Parents' Preferences for Primary Care-Based Behavioral Services and the COVID-19 Pandemic: A Mixed Method Study

Area of Science:

• Pediatric primary care
• Behavioral health integration
• Family psychology

Background:

• The COVID-19 pandemic significantly impacted family functioning and parental well-being.
• Understanding parental attitudes towards integrated behavioral health (IBH) is crucial for effective pediatric care.
• Family factors play a role in shaping parental preferences for healthcare services.

Purpose of the Study:

• To examine how family factors influenced parents' attitudes toward integrated behavioral health (IBH) in pediatric primary care during the COVID-19 pandemic.
• To investigate the relationship between COVID-19's impact on families and their interest in IBH.
• To explore how pre-existing family characteristics predict interest in different IBH modalities.

Main Methods:

• Survey administered to 301 parents of children aged 1.5-5 years across five primary care clinics.
• Assessment of familial contextual factors (income, race/ethnicity, childhood adversity), COVID-19 impact, family functioning, and IBH preferences.
• Qualitative interviews with 23 parents to gain deeper insights into quantitative findings.

Main Results:

• Increased COVID-19 impact correlated with poorer parent mental health and child behavior, and reduced interest in virtual IBH support.
• Parents from lower socioeconomic status (SES) and racial/ethnic minority backgrounds expressed greater interest in IBH modalities.
• Qualitative data revealed pandemic stressors heightened the need for pediatrician-provided behavioral support, emphasizing desired provider communication and service flexibility.

Conclusions:

• Findings underscore the importance of enhancing parental access to IBH services in primary care.
• Proactive provision of evidence-based resources and continued telehealth support are essential for meeting families' behavioral health needs.
• Tailoring IBH services to address diverse family needs and preferences is critical for successful implementation.