Mission: The center seeks sustainable ways to increase primary care providers'capacity to improve function, reduce distress, and prevent disability among children with mental health problems. Background: The mental health issues treated in pediatric primary care are characterized by high prevalence and a preponderance of children with impairment but without a diagnosis. Parent distress frequently complicates children's mental health problems and requires simultaneous attention. The ability to engage families around their needs promotes access to treatment and contributes to reducing ethnic (disparities. Goal and specific aims: The Center will develop an evidence-based model for mental health in primary care that 1) applies to the range of problems seen in primary care, 2) engages existing skills and knowledge of families and pediatric providers, and 3) results in sustainable increases in the mental health treatment capacity of primary care.
Its specific aims are to: 1) adapt Wagner's Chronic Care Model (CCM) of primary care mental health service to include treatment based on """"""""common factors"""""""" and """"""""common treatment elements."""""""";la) within the CCM's 5 domains, address priority research needs related to the impact of common factors and their implementation in office practice;lb) develop packages of practical interventions, built around domains of the adapted CCM, for larger scale trials in pediatric primary care;2) develop measurements, study designs and analytic methods to efficiently assess outcomes in community settings;and 3) stimulate innovation in pediatric mental health services through multidisciplinary and community-academic collaboration, attracting new and diverse scholars and providing a resource for scientists, policy makers, and advocates. Methods: The Center's faculty is a team of pediatricians, psychologists, psychiatrists, and other scholars from six institutions that include rural, suburban, and urban settings. Their work is informed by ties to the American Academy of Pediatrics'Task Force on Mental Health and leaders in state mental health policy. Guidance and focus come from a community advisory committee and a national scientific advisory board. Research Methods Core studies address priority questions about the evidence base for common factors, the burden of mental health care, and feasible clinical data systems. Principal Research Core studies test complementary common factors approaches for children with anxiety problems. The Operations Core promotes recruiting underrepresented trainees, meaningful community interaction, quality control, and innovative study design.

Public Health Relevance

The Center's work develops a model of mental health prevention and treatment that can be practically implemented in pediatric primary care. The model has the potential to make care available to populations that currently have limited access to specialized mental health services. It will create a resource for other researchers in this field and lay the groundwork for larger scale, community-based trials.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Exploratory Grants (P20)
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Special Emphasis Panel (ZMH1-ERB-B (01))
Program Officer
Pringle, Beverly
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Johns Hopkins University
Public Health & Prev Medicine
Schools of Public Health
United States
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King, Melissa A; Wissow, Lawrence S; Baum, Rebecca A (2018) The role of organizational context in the implementation of a statewide initiative to integrate mental health services into pediatric primary care. Health Care Manage Rev 43:206-217
Brown, Jonathan D; King, Melissa A; Wissow, Lawrence S (2017) The Central Role of Relationships With Trauma-Informed Integrated Care for Children and Youth. Acad Pediatr 17:S94-S101
Wissow, Lawrence S; Zafar, Waleed; Fothergill, Kate et al. (2016) Using vignettes to assess contributions to the work of addressing child mental health problems in primary care. BMC Health Serv Res 15:584
Ginsburg, Golda S; Drake, Kelly; Winegrad, Heather et al. (2016) An Open Trial of the Anxiety Action Plan (AxAP): A Brief Pediatrician-Delivered Intervention for Anxious Youth. Child Youth Care Forum 45:19-32
Arora, Prerna G; Stephan, Sharon Hoover; Becker, Kimberly D et al. (2016) Psychosocial interventions for use in pediatric primary care: An examination of providers' perspectives. Fam Syst Health 34:414-423
Wissow, Lawrence S; van Ginneken, Nadja; Chandna, Jaya et al. (2016) Integrating Children's Mental Health into Primary Care. Pediatr Clin North Am 63:97-113
Gadomski, Anne M; Fothergill, Kate E; Larson, Susan et al. (2015) Integrating mental health into adolescent annual visits: impact of previsit comprehensive screening on within-visit processes. J Adolesc Health 56:267-73
Larson, Justine Julia; Lynch, Sean; Tarver, Leslie Bishop et al. (2015) Do Parents Expect Pediatricians to Pay Attention to Behavioral Health? Clin Pediatr (Phila) 54:888-93
Kim, Rachel E; Becker, Kimberly D; Stephan, Sharon H et al. (2015) Connecting Students to Mental Health Care: Pilot Findings from an Engagement Program for School Nurses. Adv Sch Ment Health Promot 8:87-103
Biel, Matthew G; Kahn, Nicole F; Srivastava, Anjuli et al. (2015) Parent Reports of Mental Health Concerns and Functional Impairment on Routine Screening With the Strengths and Difficulties Questionnaire. Acad Pediatr 15:412-20

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