Introduction to the special issue: Clinical approaches to address health disparities in pediatric psychology.

Abstract

The demographics of the communities that pediatric psychologists serve are rapidly becoming more diverse. This special issue focuses on clinical approaches to consider in ensuring access to and effective delivery of services for children and adolescents from racial, ethnic, and low-income backgrounds. Specifically, this special issue includes papers focused on 3 central themes: factors affecting service utilization among diverse families, strategies to engage and intervene with diverse youth and families, and the use of paraprofessionals to increase access to behavioral health services. With recent public health issues, there is perhaps no better time for our field to move beyond traditional approaches to clinical care. The work included in this special issue provides clear examples for pediatric psychologists to follow and integrate into their clinical settings. These approaches provide direction to better serve diverse and low-income children and families, improve children and adolescents' behavioral health outcomes, and ultimately address disparities in pediatric behavioral health. Implications for Impact StatementThis special issue depicts evolving trends in how pediatric psychologists can serve diverse and low-income families more effectively to address health disparities. Factors affecting service use, approaches to engage families and provide treatment, and strategic use of paraprofessionals to increase access to services are highlighted. Incorporating these approaches across settings has the potential to address service gaps and improve behavioral health outcomes for our most vulnerable children.

Kicking in Diabetes Support (KIDS) intervention effects: Parent reports of diabetes management.

“…Therefore, focus group feedback may be helpful to identify factors that may impact behavioral intervention uptake and strategies to retain individuals who represent diverse racial/ethnic groups or socioeconomic status levels. As outlined in McQuaid and Everhart (2020), as a field, pediatric psychology needs to develop more innovative care delivery models to address health disparities in pediatric populations, including the use of more paraprofessionals in the community to be the group therapists. It also may be that the burden of multiple sessions is too great for some families logistically, and that a briefer intervention of the core sessions may be worthwhile (Steinglass et al, 2019).…”

Incorporating DEI informed-frameworks and increasing access to parent-focused interventions in pediatric psychology.

“…Individual interventions, such as Parent Child Interaction Therapy (PCIT), can also be adapted to telehealth for children with chronic medical conditions (Christian-Brandt & Santacrose, 2020;McQuaid & Everhart, 2020). One such case study is presented in the current issue, in which PCIT was delivered via telehealth for a family of a patient with cancer during the beginning of the COVID-19 pandemic (Bono, 2022).…”

“…Advancing health equity in psychology has been recognized by the APA Council of representatives as a fundamental necessity (American Psychological Association, 2021). Strategies including low-literacy interventions, partnerships with schools and community organizations, and video-based interventions have been noted as ways providers can enhance interventions at the parent or family levels (e.g., McQuaid & Everhart, 2020; Rodriguez et al, 2020).…”

Relating multidimensional deprivation index to adherence outcomes in pediatric solid organ transplant.

“…However, the ways in which systemic barriers impact adherence (e.g., poverty, insurance type, neighborhood quality, and medication cost) remain understudied (Patzer et al, 2012; Rea et al, 2023; Steinberg et al, 2018). Additionally, there are currently no unified guidelines within pediatric SOT to screen for systemic barriers or to support underserved families (McQuaid & Everhart, 2020). More research is needed to better understand how to support families with unmet social needs, address health disparities resulting from systemic inequities, and promote adherence in pediatric settings.…”