TREATING BEHAVIOR PROBLEMS IN PRIMARY CARE

描述（改编自申请人的摘要）：本申请正在 针对RFA MH-00 - 011提交的题为"干预措施的实施"的报告 有破坏性行为的儿童的策略"。儿童社会心理 问题，如对立的行为或行为问题，往往是 在医疗机构中被低估和服务不足。本申请寻求 评估专门的心理社会治疗方案的应用 在儿科初级保健中有破坏性行为问题的儿童。 治疗程序源自研究者现有的 多模式治疗方案，其有效性正在审查中， 社区（MH 57727;"社区服务对行为的有效性 问题"）。将从5个儿科患者中招募共计150名患者， 与儿童社区保健有关的初级保健做法 网络表现出DBP的儿童将被随机分配到该专业 治疗方案（STP）或常规治疗（TAU）。例 被分配到STP的护士将接受训练有素的护士-临床医生的服务， 在儿科办公室管理选定的治疗模块， 参与者（儿童、家长/家庭、教师电话）。计划的分析将 检查治疗参与者/过程、程序、结果 和成本效益作为治疗条件的函数。相对于TAU， 研究者预测STP将与更高的治疗相关 参与率，多个临床结局相关的更大改善 对儿童和家庭功能的影响，以及更高的成本效益。等 根据治疗类型的变化， 在儿科初级保健中向这一人群提供， 儿童精神卫生保健综合服务体系， 临床实践和技术的基础上，从最近的实证结果的证据 问题研究这些结果将在经验上支持整合的决定 在儿科卫生保健环境中使用具有成本效益的专业治疗方法。

DESCRIPTION (Adapted from Applicant's Abstract): This application is being submitted in response to RFA MH-00-011 entitled "Implementation of Intervention Strategies for Children with Disruptive Behaviors". Children's psychosocial problems, such as oppositional behaviors or conduct problems, are often underidentified and underserved in healthcare settings. This application seeks to evaluate the application of a specialized psychosocial treatment protocol for children with disruptive behavior problems (DBP) in pediatric primary care. The treatment procedures are derived from the investigator's existing multimodal treatment protocol whose effectiveness is being examined in the community (MH 57727; "Effectiveness of Community Services for Conduct Problems"). A total of 150 patients will be recruited from five pediatric primary care practices affiliated with the Children's Community Care health network. Children exhibiting DBP would be randomly assigned to the specialty treatment protocol (STP) or treatment-as-usual (TAU) in each practice. Cases assigned to STP would receive services from trained nurse-clinicians who would administer selected treatment modules in the pediatric office with designated participants (children, parents/families, teacher calls). Planned analyses will examine differences in treatment participants/process, procedures, outcomes, and cost-effectiveness as a function of treatment condition. Relative to TAU, the investigator predicts that STP will be associated with higher treatment participation rates, greater improvements in multiple clinical outcomes related to child and family functioning, and greater cost-effectiveness. Such real-world information is timely in light of changes in the types of treatments being provided to this population in pediatric primary care, the evolution of an integrated pediatric mental health care service system, and developments in clinical practice and technique based on evidence from recent empirical outcome studies. These outcomes would empirically support decisions to integrate cost-effective, specialty treatment methods in pediatric health care settings.