Parent Partners: Evaluation of a Novel Peer-Support Intervention for the Caregivers of Children Hospitalized for
Eric J Lammers1, Joseph S Zickafoose2, G Greg Peterson3
1Mathematica Policy Research (EJ Lammers), Oakland, Calif.
Insights
A new parent peer support program for caregivers of hospitalized children was successfully implemented. While not significantly impacting healthcare use post-discharge, findings suggest potential benefits for emergency department visits.
Area of Science:
- Child and Adolescent Psychiatry
- Health Services Research
- Implementation Science
Background:
- Nearly 10% of hospitalized children have primary behavioral health diagnoses.
- Caregiver challenges in navigating behavioral health systems can limit treatment effectiveness.
- A novel peer-support intervention was developed for caregivers of children in inpatient psychiatric units.
Purpose of the Study:
- To assess the implementation of a parent partner peer-support intervention.
- To evaluate the impact of the intervention on healthcare utilization after discharge.
Main Methods:
- Mixed-methods approach: document review, interviews, and difference-in-differences analysis of Medicaid claims.
- Compared children admitted to an intervention unit with matched children in comparison units.
- Assessed outpatient behavioral health visits, readmissions, and emergency department visits post-discharge.
Main Results:
- High caregiver engagement (96%) with parent partners was observed.
- Implementation challenges included parent partner's own child crises and clinician engagement.
- No statistically significant differences were found in outpatient visits, readmissions, or ED visits.
Conclusions:
- The parent partner intervention was successfully implemented in an inpatient psychiatric setting.
- While not statistically significant, emergency department visit findings suggest potential benefits.
- Further investigation of parent peer support in inpatient settings is warranted.
Objective:
Nearly 10% of all hospitalized children have a primary behavioral health diagnosis, but the effectiveness of treatment can be limited by caregivers' challenges navigating the behavioral health system. In this study, we assessed a novel peer-support intervention ("parent partners") designed for the caregivers of children admitted to an inpatient psychiatric unit.
Methods:
We used a mixed-methods approach including 1) document review and interviews to assess implementation and 2) a difference-in-differences analysis using claims for Medicaid-enrolled children admitted to the intervention inpatient psychiatric unit and matched comparison children admitted to other inpatient psychiatric units to assess the impacts on health care use after discharge.
Results:
Ninety-six percent of caregivers who were offered the intervention engaged with a parent partner. The primary challenges to implementation were accommodating the needs of parent partners to address behavioral health crises among their own children and initial limited engagement from behavioral health clinicians. The intervention leaders reported success in addressing these through adjustments to staffing policies, training parent partners in engagement with clinicians, and incorporating parent partners into team rounds. We did not find a statistically significant difference in follow-up outpatient behavioral health visits (adjusted treatment to comparison difference +3% [90% CI = -2%, +9%]), readmissions (+5% [-33%, +43%]), or behavioral health ED visits (-15% [-44%, +14%]).
Conclusions:
This novel intervention was implemented successfully, and although our study did not find statistically significant impacts on health care use after discharge, the findings for ED visits are suggestive of benefits. Parent peer support in inpatient settings warrants additional investigation.
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