National guidelines (e. g., American Academy of Pediatrics, 2002;New Freedom Commission, 2003) call for primary care clinicians to screen for and triage problems related to mental health, development, and family functioning. However, most clinicians lack the time to adequately perform these services and have limited information regarding available and appropriate screening tools, treatments, and referral options. The Child Health and Development Interactive System for Infants and Toddlers (CHADIS 0-3) is a web-based tool designed to assist pediatricians in better assessing and managing mental health and developmental problems among infants, toddlers, and their families, while also streamlining other requirements of the pediatric visit. Through CHADIS 0-3, parents complete questionnaires assessing child and family functioning online via a secure website. This information is summarized and translated to an electronic clinician worksheet for use by the pediatrician during the visit. This worksheet also provides the clinician with linked educational text for his/her use, as well as linking identified problems directly to a database of resources for parents, including educational text, recommended books and other products, and local specialists relevant to the problem(s).This proposal focuses on finalizing CHADIS 0-3 through consultation with national experts and through focus groups and pilot testing, and subsequently assessing its validity, acceptability, and feasibility in preparation for marketing the product. Phase I efforts will include: testing the system's technology;vetting of the system by national experts in infant/toddler mental health and pediatrics;focus groups and pilot testing by parents and pediatricians;and an assessment of test-retest reliability. Phase II efforts will be centered on the assessment of CHADIS'validity, acceptability, and feasibility. Four hundred fifty caregivers of infants and toddlers ages 4-36 months from two general and one NICU graduate clinics will complete CHADIS questionnaires prior to pediatric visits. Caregivers and their children will then attend their scheduled visits, in which participating physicians will use CHADIS data and tools. Caregivers will also complete comparison measures assessing infant/toddler and family functioning to evaluate validity. Measures of satisfaction will be completed by caregivers, as well as physicians and office staff. Once feasibility is proven, a number of possible marketing options can be explored. Child health professionals will want to use it to enhance their clinical work. EMR vendors will see value added by CHADIS. Other professionals such as home visitors and therapists can benefit from using CHADIS. Finally, online CHADIS data can be shared by all professionals involved with a family, forming a communication network and making CHADIS of potential value to systems of care. The proposed research has significant public health implications in that it focuses on the development of a web-based assessment tool called the Child Health and Development Interactive System (CHADIS) 0-3 that enables child health providers to fulfill the recommendations of the American Academy of Pediatrics and Surgeon General for universal mental health screening. CHADIS 0-3 also comprises a point of contact clinician education and resource identification tool and communication mechanism to help users better address the problems identified. Should CHADIS 0-3 prove valid, acceptable, and feasible, as is expected to be determined in this proposal, and widely disseminated more positive mental health of children and families and improved functional long term outcomes may be obtained.
| Howard, Barbara J; Sturner, Raymond (2017) Use of an Online Clinical Process Support System as an Aid to Identification and Management of Developmental and Mental Health Problems. Curr Dev Disord Rep 4:108-117 |
