What’s known about implementing co-located paediatric integrated care: a scoping review

Abstract Several studies have demonstrated clinical benefits of integrated care for a range of child and adolescent mental health outcomes. However, there is a significant gap between the evidence for efficacy of integrated care interventions vs their implementation in practice. While several studies have examined large-scale implementation of co-located integrated care for adults, much less is known for children. The goal of this scoping review was to understand how co-located mental health interventions targeting children and adolescents have been implemented and sustained. The literature was systematically searched for interventions targeting child and adolescent mental health that involved a mental health specialist co-located in a primary care setting. Studies reporting on the following implementation outcomes were included: acceptability, adoption, appropriateness, feasibility, fidelity, implementation cost, penetration, and sustainability. This search identified 34 unique studies, including randomized controlled trials, observational studies, and survey/mixed method approaches. Components facilitating implementation of on-site integrated behavioural healthcare included interprofessional communication and collaboration at all stages of implementation; clear protocols to facilitate intervention delivery; and co-employment of integrated care providers by specialty clinics. Some studies found differences in service use by demographic factors, and others reported funding challenges affecting sustainability, warranting further study.

• Publication year

  2018

• Venue

  International Review of Psychiatry

• Publication date

  2018-11-02

• Fields of study

  Medicine, Psychology

• Identifiers
  DOI 10.1080/09540261.2018.1563530PMID 30912463PMCID PMC6499629
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• Mental Health Screening

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  2018influential reference
• Early Childhood Behavioral Health Integration Activities and HealthySteps: Sustaining Practice, Averting Costs

  2018cited by this paper
• General Pediatricians and Value-Based Payments

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• Large-Scale Implementation of Collaborative Care Management for Depression and Diabetes and/or Cardiovascular Disease

  2018cited by this paper
• Prevalence and Variation of Developmental Screening and Surveillance in Early Childhood

  2018cited by this paper
• Integrated Behavioral Health Care in Pediatric Primary Care: A Quality Improvement Project

  2018influential reference
• Annual Research Review: Expanding mental health services through novel models of intervention delivery.

  2018cited by this paper
• Effectiveness in Regular Practice of Collaborative Care for Depression Among Adolescents: A Retrospective Cohort Study.

  2018influential reference
• Navigation delivery models and roles of navigators in primary care: a scoping literature review

  2018cited by this paper
• Pediatrician and Behavioral Clinician-Delivered Screening, Brief Intervention and Referral to Treatment: Substance Use and Depression Outcomes.

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  2017cited by this paper
• Collaborative Mental Health Care for Pediatric Behavior Disorders in Primary Care: Does It Reduce Mental Health Care Costs?

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• Integrated Primary Medical-Behavioral Health Care for Adolescent and Young Adult Depression: Predictors of Service Use in the Youth Partners in Care Trial

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• 20.2 Quality Improvement Learning Collaborative to Improve Mental Health Screening in Primary Care

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• Behavioral Health Integration in Large Multi-group Pediatric Practice

  2017influential reference
• Improving Adherence to Care Recommendations Using a Community Health Worker (CHW) Intervention with the Pediatric Medical Home

  2017cited by this paper
• Practitioner Review: Empirical evolution of youth psychotherapy toward transdiagnostic approaches

  2017cited by this paper
• Perception of Interprofessional Collaboration and Co-Location of Specialists and Primary Care Teams in Youth Mental Health.

  2017influential reference
• Evaluating Integrated Mental Health Care Programs for Children and Youth.

  2017cited by this paper
• Colocated Mental Health/Developmental Care

  2017influential reference
• Comparing Two Models of Integrated Behavioral Health Programs in Pediatric Primary Care.

  2017influential reference
• Implementing SBIRT (Screening, Brief Intervention and Referral to Treatment) in primary care: lessons learned from a multi-practice evaluation portfolio

  2017cited by this paper
• From Theory to Action: Children's Community Pediatrics Behavioral Health System.

  2017cited by this paper
• Improving Mental Health Access for Low-Income Children and Families in the Primary Care Setting

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• Effect of a primary care-based psychological intervention on symptoms 1 of common mental disorders in Zimbabwe: a randomized clinical trial

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  2017influential reference
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  2017influential reference
• Effect of a Primary Care-Based Psychological Intervention on Symptoms of Common Mental Disorders in Zimbabwe: A Randomized Clinical Trial.

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• Reducing Disparities in Timely Autism Diagnosis Through Family Navigation: Results From a Randomized Pilot Trial.

  2016cited by this paper
• Physician Satisfaction With Integrated Behavioral Health in Pediatric Primary Care

  2016cited by this paper
• The Scope of Behavioral Health Integration in a Pediatric Primary Care Setting.

  2016influential reference
• Work–Life Balance, Burnout, and Satisfaction of Early Career Pediatricians

  2016cited by this paper
• Redesigning Health Care Practices to Address Childhood Poverty.

  2016cited by this paper
• A Statewide Effort to Implement Collaborative Care for Depression: Reach and Impact for All Patients With Depression

  2016cited by this paper
• The Costs and Cost-effectiveness of Collaborative Care for Adolescents With Depression in Primary Care Settings: A Randomized Clinical Trial.

  2016influential reference
• Do On-Site Mental Health Professionals Change Pediatricians' Responses to Children's Mental Health Problems?

  2016influential reference
• An innovative model of integrated behavioral health: school psychologists in pediatric primary care settings

  2016influential reference
• Integrated pediatric behavioral health: Implications for training and intervention models.

  2016influential reference
• The Medical Home and Integrated Behavioral Health: Advancing the Policy Agenda

  2015cited by this paper
• Psychological Science and Innovative Strategies for Informing Health Care Redesign: A Policy Brief

  2015cited by this paper
• The Family Value of Information, Community Support, and Experience Study: Rationale, Design, and Methods of a “Family-Centered” Research Study

  2015cited by this paper
• Pediatric Nurse Practitioner Management of Child Anxiety in a Rural Primary Care Clinic With the Evidence-Based COPE Program.

  2015influential reference
• Effect of Pediatric Behavioral Health Screening and Colocated Services on Ambulatory and Inpatient Utilization.

  2015influential reference
• Integrated Medical-Behavioral Care Compared With Usual Primary Care for Child and Adolescent Behavioral Health: A Meta-analysis.

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• Behavioral health integration

  2015cited by this paper
• How personal and standardized coordination impact implementation of integrated care

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• The Family Check-Up in a Pediatric Clinic: An Integrated Care Delivery Model to Improve Behaviors in the Home Environment

  2015cited by this paper
• Outcomes for implementation science: an enhanced systematic review of instruments using evidence-based rating criteria

  2015cited by this paper
• Collaborative Care Outcomes for Pediatric Behavioral Health Problems: A Cluster Randomized Trial

  2014influential reference
• A heavy burden on young minds: the global burden of mental and substance use disorders in children and youth

  2014cited by this paper
• Examining the utility of behavioral health integration in well-child visits: implications for rural settings.

  2014cited by this paper
• Infants and Toddlers Left Behind: Mental Health Screening and Consultation in Primary Care

  2014influential reference
• Collaborative care for adolescents with depression in primary care: a randomized clinical trial.

  2014cited by this paper
• Racial/ethnic disparities in ADHD diagnosis by kindergarten entry.

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• Universal mental health screening in pediatric primary care: a systematic review.

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• Integrated Behavioral Health Services

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• Social-Emotional Screening for Infants and Toddlers in Primary Care

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• Doctor-office collaborative care for pediatric behavioral problems: a preliminary clinical trial.

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• Physician “Costs” in Providing Behavioral Health in Primary Care

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• Health Inequity in Children and Youth With Chronic Health Conditions

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  2010cited by this paper
• Improving Access to Care and Clinical Outcome for Pediatric Behavioral Problems: A Randomized Trial of a Nurse-Administered Intervention in Primary Care

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• Outcomes for Implementation Research: Conceptual Distinctions, Measurement Challenges, and Research Agenda

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• A Common Factors Approach to Improving the Mental Health Capacity of Pediatric Primary Care

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• A glossary for dissemination and implementation research in health.

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• Implementation Research in Mental Health Services: an Emerging Science with Conceptual, Methodological, and Training challenges

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• Mental health of young people: a global public-health challenge.

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• Preventive pediatric mental health care: A co-location model.

  2007influential reference
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• A program evaluation of the Pediatric Behavioral Health Project: A co -location model of integrated behavioral health care

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  2005influential reference

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• Promoting optimal mental health outcomes for children and youth.

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• Effective evidence-based pediatric mental health care in primary care

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• Virtual Collaborative Behavioral Health Model in a Community Pediatric Network: Two-Year Outcomes

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• Research Review: Integrated healthcare for children and young people in secondary/tertiary care - a systematic review.

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• Provider Perspectives on an Integrated Behavioral Health Prevention Approach in Pediatric Primary Care

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• Mental health interventions for children and young people with long-term health conditions in Children and Young People’s Mental Health Services in England

  2023cites this paper
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  2023cites this paper
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• Protocol for the implementation evaluation of an integrated paediatric and primary care model: Strengthening Care for Children (SC4C)

  2022cites this paper
• Characteristics of Patients Served by a Statewide Child Psychiatry Access Program.

  2022cites this paper
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• Community paediatricians’ experience of joint working with child and adolescent mental health services: findings from a British national survey

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• Association of Behavioral and Mental Health Professionals in Continuity Clinic with Resident-Reported Competence.

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  2022cites this paper
• Clinical Update: Collaborative Mental Health Care for Children and Adolescents in Pediatric Primary Care.

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