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01-01-2019

Do Subspecialists Ask About and Refer Families with Psychosocial Concerns? A Comparison with General Pediatricians

Authors: Cori Green, Ruth E. K. Stein, Amy Storfer-Isser, Andrew S. Garner, Bonnie D. Kerker, Moira Szilagyi, Kimberly E. Hoagwood, Sarah M. Horwitz

Published in: Maternal and Child Health Journal | Issue 1/2019

Abstract

Objectives Calls for pediatricians to tend to children’s psychosocial concerns have existed for decades because they are known to negatively impact child health. Children with chronic illnesses frequently have child- and family-level psychosocial concerns that complicate the care provided by their pediatric subspecialists. This study compares pediatricians who exclusively practice general pediatrics with subspecialists regarding their inquiring/screening and referring for psychosocial concerns. Physician and practice characteristics associated with these behaviors were examined. Methods We conducted a cross-sectional study using the 2013 American Academy of Pediatrics Periodic Survey of Fellows. Respondents included 304 pediatricians who exclusively practice general pediatrics and 147 subspecialists. The primary analysis compared the current practices of generalists vs. subspecialists with regard to inquiring/screening and referring children with 10 different psychosocial concerns. Covariates included socio-demographics, practice characteristics, and training experiences. Weighted univariate, bivariate and multivariable analyses were performed. Results Less than half of all pediatricians in the sample reported routinely inquiring/screening for most psychosocial concerns, and 2/3 of subspecialists failed to routinely inquire/screen for most of these conditions. Pediatricians who practice general pediatrics exclusively were more likely to inquire/screen (incident rate ratio (IRR) 1.41, p < .05) and refer (IRR 1.59, p < .001) for a greater number of psychosocial concerns than subspecialists, after adjusting for provider and practice characteristics. Having attended a child or adolescent mental health (MH) lecture/conference in the past 2 years was also related to inquiring/screening (IRR 1.24, p < .05). Conclusions Pediatricians infrequently inquire/screen and refer psychosocial concerns, with subspecialists addressing these concerns even less frequently.

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Title: Do Subspecialists Ask About and Refer Families with Psychosocial Concerns? A Comparison with General Pediatricians
Authors: Cori Green
Ruth E. K. Stein
Amy Storfer-Isser
Andrew S. Garner
Bonnie D. Kerker
Moira Szilagyi
Kimberly E. Hoagwood
Sarah M. Horwitz
Publication date: 01-01-2019
Publisher: Springer US
Published in: Maternal and Child Health Journal / Issue 1/2019
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI: https://doi.org/10.1007/s10995-018-2594-y

At a glance: The STEP trials

Springer Medicine

Do Subspecialists Ask About and Refer Families with Psychosocial Concerns? A Comparison with General Pediatricians

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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