Evidence-based prevention programs targeting youth mental and behavioral health in primary care: A systematic review

• Published in: Preventive medicine Vol. 120; pp. 85 - 99
• Main Authors: Rojas, Lourdes M., Bahamón, Mónica, Wagstaff, Rachel, Ferre, Isabella, Perrino, Tatiana, Estrada, Yannine, St. George, Sara M., Pantin, Hilda, Prado, Guillermo
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2019
• Subjects: Adolescent; Behavioral health; Child; Child, Preschool; Evidence-Based Medicine; Female; Health Services Needs and Demand; Humans; Male; Mental Disorders - epidemiology; Mental Disorders - prevention & control; Mental Health; Prevention; Preventive Health Services - organization & administration; Primary health care; Primary Prevention - organization & administration; Program Evaluation; Randomized Controlled Trials as Topic; Risk Assessment; Systematic review; United States; Young Adult; United States; Prevention; Systematic review; Behavioral health; Primary health care; Mental health
• ISSN: 0091-7435; 1096-0260
• DOI: 10.1016/j.ypmed.2018.12.009

The objectives of this systematic review were to: 1) identify evidence-based youth (i.e., infancy, pre-school age, school age, and adolescence) mental and behavioral health disorder preventive interventions conducted in or offered by primary care settings, and 2) describe these interventions' characteristics, efficacy, and clinical involvement. Randomized controlled trials that targeted the prevention of mental or behavioral health outcomes for youth and had a connection to primary care were included. The PRISMA guidelines were utilized for two phases: 1) searching PubMed, EMBASE, PsycInfo, CINAHL, and Cochrane databases in January 2017; and 2) searching United States Preventive Services Task Force (USPSTF) Systematic Reviews in November 2017. The two phases revealed 504 and 58 potential articles, respectively. After removal of duplicates, screening of abstracts, and full-text reviews, 19 interventions (infancy: n = 2, pre-school age: n = 3, school age: n = 6, adolescence: n = 8) were included: 1) 10 interventions described in 17 articles from the databases, and 2) 9 interventions described in 11 articles from the USPSTF reviews. The included interventions capitalized on primary care settings as a natural entry point to engage youth and families into interventions without requiring a large amount of clinic involvement. Commonalities of efficacious interventions and recommendations for future research are discussed. The authors encourage primary care providers, mental and behavioral health providers, and/or public health researchers to continue developing and testing preventive interventions, or adapting existing interventions, to be implemented in primary care. •Youth mental and behavioral health disorder prevention belongs in primary care.•Systematic review identified 19 interventions from infancy to adolescence.•Over half of the interventions produced health benefits beyond usual primary care.•Most interventions were not fully delivered during a routine medical visit.•Further research on clinic involvement and intervention strategies is needed.