Encouraging and sustaining integration of child mental health into primary care: interviews with primary care providers participating in Project TEACH (CAPES and CAP PC) in NY
Encouraging and sustaining integration of child mental health into primary care: interviews with primary care providers participating in Project TEACH (CAPES and CAP PC) in NY
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DOI：
10.1016/j.genhosppsych.2014.05.013
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发表时间：
2014-11-01
影响因子：
7
通讯作者：
Kaye, David L.
中科院分区：
文献类型：
--
作者：
Gadomski, Anne M.;Wissow, Lawrence S.;Kaye, David L.
目的：促进儿童健康培训和教育项目提供培训、咨询和转诊支持，以在初级保健提供者中建立儿童和儿童心理健康专门知识。本研究介绍了如何教从事PCP，如何程序组件导致的变化，在实践中，以及如何上下文因素影响sustainability.Method：随机选择的139个培训的PCP和10个PCP从143个注册与教，但尚未培训完成半结构化访谈。PCP的选择采用了针对区域、农村和专业的有目的抽样。访谈记录，转录和分析使用扎根theorety.Results：PCP参与促进感知患者的需求，缺乏财务和后勤障碍和PCP程序的关系，从培训到正在进行的咨询的连续性。经过培训的PCP报告说，他们对与家庭就MH进行互动、评估严重程度、开药和制定治疗计划更有信心。他们与MH专家的满意互动和家庭的积极反馈令人鼓舞。障碍包括实施筛查的困难，时间限制，竞争的需求，保守的期望患者的结果和负面印象的MH系统overall.Conclusions：像TEACH计划可以增加PCP的信心MH护理，促进增加MH治疗在初级保健，并通过与专家合作。可持续性可能取决于PCP的实践背景和实施支持。(C)2014爱思唯尔公司All rights reserved.
Objective: Project Training and Education for the Advancement of Children's Health (TEACH) provides training, consultation and referral support to build child and adolescentmental health (MH) expertise among primary care providers (PCPs). This study describes how TEACH engages PCP, how program components lead to changes in practice and how contextual factors influence sustainability.Method: Thirty PCPs randomly selected from 139 trained PCPs and 10 PCPs from 143 registered with TEACH but not yet trained completed semistructured interviews. PCP selection utilized purposeful sampling for region, rurality and specialty. Interviews were recorded, transcribed and analyzed using grounded theory.Results: PCP participation was facilitated by perceived patient needs, lack of financial and logistic barriers and continuity of PCP-program relationships from training to ongoing consultation. Trained PCPs reported more confidence interacting with families about MH, assessing severity, prescribing medication and developing treatment plans. They were encouraged by satisfying interactions with MH specialists and positive feedback from families. Barriers included difficulties implementing screening, time constraints, competing demands, guarded expectations for patient outcomes and negative impressions of the MH system overall.Conclusions: Programs like TEACH can increase PCP confidence in MH care and promote increased MH treatment in primary care and through collaboration with specialists. Sustainability may depend on the PCP practice context and implementation support. (C) 2014 Elsevier Inc. All rights reserved.