Top

Published in:

Open Access 01-10-2018

Enhancing Early Childhood Mental Health Primary Care Services: Evaluation of MA Project LAUNCH

Authors: Beth E. Molnar, Kristin E. Lees, Kate Roper, Natasha Byars, Larisa Méndez-Peñate, Christy Moulin, William McMullen, Jessica Wolfe, Deborah Allen

Published in: Maternal and Child Health Journal | Issue 10/2018

Abstract

Objectives The purpose of this study was to evaluate the efficacy of an innovative early childhood mental health intervention, Massachusetts Project LAUNCH. Early childhood mental health clinicians and family partners (paraprofessionals with lived experience) were embedded within community pediatric medical homes. Methods A longitudinal study design was used to test the hypotheses that (1) children who received services would experience decreased social, emotional and behavioral problems over time and (2) caregivers’ stress and depressive symptoms would decrease over time. Families who were enrolled in services and who consented to participate in the evaluation study were included in analyses (N = 225). Individual growth models were used to test longitudinal effects among MA LAUNCH participants (children and caregivers) over three time points using screening tools. Results Analyses showed that LAUNCH children who scored in age-specific clinically significant ranges of social, emotional and behavioral problems at Time 1 scored in the normal range on average by Time 3. Caregivers’ stress and depressive symptoms also declined across the three time points. Results support hypotheses that the LAUNCH intervention improved social and emotional health for children and caregivers. Conclusions for Practice This study led to sustainability efforts, an expansion of the model to three additional communities across the state and development of an online toolkit for other communities interested in implementation.

Abidin, R. R. (1995). Parenting stress index, third edition: professional manual. Odessa, FL: Psychological Assessment Resources.

Achenbach, T., & Rescorla, L. (2008). Manual for the ASEBA School-Age Forms & Profiles: an integrated system of multi-informant assessment. Burlington, VT: University of Vermont.

Ader, J., Stille, C. J., Keller, D., Miller, B. F., Barr, M. S., & Perrin, J. M. (2015). The medical home and integrated behavioral health: Advancing the policy agenda. Pediatrics, 135(5), 909–917.CrossRefPubMed

American Academy of Child and Adolescent Psychiatry. (2010). A guide to building collaborative mental health care partnerships in pediatric primary care. Retrieved March 15, 2017, from https://www.aacap.org/App_Themes/AACAP/docs/clinical_practice_center/guide_to_building_collaborative_mental_health_care_partnerships.pdf.

American Academy of Pediatrics. (n.d.). Salud para todos improving health through medical homes. Retrieved from https://medicalhomeinfo.aap.org/tools-resources/Documents/RI%20FactSheet.pdf.

Bayer, J. K., Ukoumunne, O. C., Lucas, N., Wake, M., Scalzo, K., & Nicholson, J. M. (2011). Risk factors for childhood mental health symptoms: National longitudinal study of Australian children. Pediatrics, 128(4), e865–e879.CrossRef

Boston Public Health Commission. (2014). Early childhood mental health toolkit: Integrating mental health services into the pediatric medical home. Retrieved March 15, 2017, from http://www.ecmhmatters.org/ForProfessionals/Pages/MedicalHome.aspx.

Brauner, B. C., & Bowers, S. C. (2006). Estimating the prevalence of early childhood serious emotional/behavioral disorders: Challenges and recommendations. Public Health Reports, 121, 303–310.CrossRefPubMedPubMedCentral

Breysse, J., Dixon, S., Gregory, J., Philby, M., Jacobs, D. E., & Krieger, J. (2014). Effect of weatherization combined with community health worker in-home education on asthma control. American Journal of Public Health, 104, e57–e64.CrossRef

Briggs, R. D., Stettler, E., Silver, E., Schrag, R., Nayak, M., Chinitz, S., & Racine, A. D. (2012). Social-emotional screening for infants and toddlers in primary care. Pediatrics, 129(2), E377–E384.CrossRef

Bruns, E. J., & Walker, J. S. (Eds.) (2008). The resource guide to wraparound. Portland, OR: National Wraparound Initiative, Research and Training Center for Family Support and Children’s Mental Health. Retrieved March 15, 2017, from https://nwi.pdx.edu/NWI-book/Chapters/COMPLETE-RG-BOOK.pdf.

Cournos, F., & Goldfinger, S. M. (2014). Family partners improve early childhood mental health services. Psychiatric Services, 65(11), 1376.CrossRef

Foy, J. M. (2010). Enhancing pediatric mental health care: Report from the American Academy of Pediatrics Task Force on Mental Health. Introduction. Pediatrics, 3, S69–S74.

Garner, A. S., Shonkoff, J. P., Siegel, B. S., Dobbins, M. I., Earls, M. F., Garner, A. S., … Wood, D. L. (2012). Early childhood adversity, toxic stress, and the role of the pediatrician: Translating developmental science into lifelong health. Pediatrics, 129(1), e224–e231. https://doi.org/10.1542/peds.2011-2662.CrossRef

Gilkey, M., Garcia, C. C., & Rush, C. (2011). Professionalization and the experience-based expert: Strengthening partnerships between health educators and community health workers. Health Promotion Practice, 12(2), 178–182.CrossRefPubMed

Godoy, L., Carter, A. S., Silver, R. B., Dickstein, S., & Seifer, R. (2014). Mental health screening and consultation in primary care: The role of child age and parental concerns. Journal of Devevelopmental and Behavior Pediatrics, 35(5), 334–343.9.CrossRef

Goodman, A., Joyce, R., & Smith, J. P. (2011). The long shadow cast by childhood physical and mental problems on adult life. Proceedings of the National Academy Sciences of the United States of America, 108(15), 6032–6037.CrossRef

Horwitz, S. M., Kelleher, K. J., Stein, R. E., Storfer-Isser, A., Youngstrom, E. A., Park, E. R.,… Hoagwood, K. E. (2007). Barriers to the identification and management of psychosocial issues in children and maternal depression. Pediatrics, 119(1), e208–e218.CrossRef

Huang, F., Chung, H., Kroenke, K., Delucchi, K., & Spitzer, R. (2006). Using the Patient Health Questionnaire-9 to measure depression among racially and ethnically diverse primary care patients. Journal of General Internal Medicine, 21(6), 547–552.CrossRefPubMedPubMedCentral

Justvig, S. P., Li, J., Caravella, G., Chen, M., Wang, H., Benz Scott, L. A., & Pati, S. (2017). Improving adherence to care recommendations using a community health worker (CHW) intervention with the pediatric medical home. Journal of Community Health, 42, 444–452.CrossRefPubMed

Kroenke, K., Spitzer, R. L., Williams, J. B. W., & Löwe, B. (2010). The patient health questionnaire somatic, anxiety, and depressive symptom scales: A systematic review. General Hospital Psychiatry, 32(4), 345–359.CrossRefPubMed

Matiz, L. A., Peretz, P. J., Jacotin, P. G., Cruz, C., Ramirez-Diaz, E., & Nieto, A., R (2014). The impact of integrating community health workers into the patient-centered medical home. Journal of Primary Care and Community Health, 5(4), 271–274.CrossRefPubMed

Meltzer-Brody, S. (2011). New insights into perinatal depression: Pathogenesis and treatment during pregnancy and postpartum. Dialogues in Clinical Neuroscience, 13(1), 89–100.PubMedPubMedCentral

Nakamura, B. J., Ebesutani, C., Bernstein, A., & Chorpita, B. F. (2008). A psychometric analysis of the child behavior checklist DSM-oriented scales. Journal of Psychopathology and Behavioral Assessment, 31(3), 178–189.CrossRef

Oppenheim, J., Stewart, W., Zoubak, E., Donato, I., Huang, L., & Hudock, W. (2016). Launching forward: The integration of behavioral health in primary care as a key strategy for promoting young child wellness. American Journal of Orthopsychiatry, 86(2), 124–131.CrossRefPubMed

Reitman, D., Currier, R. O., & Stickle, T. (2002). A critical evaluation of the parenting stress index-short form (PSI-SF) in a Head Start population. Journal of Clinical Child and Adolescent Psychology, 31(3), 384–392.CrossRefPubMed

Sharp, C., & Fonagy, P. (2008). The parent’s capacity to treat the child as a psychological agent: Constructs, measures and implications for developmental psychopathology. Social Development, 17(3), 737–754.CrossRef

Spijkers, W., Jansen, D. E., & Reijneveld, S. A. (2013). Effectiveness of primary care Triple P on child psychosocial problems in preventive child healthcare: A randomized controlled trial. BMC Medicine. https://doi.org/10.1186/1741-7015-11-240.

Squires, J., Bricker, D., Heo, K., & Twombly, E. (2001). Identification of social-emotional problems in young children using a parent-completed screening measure. Early Childhood Research Quarterly, 16, 405–419.CrossRef

Squires, J., Bricker, D., & Twombly, E. (2002). The ASQ:SE user’s guide: For the Ages & Stages Questionnaires: Social-emotional. Baltimore: Paul H Brookes.

Thompson, R., Tabone, J. K., Litrownik, A. J., Briggs, E. C., Hussey, J. M., English, D. J., & Howard, D. (2011). Early adolescent risk behavior outcomes of childhood externalizing behavioral trajectories. The Journal of Early Adolescence, 31(2), 234–257.CrossRef

Tyler, E. T., Hulkower, R. L., & Kaminski, J. W. (2017). Milbank memorial fund. Behavioral health integration in pediatric primary care: Considerations and opportunities for policymakers, planners, and providers. Retrieved March 15, 2017, from https://www.milbank.org/publications/behavioral-health-integration-in-pediatric-primary-care-considerations-and-opportunities-for-policymakers-planners-and-providers/.

Volkmann, K., & Castanares, T. (2011). Clinical community health workers: linchpin of the medical home. The Journal of Ambulatory Care Management, 34(3), 221–233.CrossRefPubMed

Wolfinger, R., & Chang, M. (1995) Comparing the SAS® GLM and MIXED procedures for repeated measurements analysis. Retrieved March 15, 2017, from https://support.sas.com/rnd/app/stat/papers/abstracts/mixedglm.html.

Zbar, A., Surkan, P. J., Fombonne, E., & Melchior, M. E. (2016). Emotional and behavioral difficulties and adult educational attainment: An 18-year follow-up of the TEMPO study. European Child and Adolescent Psychiatry, 25(10), 1141–1143.CrossRefPubMed

Title: Enhancing Early Childhood Mental Health Primary Care Services: Evaluation of MA Project LAUNCH
Authors: Beth E. Molnar
Kristin E. Lees
Kate Roper
Natasha Byars
Larisa Méndez-Peñate
Christy Moulin
William McMullen
Jessica Wolfe
Deborah Allen
Publication date: 01-10-2018
Publisher: Springer US
Published in: Maternal and Child Health Journal / Issue 10/2018
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI: https://doi.org/10.1007/s10995-018-2548-4

At a glance: The STEP trials

Springer Medicine

Enhancing Early Childhood Mental Health Primary Care Services: Evaluation of MA Project LAUNCH

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 10/2018

Newborn Screening Collection and Delivery Processes in Michigan Birthing Hospitals: Strategies to Improve Timeliness

Patient-Centered Medical Home and Receipt of Part C Early Intervention Among Young CSHCN and Developmental Disabilities Versus Delays: NS-CSHCN 2009–2010

The Effect of Paid Leave on Maternal Mental Health

Advancing Leadership Skills: A Multiyear Examination of LEND Trainee Self-Efficacy Growth

Evaluation of a Multilevel Intervention to Reduce Preterm Birth Among Black Women in Newark, New Jersey: A Controlled Interrupted Time Series Analysis

Physical Activity Patterns and Correlates of 9-Month-Old Chinese Infants in the Macau Population