Phase I of the Detecting and Evaluating Childhood Anxiety and Depression Effectively in Subspecialties (DECADES) Study: Development of an Integrated Mental Health Care Model for Pediatric Gastroenterology

Abstract

Background: Children with gastrointestinal symptoms have a very high rate of anxiety and depression. Rapid identification of comorbid anxiety and depression is essential for effective treatment of a wide variety of functional gastrointestinal disorders. Objective: The objective of our study was to determine patient and parent attitudes toward depression, anxiety, and mental health screening during gastroenterology (GI) visits and to determine patient and parent preferences for communication of results and referral to mental health providers after a positive screen. Methods: We augmented standard qualitative group session methods with patient-centered design methods to assess patient and parent preferences. We used a variety of specific design methods in these sessions, including card sorting, projective methods, experience mapping, and constructive methods. Results: Overall, 11 families (11 patients and 14 parents) participated in 2 group sessions. Overall, patients and their parents found integrated mental health care to be acceptable in the subspecialty setting. Patients’ primary concerns were for the privacy and confidentiality of their screening results. Patients and their parents emphasized the importance of mental health services not interfering with the GI visit and collaboration between the GI physician, psychologist, and primary care provider. Conclusions: Patients and their families are open to integrated mental health care in the pediatric subspecialty clinic. The next phase of the DECADES study will translate patient and parent preferences into an integrated mental health care system and test its efficacy in the pediatric GI office.

“Research Jam”: Engaging patients and other stakeholders through human-centered design to improve translational research

“…In each of the two case studies, RJ increased the relevance and effectiveness of study recruitment, materials, and outcome measures. As a busy service core, RJ has not yet formally assessed the core's effectiveness, but has made progress in describing processes and outcomes within specific projects [42][43][44] and has heard anecdotal accounts of the work's impact. For example, as part of a randomized controlled trial of surgical approaches for ureteropelvic junction obstruction thought impossible to recruit for, RJ assisted in the co-design with parents of a study information brochure and video, resulting in a recruitment rate of 92% (11 of 12 families approached over 16 months) [45].…”