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Collaborative care outcomes for pediatric behavioral health problems: a cluster randomized trial

David J Kolko1, John Campo, Amy M Kilbourne

  • 1Departments of Psychiatry.

Pediatrics
|March 26, 2014
PubMed

Insights

Collaborative care significantly improved behavior problems and ADHD symptoms in children. This integrated approach in pediatric practices proved effective for managing behavioral health conditions.

Area of Science:

  • Pediatric primary care
  • Behavioral health integration
  • Child psychology

Background:

  • Behavioral and attention-deficit/hyperactivity disorder (ADHD) problems are prevalent in children.
  • Existing care models often face challenges in providing timely and effective interventions.
  • Integrated behavioral health care aims to improve access and outcomes within primary care settings.

Purpose of the Study:

  • To evaluate the efficacy of Doctor Office Collaborative Care (DOCC) for pediatric behavior problems, ADHD, and anxiety.
  • To compare DOCC with enhanced usual care (EUC) in community pediatric practices.

Main Methods:

  • Cluster randomized trial involving 8 pediatric practices with 321 children and caregivers.
  • DOCC group received care from a dedicated care manager.
  • EUC group received psychoeducation and facilitated specialty care referral.
  • Data collected at baseline and 6, 12, and 18 months.

Main Results:

  • DOCC demonstrated significantly higher treatment initiation (99.4% vs 54.2%) and completion rates (76.6% vs 11.6%).
  • Improvements observed in behavior problems, hyperactivity, internalizing problems, and parental stress in the DOCC group.
  • Higher rates of remission, goal attainment, treatment response, and consumer satisfaction were noted with DOCC.

Conclusions:

  • Collaborative care models like DOCC are feasible and effective in community pediatric settings.
  • Integrated behavioral health care services show significant utility for managing child behavioral health issues.
  • The study supports the broader adoption of collaborative care for improved pediatric outcomes.
Abstract

Keywords:
clinical trialscollaborative careevidence-based practiceintegrated behavioral health servicespediatric behavioral health problems

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