Your browser doesn't support javascript.
loading
A systematic review and meta-analysis of pediatric integrated primary care for the prevention and treatment of physical and behavioral health conditions.
Hostutler, Cody A; Shahidullah, Jeffrey D; Mautone, Jennifer A; Rybak, Tiffany M; Okoroji, Chimereodo; Bruni, Teryn; Stephenson, Kevin G; Utset, Leah Vance; Freeman, Kurt A; LaLonde, Leah; Riley, Andrew R.
Afiliación
  • Hostutler CA; Pediatric Psychology and Neuropsychology, Nationwide Childrens Hospital, The Ohio State University, Columbus, OH, United States.
  • Shahidullah JD; Department of Psychiatry and Behavioral Sciences, Dell Medical School, The University of Texas at Austin, Austin, TX, United States.
  • Mautone JA; Department of Child & Adolescent Psychiatry & Behavioral Sciences, Children's Hospital of Philadelphia & Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
  • Rybak TM; Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
  • Okoroji C; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States.
  • Bruni T; Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
  • Stephenson KG; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States.
  • Utset LV; Department of Psychology, Algoma University, Marie, ON, Canada.
  • Riley AR; Institute on Development and Disability, Department of Pediatrics, Oregon Health & Science University, Portland, OR, United States.
J Pediatr Psychol ; 2024 Jun 12.
Article en En | MEDLINE | ID: mdl-38867311
ABSTRACT

OBJECTIVE:

To evaluate the effects of behavioral health interventions delivered within pediatric integrated primary care models on clinical outcomes.

METHODS:

We searched Medline, EMBASE, CENTRAL, PsycINFO, and SCOPUS for studies published from January 1, 1998, to September 20, 2023. We included studies that evaluated onsite behavioral health integration in pediatric primary care using a comparator condition (usual, enhanced usual care, or waitlist). Outcome data on symptom change, impairment/quality of life, health indicator, and behavior change were extracted using Covidence software. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline was followed Risk of bias analysis was conducted using the Cochrane Risk of Bias tool. We used multilevel meta-analysis to synthesize multiple outcomes nested within studies. Open Science Foundation pre-registration #10.17605/OSF.IO/WV7XP.

RESULTS:

In total, 33 papers representing 27 studies involving 6,879 children and caregivers were included. Twenty-four studies were randomized controlled trials and three were quasi-experimental designs. Seventeen papers reported on treatment trials and 16 reported on prevention trials. We found a small overall effect size (SMD = 0.19, 95% confidence interval [0.11, 0.27]) supporting the superiority of integrated primary care to usual or enhanced usual care. Moderator analyses suggested similar effectiveness between co-located and integrated models and no statistically significant differences were found between treatment and prevention trials.

CONCLUSIONS:

Results suggest that integrated primary care is superior to usual and enhanced usual care at improving behavior, quality of life, and symptoms. Integrated primary care research needs improved standards for reporting to promote better synthesis and understanding of the literature.
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Pediatr Psychol Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Pediatr Psychol Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos