Parents’ Preferences for Primary Care-Based Behavioral Services and the COVID-19 Pandemic: A Mixed Method Study

• Published in: Journal of pediatric psychology Vol. 48; no. 11; pp. 879 - 892
• Main Authors: Hails, Katherine A, Wellen, Brianna C, Simoni, Marisa, Gaultney, Wendy M, Petts, Rachel A, Hostutler, Cody A, Riley, Andrew R
• Format: Journal Article
• Language: English
• Published: United States Oxford University Press 16.11.2023
• Subjects: Child; COVID-19; Ethnicity; Humans; Minority Groups; Pandemics; Parenting - psychology; Parents - psychology; Primary Health Care; COVID-19; preschool children; primary care; behavior problems; parenting
• ISSN: 0146-8693; 1465-735X; 1465-735X
• DOI: 10.1093/jpepsy/jsad034

Abstract Objective This study examined how family factors impacted parents’ attitudes toward integrated behavioral health (IBH) in pediatric primary care during the COVID-19 pandemic. We hypothesized that COVID-19 impact would predict family functioning challenges, and that pre-existing familial contextual factors would predict parents’ interest in IBH modalities. Methods Parents of children ages 1.5–5 years (N = 301) from five primary care clinics completed a survey with measures assessing familial contextual factors (income, race and ethnicity, and parents’ childhood adversity), COVID-19 impact on family relationships and wellbeing, family functioning (child behavior, parenting self-efficacy, and parent psychological functioning), and parents’ preferences for behavioral support in primary care. A subsample of parents (n = 23) completed qualitative interviews to provide deeper insights into quantitative relationships. Results Higher COVID-19 impact was significantly associated with worse parent mental health and child behavior problems, as well as lower interest in IBH virtual support options. Overall, lower SES and racial and/or ethnic minority parents both indicated greater interest in IBH modalities compared to higher SES and White parents, respectively. Qualitative interviews identified how pandemic stressors led to increases in parents’ desire for behavioral support from pediatricians, with parents sharing perspectives on the nature of support they desired, including proactive communication from providers and variety and flexibility in the behavioral supports offered. Conclusions Findings have important implications for the provision of behavioral supports for families in primary care, underlying the need to increase parents’ access to IBH services by proactively providing evidence-based resources and continuing to offer telehealth support.