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Factors related to providers screening children for behavioral health risks in primary care settings

L.M. Jones, K. Nolte, A.J. O'Brien, J.M. Trumbell, K.J. Mitchell
J Pediatr Nurs

Purpose: To provide information from a large sample of pediatric and family medicine primary care providers on practices in screening children for behavioral health risks.

Design and methods: Participants were a sample of physicians (n=319) and nurse practitioners (n=292) from across the U.S. who completed a confidential online survey about screening practices through a computer-assisted self-interview.

Results: Almost all respondents (89%) reported screening children for depression/anxiety and behavior problems. Child substance use (82%), family social support (74%), significant household changes (73%), bullying (72%), child abuse (62%) and domestic violence (52%) were also asked about regularly, although with high rates of informal screening methods. Caregiver mental health (49%), caregiver substance use (35%), family financial strain (33%) and transportation difficulties (27%) were screened less frequently. Screening was associated with higher rates of referral for risk-related problems, and was more likely when providers reported greater confidence providing support to clients, perceived community resource availability as higher, and worked in systems with integrated primary care and behavioral health.

Conclusions: Findings suggest a great amount of diversity in how providers screen for behavioral health risks. There is reluctance to screen when options for addressing the problems are seen as limited. Research is needed to better guide healthcare providers in determining the right context and methods for screening social risks.

Jones LM, Nolte K, O'Brien AJ, Trumbell JM, Mitchell KJ. Factors related to providers screening children for behavioral health risks in primary care settings. J Pediatr Nurs. 2021 Jan 15;59:37-44. doi: 10.1016/j.pedn.2020.12.014. Epub ahead of print. PMID: 33460878.

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Publication year
Resource type
Peer Reviewed Research
Screening research
Social Determinant of Health
Economic Security
Social Support/Social Isolation
Study design
Other Study Design