综合行为健康服务和儿童的社会心理症状
Jihye Kim1, Megan B Cole2, Jessica Rosenberg1
1Research Support Services Department, Boston Medical Center, Boston, Massachusetts.
JAMA network open
|September 16, 2025
概括
综合行为健康服务,包括行为健康临床医生 (BHC) 接触和精神药物处方,改善了儿童的社会心理症状. 这凸显了为边缘化儿科人口扩展这些服务的潜力.
科学领域:
- 儿科行为健康 儿科行为健康
- 医疗保健服务研究 医疗服务研究
- 公共卫生 公共卫生
背景情况:
- 综合儿科行为健康护理至关重要,但研究不足,特别是使用电子病历 (EMR) 数据.
- 联邦合格卫生中心 (FQHCs) 是向服务不足的人群提供综合护理的关键地点.
研究的目的:
- 评估综合行为健康服务与FQHC儿童心理社会症状变化之间的关联.
- 评估特定干预措施的影响,如行为健康临床医生 (BHC) 接触,社区卫生工作者 (CHW) 接触和精神药物处方.
主要方法:
- 一项使用来自马萨诸塞州4个FQHC的EMR数据的队列研究 (2020年6月至2023年4月).
- 包括4至18岁的儿童,有已确定的行为健康问题.
- 倾向性得分匹配被用来比较接受干预措施的儿童 (BHC遭遇,CHW遭遇,精神药物处方) 与对照组.
主要成果:
- 接受BHC接触的儿童在儿科症状检查清单 (PSC-17) 得分 (-1.51分) 中显著下降.
- 精神药物处方也与PSC-17分数的显著降低有关 (-2.21分).
- 在接受CHW接触的儿童中,没有观察到PSC-17得分的显著变化.
结论:
- 综合行为健康服务,特别是BHC接触和精神药物,与在FQHC治疗的儿童中改善心理社会结果有关.
- 扩大综合儿科行为健康护理可以提高边缘化儿科人口的结果.
- 需要进一步的研究来优化FQHC中CHW服务的整合.
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