Latent class analysis of behavioral health service use among underserved youth in integrated primary care

To identify distinct and heterogeneous typologies of behavioral health service use and associated factors based on need, predisposing, and enabling determinants, among a predominantly Black and publicly insured youth population in integrated pediatric primary care (IPPC). This study aims to address the unmet behavioral health needs of youth by understanding the characteristics associated with behavioral health engagement in order to tailor interventions accordingly.

Latent class analysis was used to explore distinct subgroups among 416 youth (M_age = 10.81, SD_age = 3.74; 51% female; 74% Black; 74% public insurance) receiving integrated behavioral health services in a large, urban pediatric primary care setting in the Southeastern United States. Caregivers completed the Pediatric Symptom Checklist-17 to assess psychosocial problems in youth.

Latent class analyses revealed two distinct classes of IPPC youth: "high attention and mixed problems," primarily younger boys with nonprivate insurance coverage, and "low attention/externalizing and moderate internalizing problems," primarily older girls with private insurance coverage.

These findings highlight the need for behavioral health services in IPPC for behavioral health specialists, pediatricians, and other interdisciplinary professionals to provide tailored, culturally responsive, and flexible treatment to address the unmet and unique behavioral health needs of this population. (PsycInfo Database Record (c) 2026 APA, all rights reserved).