Addressing behavioral health issues during well child visits by pediatric residents

Area of Science:

• Pediatrics
• Behavioral Health
• Child Psychology

Background:

• Pediatric residents provide crucial care during well-child visits.
• Psychosocial care is an integral component of comprehensive pediatric healthcare.
• Effective identification and management of behavioral health issues in children are essential.

Purpose of the Study:

• To examine pediatric residents' practices regarding psychosocial care during well-child visits.
• To determine the frequency and types of behavioral health issues discussed.
• To analyze resident management strategies for identified behavioral health concerns.

Main Methods:

• A review of medical records from a random sample of well-child visits (n=719).
• Analysis of practices by 61 pediatric residents.
• Logistic regression to identify factors influencing treatment or referral.

Main Results:

• Behavioral health issues were discussed in 38% of visits.
• Medically focused problems were most frequent; mood-related problems were rare (<1%).
• Residents treated 67% of cases and referred 20%; they were more likely to treat medical problems and refer social/environmental or learning issues.

Conclusions:

• Pediatric residents' current practices indicate a gap in addressing certain psychosocial concerns, particularly mood disorders.
• There is a need for enhanced training in recognizing internalizing disorders in pediatric patients.
• Current management strategies may be biased towards medically focused problems over social or emotional ones.