Grant Status: Active
Grant Title: San Joaquin Valley Collaborative Office Rounds (COR): A Longitudinal Curriculum Enhancing Primary Care Providers Abilities to Address Psychosocial, Developmental, and Behavioral Aspects of Child Health
Serena Yang, MD, MPH
University of California, San Francisco, Fresno
155 N. Fresno Street
Fresno, CA 93701
The San Joaquin Valley of central California is rich in cultural and linguistic diversity and agricultural wealth, but fraught with some of the most impoverished and medically underserved areas in the US. The overall goal of San Joaquin Valley COR is to enhance primary care providers' abilities in prevention, early detection, and management of psychosocial, developmental, and mental health concerns of at-risk children in collaboration with developmental-behavioral pediatricians and child psychiatrists. This COR project builds on successes and lessons learned in implementing this HRSA COR curriculum since 2011.
(1) To enhance primary care provider understanding of psychosocial aspects of child development, disorders, and disability. We aim to increase: 1a) provider knowledge of and screening for psychosocial-developmental concerns. 1b) numbers of patients whom providers feel they managed these problems effectively. (2) To increase provider ability to help children and families address these issues. We aim to increase provider confidence and practice of relationship-based care and establishing trust with patients and families in shared decision-making around these issues. (3) To expand provider ability to distinguish between transient disturbances and more serious psychiatric disorders requiring referral. We aim to increase: 3a) practitioner confidence in identifying and managing transient disturbances, as well as anxiety and depression, with emphasis on those resulting from trauma. 3b) numbers of successful referrals with serious psychiatric disorders. (4) To promote collaboration among primary care providers, developmental-behavioral pediatricians, and child psychiatrists. We aim to improve: 4a) provider perception of collaboration between developmental-behavioral specialists and child psychiatrists. 4b) provider knowledge and utilization of community resources. 4c) systems changes in practice that promote collaboration. (5) To facilitate a comprehensive approach to health supervision. We aim to increase providers' knowledge and practice of comprehensive health supervision as outlined in Bright Futures.
We have a longitudinal curriculum that blends case-oriented small study group team-based learning with web-based exercises, evidence-based resources/tools, and large group activities. We emphasize practical challenges faced by primary care providers when dealing with psychosocial, developmental, behavioral/mental health concerns. Moderators are General Pediatrics, Developmental-Behavioral Pediatrics, and Child Psychiatry faculty. Participants are UCSF Fresno residents, faculty, midlevels, and students from Pediatrics, Family Medicine, and Psychiatry, and other community-based pediatric providers and child health advocates.
We assess learner demographics, pre and post-test knowledge and confidence, and changes in practice. We track session attendance, in addition to COR-related scholarly products. We obtain feedback on the curricular content and effectiveness of sessions and resources/tools. The project is designed with the intent of exportability of results and products to other COR programs and the community.