MCH COR: Enhancing Community Provider Capacity to Support Child Mental & Behavioral Health Through a WA /VA Partnership (MCH COR WAVA)
Grant Status: Completed
Training Category: Collaborative Office Rounds
Project Director(s):
Beth Ellen Davis, MD MPH
University of Washington
Center on Human Development & Disability, Box 357920
Seattle, WA 98195
Phone: (434) 924-8184
Email: bed9kr@virginia.edu
Problem:
Community-based primary care providers (PCPs) lack knowledge and skills to address pediatric mental/behavioral conditions. Training and collaboration is needed to enhance local PCPs capacity for assessment, management, referral and access to resources of psychosocial variations, problems or disorders in children and youth.
Goals and Objectives:
Goal 1: Enhance, PCPs understanding of psychosocial aspects of child development, disorders and disability. Obj. 1.1: Recruit, enroll and increase mental /behavioral health (M/BH) knowledge and skills of =10 child-serving community-based PCPs annually, for 5 years. Obj. 1.2: Increase PCPs use of MB/H screening tools by =25% annually. Obj. 1.3: 100% PCP will be able to identify and respond to adverse childhood experiences. Goal 2: Facilitate a comprehensive approach to health supervision outlined in the 4th edition Bright Futures (BF): Guidelines for Health Supervision of Infants, Children & Adolescents. Obj. 2.1: Provide PCPs with 4th ed. BF Guidelines, periodicity table, pocket guide and Primary Care Mental Health Care Guide. Obj. 2.2: 100% PCPs will be able to access community mental health providers. Goal 3: Increase PCP ability to help children and families address psychosocial aspects of child health. Obj. 3.1: 100% PCPs will recognize the role of cultural competence in addressing psychosocial aspects of child health. Obj. 3.2: 100% PCPs will be able to differentiate childhood M/BH transient disturbances from more serious psychiatric disorders requiring referral. Obj. 3.3: 100% PCPs will be able to implement office strategies (diagnostic or therapeutic) for M/BH problems. Obj. 3.4: 100% PCPs will identify risks of military-connected children and resources. Goal 4: Promote collaboration between pediatricians and child psychiatrists. Obj. 4.1: 100% PCPs will formulate appropriate child psychiatry referrals, including severity of symptoms. Obj. 4.2: 100% PCPs will identify resources for postnatal depression. Obj. 4.3: PCP members may participate in project sustainability planning.
Methodology:
Provide 60- 90 min/month of CME awarded blended adult learning for =10 PCPs/year for 5 annual cohorts, to include: monthly (10/year) case-based virtual collaborative discussions, preparatory activities, access to screening tools, & 1:1 resource coordination support. Didactics address the 4 R's: Recognize (ID, screen), Respond (brief interventions), Refer (know when), and Resources (local, state) for children, across the age range. Diverse PCPs will be recruited and include = 1 military PCP/year. Interdisciplinary trainees may attend. Sessions are co-moderated by Child Psychiatrist and Developmental Behavioral Pediatrician. Zoom teleconferencing will ensure virtual access for PCPs. Unique emerging issues ( HP 2020) will be addressed.
Coordination:
WA/VA Depts. of Health, AAP chapters, LEND programs, DBP & Child Psych. fellows, and WA has a telepsychiatry consult service for PCPs.
Evaluation:
Individual & programmatic evaluations include PCP attendance, pre/post questionnaires, annual cultural competence self-assessment, PCPs demographic & satisfaction surveys and CQI. Use of screening tools, brief office interventions, and community resources will demonstrate PCPs practice change and serve to reinforce and sustain learning.