Integrated Behavioral Health and Implementation of the Safe Environment for Every Kid Approach in Pediatric Primary...

Area of Science:

• Pediatric primary care
• Behavioral health integration
• Child maltreatment prevention

Background:

• Integrated behavioral health care (IBH) is increasingly adopted in pediatric settings.
• Safe Environment for Every Kid (SEEK) is an evidence-based approach to prevent child maltreatment.
• The association between IBH and the implementation of SEEK requires further investigation.

Purpose of the Study:

• To determine if integrated behavioral health care (IBH) in pediatric practices improves the implementation of the Safe Environment for Every Kid (SEEK) program.
• To explore the facilitators and barriers to implementing SEEK in pediatric primary care settings with and without IBH.

Main Methods:

• A longitudinal multisite trial involving 44 US pediatric practices, with half offering IBH.
• Semi-structured interviews with 49 practice leaders and staff.
• The Stages of Implementation Completion measure was used to collect quantitative data on implementation progress.

Main Results:

• Qualitative data indicated that IBH can facilitate SEEK adoption and implementation, and vice versa.
• Quantitative analyses showed no statistically significant differences in program startup rates, completion of implementation activities, or competency between practices with and without IBH.
• Practices with IBH experienced a longer duration for program startup.

Conclusions:

• Integrated behavioral health care may support the implementation of interventions addressing social determinants of health and reducing child maltreatment risk.
• Current quantitative findings do not provide significant evidence that IBH improves the uptake of SEEK.
• Further research is warranted to fully understand the impact of IBH on the implementation of programs like SEEK.