Brief provider communication training had a positive impact on parent mental health symptoms and reduced minority children's impairment across a range of problems.

Objective-To examine inter-rater agreement when screening for child mental health problems during primary care visits.Design and Methods-Children age 5-10 (n = 227) and one of their parents were systematically recruited from the waiting rooms of 15 primary care sites located in Baltimore, MD, Washington, DC, and rural New York from [2002][2003][2004][2005]. The parent and teacher of the child completed the Strengths and Difficulties Questionnaire to measure the child's emotions, behaviors, and functional impairment.Results-Parents and teachers identified a similar proportion of children as having high symptoms (25% vs. 23%) and high impairment (27% vs. 32%) but rarely agreed in their assessments of specific children. Parent ratings alone missed 52% of children rated by teachers as having both high symptoms and high impairment (κ = 0.15). Only 6% of these discrepant visits were for mental health problems, making it unlikely that teacher reports would have been solicited. Conclusion-Parent reports failed to detect half of school-aged children considered to be seriously disturbed by their teachers. Efforts to improve detection of mental health problems using screening tools in primary care may require algorithms that help providers judge when to solicit teacher reports and how to interpret conflicting information from parents and teachers.

Race and ethnicity were associated with parents' attitudes on receiving advice about child mental health from a PCP. Primary care may be a good point of intervention for Hispanic youth with mental health needs.

This study examined the prevalence of senior centres providing multi-component falls prevention education and the perceived barriers in implementing this education. A telephone interview was conducted in 2006 with 500 senior centres nationwide. Centre directors were asked about the types of multi-component falls prevention education offered (ie, balance exercise classes, medication management, home safety information) and barriers to offering this education. Seventy percent of senior centres offered balance exercise classes, 68% offered medication management and 53% provided home safety information. Thirty-two percent offered all three components. Lack of staff, time and staff not feeling they had sufficient knowledge to deliver falls prevention education were the leading barriers to providing multicomponent education. Senior centres provide components of effective falls prevention education and, while some may not address all components of a multifaceted programme, many have existing resources that may be adapted for translation of evidence-based programmes.

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