(PS7-D95) Increasing Access and Utilization of Behavioral Health Services in the Primary Care Setting: A Feasibility Study of Phone-based Parent Management Training Using Trained Pediatric Nurses

Many young children struggle with disruptive behaviors such as physical and verbal aggression, defiance, poor cooperation, and temper tantrums (Bultas, 2016; Gomez et al., 2014) that impact their daily functioning at home, in school, or daycare settings.  Research suggests that 12% to 16% of children present to their primary care providers with behavioral health concerns (Briggs-Gowan et al., 2003; Polaha et al., 2011). Behavioral health services are being implemented in the primary care setting (Gomez et al., 2014; Kjobli & Ogden, 2012), which significantly aids with access to treatment. However, factors such as transportation, provider availability, provider training, and childcare during sessions still remain as barriers to access and utilization of such treatment. Accordingly, this quality improvement study examined the feasibility of the Support and Advocacy through Providing Parents Helpful Interventions, Resources, and Education (SAPPHIRE) program, a phone-based intervention for parents/guardians of young children with disruptive behaviors.
SAPPHIRE was delivered by pediatric primary care nurses who were trained by specialists in evidence-based parent management strategies. Eligible participants were parents/guardians of a child between the ages of 2 and 7, who had expressed concerns about their child’s behavior. Thirty-six parents/guardians were enrolled in SAPPHIRE through primary care and participated in at least one nurse call.
Preliminary results indicate high feasibility for this model of treatment with nurses spending an average of 120.8 minutes on behavioral health phone calls across a 3-month time span. Retention was high, with 31 (86%) parents/guardians completing the 3-month pilot. Additionally, both nurses and parents/guardians rated this model of treatment as highly acceptable, with parents/guardians on average rating the time spent in the SAPPHIRE program as “just right” and the phone-based format as “very convenient”. Even more, parents/guardians reported that they would be “very likely” to engage in the program if they were to go back, and that they were “absolutely” likely to recommend the program to family and friends with children experiencing behavioral health concerns. These preliminary results suggest that using a phone-based intervention with pediatric nurses in primary care is both a feasible and acceptable model of treatment. These findings will be essential for further developing treatment in the primary care setting, as well as useful for decreasing health care disparities by increasing access and utilization of treatment aimed at younger children.