Reported Physician Skills in the Management of Children's Mental Health Problems Following an Educational Intervention

Laraque, Danielle; Adams, Richard; Steinbaum, Deborah; Zuckerbrot, Rachel; Schonfeld, David; Jensen, Peter S.; Demaria, Thomas; Barrett, Minna; Dela-Cruz, Maan; Boscarino, Joseph A.

doi:10.1016/j.acap.2009.01.009

« Previous Next »Academic Pediatrics
Volume 9, Issue 3 , Pages 164-171, May 2009

Reported Physician Skills in the Management of Children's Mental Health Problems Following an Educational Intervention

Mount Sinai School of Medicine, Division of General Pediatrics, New York, NY (Dr Laraque, Dr Adams, Dr Steinbaum, Mr Dela-Cruz, and Dr Boscarino); Department of Sociology, Kent State University, Kent, Ohio (Dr Adams); College of Physicians and Surgeons, Columbia University, New York, NY (Dr Zuckerbrot); Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (Dr Schonfeld); The REACH Institute, New York, NY (Dr Jensen); South Nassau Communities Hospital, Manhasset, NY (Dr Demaria); State University of New York, Stony Brook, NY (Dr Barrett); and Henry Hood Center for Health Research, Geisinger Clinic, Danville, Pa (Dr Boscarino)

Received 3 September 2008; accepted 31 January 2009.

Objective

The tristate Reaching Children Initiative (RCI) was designed to engage primary care physicians (PCPs) and increase reported knowledge and skills in the diagnosis and management of the most common mental health (MH) problems among children and adolescents.

Methods

PCPs responded to a baseline survey and agreed to participate in an educational intervention or serve in a comparison group. The program, delivered by an interdisciplinary faculty, engaged the audience in role play, motivational techniques, and didactics. To assess the overall effectiveness of the intervention, baseline, and 6-month follow-up, surveys asked PCPs to rate their knowledge, diagnostic skills regarding socioemotional problems, knowledge of treatment strategies for these problems, awareness of MH resources, and attitudes towards diagnosing and treating MH problems.

Results

Of the 215 baseline respondents, 137 chose to participate in the educational intervention and 78 served as a comparison group; of these, 64% and 59%, respectively, completed the 6-month survey. The overall sample was predominantly female (70.2%), white (64.7%), and had been in practice for over 10 years (57.5%). Repeated measures analysis, confirmed by propensity analyses, revealed significantly improved reported mean scores for diagnostic skills and knowledge of clinical strategies for the intervention relative to the comparison group. The intervention did not significantly impact awareness of resources or attitudes.

Conclusions

Following the RCI, PCPs did report significant changes in self-efficacy specific to diagnostic skills and knowledge of clinical treatment strategies for targeted MH content. This educational approach merits further study.

Key Words: anxiety, child, depression, mental health, post-traumatic stress