Related Experiment Videos
Primary care clinicians' use of standardized tools to assess child psychosocial problems
William Gardner1, Kelly J Kelleher, Kathleen A Pajer
1Department of Medicine and Center for Research on Health Care, University of Pittsburgh, Pittsburgh, PA 15213-2593, USA. gardnerwp@msx.upmc.edu
Insights
Primary care clinicians infrequently use standardized tools for children's psychosocial problems, even when identified. This limits accurate diagnosis and management of these common childhood issues.
Area of Science:
- Pediatric Primary Care
- Child Psychology
- Healthcare Quality Improvement
Background:
- Childhood psychosocial problems are common but frequently misdiagnosed in primary care settings.
- Accurate identification is crucial for timely intervention and improved child well-being.
- Existing standardized tools offer potential for more consistent assessment.
Purpose of the Study:
- To investigate the utilization rates of standardized assessment tools by primary care clinicians (PCCs).
- To identify factors associated with the use or non-use of these tools for children's psychosocial problems.
- To understand current practices in screening, confirming, and monitoring psychosocial issues in pediatric primary care.
Main Methods:
- Analysis of data from 21,065 pediatric visits (ages 4-15) across 204 practices.
- Inclusion of 3,934 children identified by PCCs as having psychosocial problems.
- Primary outcome measured: PCC usage of standardized tools for psychosocial problem assessment.
Main Results:
- Standardized tools were used in only 20.2% of visits where a psychosocial problem was recognized.
- Fifty percent of PCCs reported never using such tools.
- Tool usage was lower among female PCCs, family practitioners, and for girls and African American children; higher for attention problems and when the PCC had prior knowledge.
Conclusions:
- Primary care clinicians demonstrate infrequent use of standardized tools for pediatric psychosocial problems.
- This underutilization may contribute to diagnostic inaccuracies and suboptimal care.
- Further research and implementation strategies are needed to promote tool adoption in pediatric primary care.
Background And Objectives:
Children's psychosocial problems are prevalent but often inaccurately diagnosed. This study investigated primary care clinicians' (PCCs) use of standardized tools for psychosocial problems among children in whom they reported finding a problem.
Methods:
The data consisted of 21 065 unique visits by children ages 4 to 15 years in 204 practices. Parents completed questionnaires before seeing the PCCs, who completed a survey after the visit. This analysis included 3934 children who were recognized by PCCs as having one or more psychosocial problems. The primary outcome was the PCCs' usage of a tool to assess child psychosocial problems.
Results:
PCCs used a tool in 20.2% of visits where a psychosocial problem was recognized, whereas 50% of PCCs never used such tools. Tools were less likely to be used by female PCCs and family practitioners and were less likely to be used with girls and African American children. Tools were more frequently used with children with attention problems, during visits for psychosocial problems, and when the PCC knew about the problem before the visits.
Conclusions:
PCCs use standardized tools infrequently to screen for, confirm, or monitor psychosocial problems.