Integrated Behavioral Health Increases Well-Child Visits and Immunizations in the First Year
Robert T Ammerman1,2, Rachel Herbst1,2, Constance A Mara1,2
1Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, USA.
Insights
Integrated behavioral health (IBH) prevention encounters during well-child visits (WCVs) improve WCV adherence and early childhood immunization rates. This approach positively impacts child health outcomes by addressing family concerns.
Area of Science:
- Pediatric primary care
- Behavioral health integration
- Public health
Background:
- Well-child visits (WCVs) are crucial for monitoring child development and administering immunizations.
- Integrated behavioral health (IBH) models aim to address psychosocial needs within primary care settings.
- Adherence to WCV schedules and timely immunizations are key indicators of early childhood health.
Purpose of the Study:
- To determine if IBH prevention encounters during WCVs are associated with increased WCV adherence and timely immunizations in the first year of life.
- To evaluate the impact of IBH on pediatric healthcare utilization and preventive care completion.
Main Methods:
- A retrospective study analyzed data from 813 children in an urban, low-income pediatric clinic using the HealthySteps model.
- Electronic health records were used to extract data on WCV attendance, IBH encounters, immunization status at 5 and 14 months, and demographic/risk factors.
- Statistical analyses controlled for covariates to assess associations between IBH encounters and health outcomes.
Main Results:
- Children receiving IBH prevention encounters showed significantly higher odds of attending 6, 9, and 12-month WCVs.
- Each IBH encounter in the first four months was associated with a 1.52 odds ratio for immunization completion by 5 months (p = .001).
- Association with immunization completion at 14 months was not statistically significant (OR = 1.18, p = .059).
Conclusions:
- IBH prevention encounters are linked to improved adherence to WCV schedules in the first year.
- IBH positively influences early childhood immunization completion, particularly by 5 months of age.
- These findings support IBH's broad positive impact on child health through strong family relationships and addressing behavioral concerns during WCVs.
Objective:
To assess whether integrated behavioral health (IBH) prevention encounters provided during well-child visits (WCVs) is associated with increased adherence to WCVs and timely immunizations in the first year.
Methods:
Data were collected in an urban pediatric primary care clinic serving a low-income population and using the HealthySteps model. Subjects were 813 children who attended a newborn well-child visit between January 13, 2016 and August 8, 2017. Data from the electronic health record was extracted on attendance at six well-child visits in the first year of life, IBH prevention encounters by the HealthySteps specialist, completion of immunizations at 5 and 14 months, and demographics and social and clinical risk factors.
Results:
After controlling for covariates, odds of attendance at 6, 9, and 12-month WCVs were significantly higher for those who had IBH prevention encounters at previous WCVs. Odds of immunization completion by 5 months was associated with number of IBH prevention encounters in the first 4 months (OR = 1.52, p = .001) but not immunization completion at 14 months (OR = 1.18, p = .059).
Conclusions:
IBH prevention encounters were associated with increased adherence to WCVs in the first year and vaccine completion at 5 months of age. These findings are consistent with IBH having a broad positive effect on child health and health care through strong relational connections with families and providing value in addressing emotional and behavioral concerns in the context of WCVs.
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