Utility of MyHEARTSMAP for Universal Psychosocial Screening in the Emergency Department

Doan, Quynh; Wright, Bruce; Atwal, Amanbir; Hankinson, Elizabeth; Virk, Punit; Azizi, Hawmid; Stenstrom, Robert; Black, Tyler; Gokiert, Rebecca; Newton, Amanda S

doi:10.1016/j.jpeds.2019.12.046

Cited by 13 publications

(8 citation statements)

References 38 publications

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“…We conducted a qualitative study during the one-month follow-up period of a two-centre, prospective cohort study aimed at evaluating the utility of ED-based universal psychosocial screening ( Doan et al, 2020 ). Ethics approval was granted by our institutions behavioural research ethics board.…”

Section: Methodsmentioning

confidence: 99%

“…consent, assent) in English, did not have a parent present to provide consent, or the parent would be unavailable to complete 30-day follow-up. Additional study population and demographic information have been previously published ( Doan et al, 2020 ). The study population of the current qualitative component included caregivers of youth aged 10–17 years who presented to the ED with a non-mental health-related complaint, screened positive for a psychosocial issue, and were provided psychosocial resource recommendations by the MyHEARTSMAP tool.…”

Section: Methodsmentioning

confidence: 99%

“…MyHEARTSMAP has previously been evaluated for its content validity and psychometric properties in community and clinical youth populations. Among youth and guardians presenting with non-mental health-related complaints to the ED, MyHEARTSMAP displayed 92.7% and 93.1% sensitivity in detecting psychiatric concerns, and 98.5% and 98.9% specificity, respectively, in detecting youth with no or only mild issues ( Doan et al, 2020 ). High sensitivity (99.5%) was also reported among youth explicitly seeking mental health care in the ED ( Li et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

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Exploring parental perceptions of psychosocial screening in paediatric emergency departments

Virk

Atwal

Wright

et al. 2022

Clin Child Psychol Psychiatry

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Objective: To explore parental perceptions of psychosocial screening in the paediatric emergency department and identify post-screening barriers to accessing mental health care. Methods: We conducted a qualitative study during the 30-day follow-up period of a larger prospective cohort study. Eligible youth and their accompanying parent/guardian first completed psychosocial self/proxy-screening using the MyHEARTSMAP tool and then received a standardized clinical mental health assessment. If the MyHEARTSMAP assessment provided youth with mental health resources recommendations, their parents were invited to a follow-up session. Thirty days (±5 days) after their ED visit, parents participated in a virtual interview to reflect and share their attitudes, perceptions and thoughts around the screening and mental health care-seeking process. Results: Of the 171 participants who received resource recommendations during their ED visit, 124 parents (72.5%; 95% CI 65.2–79.1%) completed the follow-up interview. Most parents endorsed positive perceptions of the screening process, describing it as an ‘eye-opening’ process that ‘sparked conversation’. Most participants (74.2%; 95% CI 65.6–81.6) agreed with the resource recommendations they received. In terms of resources-seeking, only 41 participants (33.1%; 95% CI 24.9–42.1) attempted to access recommended supports. Families generally felt identified concerns were mild and ‘not serious enough’ to warrant resource-seeking, though many expressed an intention to seek care if concerns escalated. Conclusion: Perceptions of psychosocial screening in the ED were favourable and encouraging among participating parents of youth screened positive for psychosocial issues. Despite positive attitudes, only a fraction of the families invited to follow-up attempted to access care. Mental health may be perceived as low priority for many families, signifying the need for improved education and awareness building on the importance of early intervention.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Exploring parental perceptions of psychosocial screening in paediatric emergency departments

Virk

Atwal

Wright

et al. 2022

Clin Child Psychol Psychiatry

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“…Studies reporting on psychosocial screening in EDs have reported a higher prevalence of social, mood, and anxiety concerns among nonmental health presentations than in surveys of the general pediatric population. 44,45 Further, due to attrition, approximately 20% of our enrolled cohort did not provide retrospective ratings of symptoms or preinjury psychosocial function, and thus were not included in the analysis. The demographics of participants who were included versus excluded from analyses were mostly comparable, but differences were apparent in race that may have impacted prevalence and severity of reported PCS.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

A Prospective Cohort Study of the Association Between Preinjury Psychosocial Function and Postconcussive Symptoms in Pediatric Mild Traumatic Brain Injury: An A-CAP Study

Doan

Chadwick

Tang

et al. 2022

Journal of Head Trauma Rehabilitation

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Objective: We evaluated the moderating effect of preinjury psychosocial function on postconcussion symptoms for children with mild traumatic brain injury (mTBI). Design, Setting, and Population: We conducted a prospective cohort study of children ages 8.0 to 16.9 years with mTBI (n = 633) or orthopedic injury (OI; n = 334), recruited from 5 pediatric emergency departments from September 2016 to December 2018. Main Measures: Participants completed baseline assessments within 48 hours of injury, and postconcussion symptoms assessments at 7 to 10 days, weekly to 3 months, and biweekly to 6 months post-injury. Preinjury psychosocial function was measured using parent ratings on the Pediatric Quality of Life Inventory (PedsQL) and the Strengths and Difficulties Questionnaire (SDQ), retrospectively evaluating their child's status prior to the injury. Parent and child ratings on the Health and Behavior Inventory (HBI) (cognitive and somatic subscales) and the Post-Concussion Symptom Interview (PCS-I) were used as measures of postconcussion symptoms. We fitted 6 longitudinal regression models, which included 747 to 764 participants, to evaluate potential interactions between preinjury psychosocial function and injury group as predictors of child- and parent-reported postconcussion symptoms. Results: Preinjury psychosocial function moderated group differences in postconcussion symptoms across the first 6 months post-injury. Higher emotional and conduct problems were significantly associated with more severe postconcussion symptoms among children with mTBI compared with OI. Wald's χ2 for interaction terms (injury group × SDQ subscales) ranged from 6.3 to 10.6 (P values <.001 to .043) across parent- and child-reported models. In contrast, larger group differences (mTBI > OI) in postconcussion symptoms were associated with milder hyperactivity (Wald's χ2: 15.3-43.0, all P < .001), milder peer problems (Wald's χ2: 11.51, P = .003), and higher social functioning (Wald's χ2: 12.435, P = .002). Conclusions: Preinjury psychosocial function moderates postconcussion symptoms in pediatric mTBI, highlighting the importance of assessing preinjury psychosocial function in children with mTBI.

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“…MyHEARTSMAP is a self-administered version allowing self-/proxy-screening, to facilitate universal screening by youth and parents (43). Both instruments have demonstrated evidence for strong psychometric properties (42)(43)(44)(45), high clinical utility (46,47), and user acceptability (48). These instruments expand on the seminal HEADSS psychosocial interview and history-taking tool (49,50) and assess ten broad psychosocial sections: Home, Education and activities, Alcohol and drugs, Relationships and bullying, Thoughts and anxiety, Safety, Sexual Health, Mood, Abuse, and Professional resources.…”

Section: Introductionmentioning

confidence: 99%

HEARTSMAP-U: Adapting a Psychosocial Self-Screening and Resource Navigation Support Tool for Use by Post-secondary Students

et al. 2022

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BackgroundMental health challenges are highly prevalent in the post-secondary educational setting. Screening instruments have been shown to improve early detection and intervention. However, these tools often focus on specific diagnosable conditions, are not always designed with students in mind, and lack resource navigational support.ObjectiveThe aim of this study was to describe the adaptation of existing psychosocial assessment (HEARTSMAP) tools into a version that is fit-for-purpose for post-secondary students, called HEARTSMAP-U.MethodsWe underwent a three-phase, multi-method tool adaptation process. First, a diverse study team proposed a preliminary version of HEARTSMAP-U and its conceptual framework. Second, we conducted a cross-sectional expert review study with Canadian mental health professionals (N = 28), to evaluate the clinical validity of tool content. Third, we conducted an iterative series of six focus groups with diverse post-secondary students (N = 54), to refine tool content and language, and ensure comprehensibility and relevance to end-users.ResultsThe adaptation process resulted in the HEARTSMAP-U self-assessment and resource navigational support tool, which evaluates psychosocial challenges across 10 sections. In Phase two, clinician experts expressed that HEARTSMAP-U's content aligned with their own professional experiences working with students. In Phase three, students identified multiple opportunities to improve the tool's end-user relevance by calling for more “common language,” such as including examples, definitions, and avoiding technical jargon.ConclusionsThe HEARTSMAP-U tool is well-positioned for further studies of its quantitative psychometric properties and clinical utility in the post-secondary educational setting.

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Utility of MyHEARTSMAP for Universal Psychosocial Screening in the Emergency Department

Cited by 13 publications

References 38 publications

Exploring parental perceptions of psychosocial screening in paediatric emergency departments

Exploring parental perceptions of psychosocial screening in paediatric emergency departments

A Prospective Cohort Study of the Association Between Preinjury Psychosocial Function and Postconcussive Symptoms in Pediatric Mild Traumatic Brain Injury: An A-CAP Study

HEARTSMAP-U: Adapting a Psychosocial Self-Screening and Resource Navigation Support Tool for Use by Post-secondary Students

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