Leveraging community health workers in extending pediatric telebehavioral health care in rural communities: Evaluation design and methods.

Nelson, Eve‐Lynn; Zhang, E.; Punt, Stephanie; Engel, Ilana; Giovanetti, Annaleis K.; Stiles, Robert

doi:10.1037/fsh0000742

Cited by 5 publications

(3 citation statements)

References 15 publications

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“…One potential solution is considering how site coordinators can bill as community health workers. Site coordinators’ responsibilities, such as care coordination, case management, health coaching, resource linking, patient follow‐up, and social and health literacy support, evolve towards those of a community health worker (Humphry & Kiernan, 2019; Nelson et al, 2022).…”

Section: Discussionmentioning

confidence: 99%

Site coordinators’ perspectives on implementing a school‐based telebehavioral health program

Zhang,

Engel,

Giovanetti

et al. 2023

Psychology in the Schools

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School‐based telebehavioral health service is increasingly important in addressing the health disparities youth in rural communities face. The study examines barriers and successes of implementation and sustainability of a rural school‐based telebehavioral health program from the perspective of site coordinators or school champions informed by the Consolidated Framework for Implementation Research framework. Six coordinators participated in semi‐structured interviews and completed a self‐report questionnaire (organizational readiness for implementing change) to describe their experiences with telebehavioral health. The authors used thematic analysis to extract themes. The overarching themes included (1) benefits, challenges, and opportunities; (2) resources and support; and (3) work processes and challenges. Site coordinators endorsed their workplaces’ commitment to telebehavioral health but shared uncertainty about the telebehavioral health program's sustainability. The emphasis coordinators place on relationships, communication, continuity, and advocacy for families and students underscores their critical role in providing high‐quality telehealth services in schools and the broader community. Their perspectives are vital to ensuring these services’ continued successful implementation and sustainability. Site coordinators’ focus on the need for school‐based champions and increased awareness of telehealth services in their communities highlights a need for outreach efforts to continue engaging relevant stakeholders.

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Section: Discussionmentioning

confidence: 99%

Site coordinators’ perspectives on implementing a school‐based telebehavioral health program

Zhang,

Engel,

Giovanetti

et al. 2023

Psychology in the Schools

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“…In particular, Black pediatric patients specifically face under-recognition of mental health disorders during the first step to identifying behavioral health needs, thus subsequently impacting the care they receive (72,73). Culturally responsive efforts that can be scaled and generalized across the U.S. to address growing behavioral health disparities between and within sociodemographic groups are needed (72,(74)(75)(76)(77). Examples include leveraging lay/community health workers to assist with behavioral health care navigation needs and going beyond 'clinic walls' to establish partnerships with racially and ethnically diverse local community-based settings (e.g., churches, schools, or community centers that serve and engage families from communities of color).…”

Section: Race and Ethnicity And Other Sociodemographic Factorsmentioning

confidence: 99%

Disparities in accessing specialty behavioral health services during the COVID-19 pandemic and why we need pediatric integrated primary care

Chakawa,

Crawford,

Belzer

et al. 2024

Front. Psychiatry

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ObjectiveYouth unmet behavioral health needs are at public health crisis status and have worsened since the onset of the coronavirus disease 2019 pandemic (Covid-19). Integrating behavioral health services into pediatric primary care has shown efficacy in addressing youth behavioral health needs. However, there is limited guidance on facilitating equitable access to care in this setting, including in triaging access to co-located services (i.e., onsite outpatient behavioral health services with only the behavioral health provider) or to specialty behavioral health services in other clinics within larger health systems.MethodsA retrospective, comparative study was conducted to examine variability in access to co-located and specialty behavioral health (SBH) services for a pre-Covid-19 cohort (April 2019 to March 2020; n = 367) and a mid-Covid-19 cohort (April 2020 to March 2021; n = 328), while accounting for integrated primary care consultation services. The sample included children 1-18 years old served through a large, inner-city primary care clinic. Logistic regression models were used to examine the association between scheduled and attended co-located and SBH visits, pre- and mid-Covid-19 effects, and sociodemographic factors of race and ethnicity, language, health insurance (SES proxy), age, and sex.ResultsThe majority of youth were not directly scheduled for a co-located or SBH visit but the majority of those scheduled attended their visit(s). The odds of not being directly scheduled for a co-located or SBH visit were greater for the mid-Covid-19 cohort, Black youth, and older youth. Accounting for integrated primary care consultation visits addressed these disparities, with the exception of persisting significant differences in scheduled and attended co-located and SBH visits for Black youth even while accounting for IPC consultation.ImplicationFindings from the current study highlight the effective role of integrated primary care consultation services as facilitating access to initial behavioral health services, especially given that referrals to integrated primary care co-located and SBH services within the larger health system often involve barriers to care such as longer wait-times and increased lack of referral follow through. Ongoing research and equitable program development are needed to further this work.

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“…This minimized disruption of services and extended services to children and families coping with stresses and losses associated with the pandemic. During this transition, the Telehealth ROCKS program was able to continue working with our school partners (e.g., local telehealth coordinators) to advance home-based telehealth to diverse families and address not only behavioral health but also provide resources related to social determinants of health (e.g., resources for food, housing, primary care; Nelson et al, in press). Due to associated workforce shortages, Telehealth ROCKS expanded collaborations with local community providers (e.g., federally qualified health centers and community mental health centers) around strategies to meet student behavioral health and trauma-related needs across the evidence-based/supported tiered service pyramid (e.g., universal, targeted, intensive interventions).…”

Section: Implications and Future Directionsmentioning

confidence: 99%

Telehealth ROCKS at home: Pandemic transition of rural school-based to home-based telebehavioral health services.

Nelson¹,

Zhang²,

Bellinger³

et al. 2023

Journal of Rural Mental Health

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Leveraging community health workers in extending pediatric telebehavioral health care in rural communities: Evaluation design and methods.

Cited by 5 publications

References 15 publications

Site coordinators’ perspectives on implementing a school‐based telebehavioral health program

Site coordinators’ perspectives on implementing a school‐based telebehavioral health program

Disparities in accessing specialty behavioral health services during the COVID-19 pandemic and why we need pediatric integrated primary care

Telehealth ROCKS at home: Pandemic transition of rural school-based to home-based telebehavioral health services.

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