Lost in Translation: Identifying Behavioral Health Disparities in Pediatric Primary Care

Area of Science:

• Pediatric primary care
• Health disparities
• Behavioral health integration

Background:

• Medical homes improve parental satisfaction and healthcare utilization.
• Persistent racial/ethnic and language disparities exist in healthcare settings.
• Integrated, team-based care models can reduce health disparities.

Purpose of the Study:

• To examine disparities in clinician-identified presenting concerns and recommendations.
• To investigate differences across English-, Spanish-, and Other-language-speaking families.
• To analyze factors in medical record documentation across language groups and provider types.

Main Methods:

• Retrospective analysis of 2,353 youth medical records.
• Study conducted in an urban, pediatric primary care clinic with behavioral health consultation.
• Three-phase, mixed-method approach to data examination.

Main Results:

• Significant disparities found among language groups in presenting concerns.
• Referral rates to behavioral health services varied by language group.
• Medical record documentation differed across language groups and by provider type.

Conclusions:

• Language barriers contribute to disparities in behavioral health identification and referral.
• Further research is needed to address psychosocial concerns for limited English proficiency (LEP) families.
• Development of evidence-based primary care approaches for LEP families is essential.