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Scope-of-Practice Expansions Associated with Reduced Racial Disparities in Pediatric Mental Health Care.
Hughes, Phillip M; Graaf, Genevive; Gigli, Kristin H; deJong, Neal A; McGrath, Robert E; Thomas, Kathleen C.
Afiliación
  • Hughes PM; Division of Pharmaceutical Outcomes and Policy, University of North Carolina Eshelman School of Pharmacy, Chapel Hill, NC, USA. phughes1@email.unc.edu.
  • Graaf G; Division of Research, UNC Health Sciences at MAHEC, Asheville, NC, USA. phughes1@email.unc.edu.
  • Gigli KH; Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC, USA. phughes1@email.unc.edu.
  • deJong NA; UNC Eshelman School of Pharmacy Campus, 301 Pharmacy Lane, Box 7573, Chapel Hill, NC, 27599-7573, USA. phughes1@email.unc.edu.
  • McGrath RE; School of Social Work, University of Texas at Arlington, Arlington, TX, USA.
  • Thomas KC; College of Nursing and Health Innovation, University of Texas in Arlington, Arlington, TX, USA.
Article en En | MEDLINE | ID: mdl-38954142
ABSTRACT
To examine the association between scope-of-practice (SoP) regulations and racial disparities in pediatric mental health services. We used the National Survey of Children's Health (2016-2020; n = 33,790) to examine racial disparities in unmet mental health care needs and receipt of mental health medication between states with and without SoP expansions for psychologists and nurse practitioners (NP). Our primary outcomes were (1) unmet mental health care needs and (2) receipt of mental health medication. We examined heterogeneous treatment effects of SoP expansion on the outcomes using logistic regression with interaction terms between SoP expansion and race/ethnicity. We estimated population-level racial disparities for both outcomes stratified by SoP expansion to identify differences in racial disparities. The psychologist SoP expansion-associated reduction in unmet need was 15.8 percentage-points (CI= -25.3, -6.2) larger for Other-race children than for White children. The psychologist SoP expansion-associated increase in medication was 5.1%-points (CI=. 0.8, 9.4) larger for Black children and 5.6%-points (CI = 0.5, 10.8) for Other-race children. No differences were found for NP SoP expansion. Racial disparities in both outcomes were lower in psychologist SoP expansion states but varied in NP SoP states. Expanded SoP was generally associated with lower racial disparities in pediatric mental health care access.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Community Ment Health J Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos

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