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1.
J Health Care Poor Underserved ; 30(2): 637-652, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31130542

RESUMO

OBJECTIVE: In a novel model of embedded primary care child psychiatry serving an urban Latino population, we examined determinants of successful referral and relationship between clinical need and service intensity. METHODS: We conducted a chart review of referred patients from July 2013-March 2015. We used multiple logistic regressions controlling for confounders to identify determinants of successful referral. We examined the relationship between service intensity and clinical need using Poisson regression, adjusting for exposure time, age, sex, ethnicity, and language. RESULTS: Seventy-four percent of patients completed an evaluation. Younger children (p=.0397) and those with a history of therapy (p=.0077) were more likely to make initial contact. The markers of clinical need included PSC-35 Global Scores (p=.0027) and number of psychiatric diagnoses (p=.0178) predicted number of visits. CONCLUSIONS: Our findings support early referral to improve engagement, and provide initial evidence that embedded child psychiatry consultation is feasible and may increase access to care.


Assuntos
Psiquiatria Infantil/métodos , Hispânico ou Latino , Atenção Primária à Saúde/métodos , Adolescente , Criança , Psiquiatria Infantil/estatística & dados numéricos , Pré-Escolar , Prestação Integrada de Cuidados de Saúde/métodos , Feminino , Humanos , Masculino , Transtornos Mentais/etnologia , Transtornos Mentais/terapia , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Encaminhamento e Consulta , População Urbana
2.
Ethn Dis ; 28(Suppl 2): 445-456, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30202198

RESUMO

Objective: To describe the development and evaluation of two integrated care models using a partnered formative evaluation approach across a private foundation, clinic leaders, providers and staff, and a university-based research center. Design: Retrospective cohort study using multiple data sources. Setting: Two federal qualified health care centers serving low-income children and families in Chicago. Participants: Private foundation, clinic and academic partners. Interventions: Development of two integrated care models and partnered evaluation design. Main Outcome Measures: Accomplishments and early lessons learned. Results: Together, the foundation-clinic-academic partners worked to include best practices in two integrated care models for children while developing the evaluation design. A shared data collection approach, which empowered the clinic partners to collect data using a web-based tool for a prospective longitudinal cohort study, was also created. Conclusion: Across three formative evaluation stages, the foundation, clinic, and academic partners continued to reach beyond their respective traditional roles of project oversight, clinical service, and research as adjustments were collectively made to accommodate barriers and unanticipated events. Together, an innovative shared data collection approach was developed that extends partnered research to include data collection being led by the clinic partners and supported by the technical resources of a university-based research center.


Assuntos
Prestação Integrada de Cuidados de Saúde , Colaboração Intersetorial , Criança , Prestação Integrada de Cuidados de Saúde/métodos , Prestação Integrada de Cuidados de Saúde/organização & administração , Humanos , Saúde Mental , Modelos Organizacionais , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Estudos Retrospectivos , Estados Unidos
3.
Psychiatr Serv ; 53(9): 1096-102, 2002 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-12221307

RESUMO

OBJECTIVE: Attention-deficit hyperactivity disorder (ADHD) is a common childhood psychiatric condition for which evidence-based treatments have been established. This study describes use of complementary and alternative medicine among children with ADHD or at risk of having ADHD and explores possible predictors of use of such treatments. METHODS: A sample of 1,615 parents of elementary school students in a public school district were interviewed in a telephone screening survey of ADHD symptoms and use of traditional and nontraditional ADHD treatment. A total of 822 parents had a child with a diagnosis of ADHD, had a child in whom ADHD was suspected, or had a child about whose emotions or behavior the parents or school staff had general concerns. RESULTS: Use of complementary and alternative medicine was significantly higher among children who had received a diagnosis of ADHD (12 percent) or in whom ADHD was suspected (7 percent) than among those about whom parents or school staff had general concerns (3 percent). Faith healing had been used for 4 percent of the 822 children. Nontraditional treatments were more likely to have been used among children with a diagnosis or a suspected diagnosis of ADHD and those whose parents used the Internet as a source of information than among other children. CONCLUSIONS: Providers should inquire about nontraditional interventions and educate families about evidence-based approaches when treating children with ADHD.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/terapia , Inquéritos Epidemiológicos , Pais , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Criança , Terapias Complementares , Demografia , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica
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