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Parents' Preferences for Primary Care-Based Behavioral Services and the COVID-19 Pandemic: A Mixed Method Study
Katherine A Hails1, Brianna C Wellen2, Marisa Simoni3
1Prevention Science Institute, University of Oregon, USA.
Insights
The COVID-19 pandemic worsened family functioning, increasing parents' desire for integrated behavioral health (IBH) support. Lower SES and minority parents showed more interest in IBH services, highlighting the need for accessible telehealth options.
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.
Objective:
This study examined how family factors impacted parents' attitudes toward integrated behavioral health (IBH) in pediatric primary care during the COVID-19 pandemic. We hypothesized that COVID-19 impact would predict family functioning challenges, and that pre-existing familial contextual factors would predict parents' interest in IBH modalities.
Methods:
Parents of children ages 1.5-5 years (N = 301) from five primary care clinics completed a survey with measures assessing familial contextual factors (income, race and ethnicity, and parents' childhood adversity), COVID-19 impact on family relationships and wellbeing, family functioning (child behavior, parenting self-efficacy, and parent psychological functioning), and parents' preferences for behavioral support in primary care. A subsample of parents (n = 23) completed qualitative interviews to provide deeper insights into quantitative relationships.
Results:
Higher COVID-19 impact was significantly associated with worse parent mental health and child behavior problems, as well as lower interest in IBH virtual support options. Overall, lower SES and racial and/or ethnic minority parents both indicated greater interest in IBH modalities compared to higher SES and White parents, respectively. Qualitative interviews identified how pandemic stressors led to increases in parents' desire for behavioral support from pediatricians, with parents sharing perspectives on the nature of support they desired, including proactive communication from providers and variety and flexibility in the behavioral supports offered.
Conclusions:
Findings have important implications for the provision of behavioral supports for families in primary care, underlying the need to increase parents' access to IBH services by proactively providing evidence-based resources and continuing to offer telehealth support.
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