Association of Behavioral and Mental Health Professionals in Continuity Clinic with Resident-Reported Competence
To assess whether residents who trained with a co-located or integrated behavioral/mental health professional (B/MHP) reported higher competence in the assessment and management of behavioral/mental health (B/MH) conditions than those who trained without an onsite B/MHP. We hypothesized that having...
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Published in | The Journal of pediatrics Vol. 248; pp. 15 - 20.e1 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
United States
Elsevier Inc
01.09.2022
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Subjects | |
Online Access | Get full text |
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Summary: | To assess whether residents who trained with a co-located or integrated behavioral/mental health professional (B/MHP) reported higher competence in the assessment and management of behavioral/mental health (B/MH) conditions than those who trained without an onsite B/MHP. We hypothesized that having an onsite B/MHP would be associated with higher self-reported competence, especially if integrated into clinic.
Cross-sectional survey of applicants for the initial American Board of Pediatrics (ABP) certifying exam. The independent variable was training in continuity clinic with no onsite B/MHP, a co-located B/MHP, or an integrated B/MHP. Outcome variables were self-reported competence in 7 B/MH assessment skills and 8 treatment skills, summarized as two composite measures. Competence was rated on a 5-point scale; high competence was defined as mean scores >4. Logistic regression assessed relationships between independent and outcome variables adjusting for covariates including individual and residency program characteristics.
Of 1503 eligible respondents, 645 (42.9%) reported no onsite B/MHP, 390 (26.0%) a co-located B/MHP, and 468 (31.1%) an integrated B/MHP. In multivariable models, respondents with a co-located B/MHP reported higher levels of B/MH assessment competence (adjusted odds ratio [aOR]=1.40 [95% confidence intervals (CI):1.06-1.86]) and treatment competence (aOR=1.45 [95% CI:1.03-2.05]) compared with those with no B/MHP. Respondents with an integrated B/MHP similarly reported higher odds of assessment (aOR=1.33 [95%CI 1.02-1.74]) and treatment competence (aOR=1.53 [95% CI: 1.10-2.13]) than the reference group.
Although specific mechanisms were not tested, training with an onsite B/MHP within continuity clinic may improve pediatric trainees' competence for addressing B/MH conditions. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0022-3476 1097-6833 |
DOI: | 10.1016/j.jpeds.2022.05.012 |