefore face the challenge of trying to calculate the varying risks of patients transitioning into the use of NMPOs while addressing the pain of patients. A primary concern is to prevent adolescents from transitioning from supervised medical use of opioids into use of NMPOs. Preventing this transition is critical because nearly 80% of adolescents who reported using heroin indicated their NMPO use preceded their heroin use.3 The question arises of which adolescents are at greatest risk of initiating this dangerous transition during this critical period of development, which can have long-term health consequences. Important foundational research is being conducted to better understand these complex and fragile trajectories of risk and protective factors associated with opioid involvement.
Topic(s):
Healthcare Disparities
See topic collection
, Opioids & Substance Use
See topic collection
Reference Links: 
View the DOI record for Association of Psychiatric Comorbidity With Opioid Prescriptions and Long-term Opioid Therapy Among US Adolescents
View DOI Record
View the PubMed citation for Association of Psychiatric Comorbidity With Opioid Prescriptions and Long-term Opioid Therapy Among US Adolescents62
Barriers and facilitators of adolescent behavioral health in primary care: Perceptions of primary care providers
Type: Journal Article
Year: 2009
Publication Place: United States
Abstract: Several major policy reports describe the central role of primary care in improving the delivery of behavioral health care services to children and adolescents. Although primary care providers are uniquely positioned to provide these services, numerous obstacles hinder the integration of these services, including time, clinic management and organization issues, training, and resources. Although many of these obstacles have been described in the literature, few studies have investigated these issues from the first-person perspective of front-line providers. The purpose of this study, therefore, is to provide an in-depth description of primary care providers' attitudes and perceptions of adolescent behavioral health care across a diversity of primary care settings (i.e., Federally Qualified Health Center [FQHC], FQHC-Look Alike, school-based, military). Sixteen focus groups were conducted at 5 primary care clinics. Thematic analysis was used to analyze the focus group data. Obstacles to integration are presented as well as strategies to overcome these challenges, using training and education, working groups, and community collaboratives.
Topic(s):
Education & Workforce
See topic collection
Reference Links:
View the DOI record for Barriers and facilitators of adolescent behavioral health in primary care: Perceptions of primary care providers
View DOI Record
View the PubMed citation for Barriers and facilitators of adolescent behavioral health in primary care: Perceptions of primary care providers63
Barriers for Ethnic Minorities and Low Socioeconomic Status Pediatric Patients for Behavioral Health Services and Benefits of an Integrated Behavioral Health Model
Type: Journal Article
Year: 2021
Abstract:
The integrated behavioral health care model in primary care has the potential to reduce barriers to care experienced by children and families from ethnic minorities and low socioeconomic status. Limited access to pediatric behavioral health care is a significant problem, with up to 40% of children and adolescents with identified mental disorders and only 30% of them receiving care. Barriers include transportation, insurance, and shortage of specialists. Primary care provider bias, decreased knowledge and feelings of competence, and cultural beliefs and stigma also affect earlier diagnosis and treatment, particularly for Hispanic families with low English proficiency and African Americans.
Topic(s):
Financing & Sustainability
See topic collection
, Healthcare Disparities
See topic collection
65
Barriers to mental health care for urban, lower income families referred from pediatric primary care
Type: Journal Article
Year: 2013
Publication Place: United States
Abstract: The aim of this study was to evaluate the association of parent-reported barriers on the likelihood of attending a mental health evaluation after referral from pediatric primary care. As the part of procedure, parents of children (N = 55) referred for mental health from primary care completed a 23-item questionnaire (three subscales; Cronbach alpha > 0.7): intangible barriers, tangible barriers, and child functioning. Logistic regression examined associations between responses and referral follow-through. The results showed that the high levels of intangible barriers were associated with decreased odds of attending the mental health evaluation (OR = 0.20, 0.06-0.83; P = 0.03). Therefore, we conclude that parental concerns about mental health care may be important for engagement in treatment.
Topic(s):
Healthcare Disparities
See topic collection
Reference Links:
View the DOI record for Barriers to mental health care for urban, lower income families referred from pediatric primary care
View DOI Record
View the PubMed citation for Barriers to mental health care for urban, lower income families referred from pediatric primary care67
Behavioral Health Integration in Large Multi-group Pediatric Practice
Type: Journal Article
Year: 2017
Publication Place: United States
Abstract: There is increasing interest in methods to improve access to behavioral health services for children and adolescents. Children's Community Pediatric Behavioral Health Service (CCPBHS) is an integrated behavioral health service whose method of (a) creating a leadership team with empowered administrative and clinical stakeholders who can act on a commitment to change and (b) having a clear mission statement with integrated administrative and clinical care processes can serve as a model for implementing integration efforts within the medical home. Community Pediatrics Behavioral Health Service (CPBHS) is a sustainable initiative that improved the utilization of physical health and behavioral health systems for youth and improved the utilization of evidence-based interventions for youth served in primary care.
Topic(s):
Healthcare Disparities
See topic collection
Reference Links:
View the DOI record for Behavioral Health Integration in Large Multi-group Pediatric Practice
View DOI Record
View the PubMed citation for Behavioral Health Integration in Large Multi-group Pediatric Practice68
Behavioral Health Problems Presented to Integrated Pediatric Behavioral Health Clinics: Differences in Urban and Rural Patients
Type: Journal Article
Year: 2017
Publication Place: United States
Abstract: Behavioral health diagnoses and service use may differ based on rurality. The purpose of this study was to examine the patterns of mental disorder diagnoses of urban, rural, and remote pediatric populations. This retrospective study used electronic medical records from integrated behavioral health clinics in Nebraska from 2012 to 2013. Bivariate and multivariable models were used to examine the differences in diagnoses. Adolescents with attention deficit and related disorders were more likely to be male, younger, have public insurance and rural/remote residents. Adjustment disorders were associated with being female, older, and urban residents. Adolescents with anxiety disorder had a significant interaction between age and gender, with both genders being older, having private insurance, and urban residents. Adolescents with mood disorder were more likely to be female, older, and urban residents. Demographic and clinical differences among patients in urban and rural/remote settings have implications for care in rural settings.
Topic(s):
Healthcare Disparities
See topic collection
69
Behavioral health service utilization: Trends in utilization within a patient-centered medical home for low-income children and women
Type: Journal Article
Year: 2019
Publication Place: India
Topic(s):
Financing & Sustainability
See topic collection
, Healthcare Disparities
See topic collection
, Medical Home
See topic collection
70
Behaviors of children following a randomized controlled treatment program for their abused mothers
Type: Journal Article
Year: 2005
Topic(s):
General Literature
See topic collection
Reference Links:
View the DOI record for Behaviors of children following a randomized controlled treatment program for their abused mothers
View DOI Record
View the PubMed citation for Behaviors of children following a randomized controlled treatment program for their abused mothers72
Beyond screening: a review of pediatric primary care models to address maternal depression
Type: Journal Article
Year: 2016
Publication Place: United States
Abstract: Depression is one of the most debilitating chronic disorders in the United States, affecting 15 million children in homes with depressed mothers, many of whom endure household chaos, inconsistent nurturing, inadequate safety practices, and harsh discipline. Depressed mothers are under diagnosed and undertreated, yet there is broad consensus about the importance of identifying and managing maternal depression, as reflected in recommendations by pediatric and obstetric professional organizations to routinely screen for perinatal depression. Screening was shown to be acceptable to women and most pediatric providers, and adding a screening component need not impair clinic efficiency. Screening, however, is not sufficient, and there are few models in the literature to guide medical practices in implementing successful interventions to identify, treat, and prevent maternal depression, particularly in the pediatric setting. We reviewed the literature and identified six studies that evaluated models for screening and managing mothers' depression in pediatric primary care settings. Some of these interventions have promise, but no studies characterized health outcomes of the depressed mothers and children. We discuss the components of these models, their implementation, and the practice and research needed to create effective pediatrics-based systems to reduce the negative effects of maternal depression on mothers, children, and families.
Topic(s):
Education & Workforce
See topic collection
Reference Links:
View the DOI record for Beyond screening: a review of pediatric primary care models to address maternal depression
View DOI Record
View the PubMed citation for Beyond screening: a review of pediatric primary care models to address maternal depression73
Brief Approaches to Developmental-Behavioral Promotion in Primary Care: Updates on Methods and Technology
Type: Journal Article
Year: 2014
Abstract: Well-child visits are a critical opportunity to promote learning and development, encourage positive parenting practices, help children acquire behavioral self-control, enhance the development and well-being of children and their families, identify problems not amenable to brief in-office counseling, and refer for services when needed. This article outlines the communication skills, instructional methods, and resource options that enable clinicians to best assist families. Also covered is how to monitor progress and outcomes. A total of 239 articles and 52 Web sites on parent/patient education were reviewed for this study. Providers require a veritable armamentarium of instructional methods. Skills in nonverbal and verbal communication are needed to elicit the parent/patient agenda, winnow topics to a manageable subset, and create the "teachable moment." Verbal suggestions, with or without standardized spoken instructions, are useful for conveying simple messages. However, for complex issues, such as discipline, it is necessary to use a combination of verbal advice, written information, and "teach-back," aided by role-playing/modeling or multimedia approaches. Selecting the approaches most likely to be effective depends on the topic and family characteristics (eg, parental literacy and language skills, family psychosocial risk and resilience factors, children's developmental-behavioral status). When providers collaborate well (with parents, patients, and other service providers) and select appropriate educational methods, families are better able to act on advice, leading to improvements in children's well-being, health, and developmental-behavioral outcomes. Provided are descriptions of methods, links to parenting resources such as cell phone applications, Web sites (in multiple languages), interactive technology, and parent training courses.
Topic(s):
Education & Workforce
See topic collection
, Healthcare Disparities
See topic collection
Reference Links:
View the DOI record for Brief Approaches to Developmental-Behavioral Promotion in Primary Care: Updates on Methods and Technology
View DOI Record
View the PubMed citation for Brief Approaches to Developmental-Behavioral Promotion in Primary Care: Updates on Methods and Technology74
Building integrated mental health and medical programs for vulnerable populations post-disaster: Connecting children and families to a medical home
Type: Journal Article
Year: 2008
Publication Place: United States
Abstract: INTRODUCTION: Hurricane Katrina, a Category 3 hurricane, made landfall in August 2005. Approximately 1,500 deaths have been directly attributed to the hurricane, primarily in Louisiana and Mississippi. In New Orleans, Louisiana, most of the healthcare infrastructure was destroyed by flooding, and > 200,000 residents became homeless. Many of these internally displaced persons received transitional housing in trailer parks ("villages") under the auspices of the [US] Federal Emergency Management Agency (FEMA). PROBLEM: The FEMA villages are isolated from residential communities, lack access to healthcare services, and have become unsafe environments. The trailers that house families have been found to be contaminated with formaldehyde. METHODS: The Children's Health Fund, in partnership with the Mailman School of Public Health at Columbia University, began a program ("Operation Assist") to provide health and mental health services within a medical home model. This program includes the Baton Rouge Children's Health Project (BRCHP), which consists of two mobile medical units (one medical and one mental health). Licensed professionals at the FEMA villages and other isolated communities provide care on these mobile units. Medical and psychiatric diagnoses from the BRCHP are summarized and case vignettes presented. RESULTS: Immediately after the hurricane, prescription medications were difficult to obtain. Complaints of headache, nosebleeds, and stomachache were observed at an unusually frequent degree for young children, and were potentially attributable to formaldehyde exposure. Dermatological conditions included eczema, impetigo, methicillin-resistant staphylococcus aureus (MRSA) abscesses, and tinea corporis and capitis. These were especially difficult to treat because of unhygienic conditions in the trailers and ongoing formaldehyde exposure. Signs of pediatric under-nutrition included anemia, failure to thrive, and obesity. Utilization of initial mental health services was low due to pressing survival needs and concern about stigma. Once the mental health service became trusted in the community, frequent diagnoses for school-age children included disruptive behavior disorders and learning problems, with underlying depression, anxiety, and stress disorders. Mood and anxiety disorders and substance abuse were prevalent among the adolescents and adults, including parents. CONCLUSIONS: There is a critical and long-term need for medical and mental health services among affected populations following a disaster due to natural hazards. Most patients required both medical and mental health care, which underscores the value of co-locating these services.
Topic(s):
Medical Home
See topic collection
75
Buprenorphine Exposures Among Children and Adolescents Reported to US Poison Control Centers
Type: Journal Article
Year: 2018
Publication Place: United States
Topic(s):
Healthcare Disparities
See topic collection
, Opioids & Substance Use
See topic collection
Reference Links: View the PubMed citation for Buprenorphine Exposures Among Children and Adolescents Reported to US Poison Control Centers
76
Buprenorphine Treatment for Adolescents and Young Adults With Opioid Use Disorders: A Narrative Review
Type: Journal Article
Year: 2018
Publication Place: United States
Abstract:
: In the past decade, a new cohort of adolescents and young adults with opioid use disorders (OUD) has emerged. While medications and psychosocial treatments are available, few adolescents and young adults with OUD can access and remain in treatment. Effective, practical, and scalable treatment paradigms for this young population are needed. Buprenorphine is a medication with unique pharmacological and regulatory characteristics that make it a promising component of adolescent and young adult OUD treatment models. Three randomized controlled trials and multiple observational studies have evaluated the use of buprenorphine to treat this population. However, data from these studies have not been consolidated into an up-to-date summary that may be useful to clinicians. The objective of this narrative review is to inform clinical practice by summarizing results of primary and secondary analyses from randomized controlled clinical trials and observational studies that have evaluated the use of buprenorphine to treat adolescents and young adults with OUD. Based on results from these studies, we encourage the conceptualization of OUD among youth as a chronic medical condition requiring a long-term management strategy. This includes treatment with buprenorphine in conjunction with medication-prescribing protocols that do not necessarily require daily clinic attendance for observed medication adherence. However, more study of treatment delivery models, addressing such issues as medication adherence and intensity requirements, is needed to determine practices that optimize outcomes for youth.
Topic(s):
Education & Workforce
See topic collection
, Healthcare Disparities
See topic collection
, Opioids & Substance Use
See topic collection
Reference Links:
View the DOI record for Buprenorphine Treatment for Adolescents and Young Adults With Opioid Use Disorders: A Narrative Review
View DOI Record
View the PubMed citation for Buprenorphine Treatment for Adolescents and Young Adults With Opioid Use Disorders: A Narrative Review78
Canadian guideline for safe and effective use of opioids for chronic noncancer pain: clinical summary for family physicians. Part 2: special populations
Type: Journal Article
Year: 2011
Publication Place: Canada
Abstract: OBJECTIVE: To provide family physicians with a practical clinical summary of opioid prescribing for specific populations based on recommendations from the Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain. QUALITY OF EVIDENCE: Researchers for the guideline conducted a systematic review of the literature, focusing on reviews of the effectiveness and safety of opioids in specific populations. MAIN MESSAGE: Family physicians can minimize the risks of overdose, sedation, misuse, and addiction through the use of strategies tailored to the age and health status of patients. For patients at high risk of addiction, opioids should be reserved for well-defined nociceptive or neuropathic pain conditions that have not responded to first-line treatments. Opioids should be titrated slowly, with frequent dispensing and close monitoring for signs of misuse. Suspected opioid addiction is managed with structured opioid therapy, methadone or buprenorphine treatment, or abstinence-based treatment. Patients with mood and anxiety disorders tend to have a blunted analgesic response to opioids, are at higher risk of misuse, and are often taking sedating drugs that interact adversely with opioids. Precautions similar to those for other high-risk patients should be employed. The opioid should be tapered if the patient's pain remains severe despite an adequate trial of opioid therapy. In the elderly, sedation, falls, and overdose can be minimized through lower initial doses, slower titration, benzodiazepine tapering, and careful patient education. For pregnant women taking daily opioid therapy, the opioids should be slowly tapered and discontinued. If this is not possible, they should be tapered to the lowest effective dose. Opioid-dependent pregnant women should receive methadone treatment. Adolescents are at high risk of opioid overdose, misuse, and addiction. Patients with adolescents living at home should store their opioid medication safely. Adolescents rarely require long-term opioid therapy. CONCLUSION: Family physicians must take into consideration the patient's age, psychiatric status, level of risk of addiction, and other factors when prescribing opioids for chronic pain.
Topic(s):
Opioids & Substance Use
See topic collection
, Education & Workforce
See topic collection
79
Care coordination for children with special health care needs: Evaluation of a state experiment
Type: Journal Article
Year: 2011
Publication Place: United States
Abstract: Care coordination (CC), a component of the medical home, may aid families who have children with special health care needs (CSHCN). Few data link CC to individual patient outcomes. To compare parent-reported outcomes for CSHCN receiving practice-based care coordination with those receiving standard care. This cross-sectional study examined two groups of CSHCN: one that received the services of a care coordinator for a year and one that did not. Parental surveys assessed: access to medical care, practice help and support, satisfaction with services, and parental mental and physical health. Associations between group status and parent-reported outcomes were assessed via regression analyses controlling for sociodemographic and health status variables. We also examined whether CC households who reported higher satisfaction with care had higher scores in the four domains. Parents in the care coordination group reported higher utilization of both primary care and specialist physicians, but did not report better practice help and support, better satisfaction with care, or better overall parental health. Parents in the care coordination group who reported being satisfied with their care rated their PCPs as more helpful than did the comparison families. Parents in this subgroup also reported significantly higher levels of care coordination than did parents in the comparison group. CSHCN appear to have higher PCP and specialist utilization when they receive supplemental care coordination. Additionally, those who are more satisfied with the care coordination they receive are happier with the assistance from their PCP and the overall care coordination provided.
Topic(s):
Medical Home
See topic collection
Reference Links: View the PubMed citation for Care coordination for children with special health care needs: Evaluation of a state experiment
80
Care Coordination for Youth With Mental Health Disorders in Primary Care
Type: Journal Article
Year: 2018
Publication Place: United States
Abstract: Many children are treated for mental health disorders in primary care settings. The system of care (SOC) provides a framework for collaboration among pediatric mental health providers, but it is unclear if youth treated for mental health disorders in primary care receive such coordination. At the South Boston Community Health Center from September /2012 to August 2013 for 74 individuals
Topic(s):
General Literature
See topic collection
Reference Links:
View the DOI record for Care Coordination for Youth With Mental Health Disorders in Primary Care
View DOI Record
View the PubMed citation for Care Coordination for Youth With Mental Health Disorders in Primary Care