Primary care providers' practices regarding patient sleep: Impact of integrated behavioral health.

INTRODUCTION: Adequate sleep is crucial for effective functioning. Although many children and adolescents have sleep issues, research indicates pediatric providers rarely address them. No research has examined whether primary care providers (PCPs) who practice within an Integrated Primary Care (IPC) model are more likely to assess sleep concerns than PCPs without IPC. The current study aimed to examine providers' current practices and knowledge regarding common sleep topics from clinics with and without IPC. METHOD: PCPs across a large health system were surveyed. Participants were 101 providers across 38 clinics, some within IPC clinics (n = 67), and others not (n = 34). Participants responded to questions regarding current sleep assessment and intervention practices, general sleep, and medications knowledge. RESULTS: Providers reported moderate comfort with behavioral interventions and low comfort with medical interventions. IPC providers were more likely to screen for snoring. Regardless of integration status, PCPs had low medication knowledge scores. DISCUSSION: IPC may enhance some areas of PCPs' knowledge and comfort with behavioral interventions. PCPs need further training in understanding and implementing interventions for sleep concerns. IPC behavioral health providers may facilitate such trainings and work collaboratively with PCPs to improve patient access to sleep interventions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Effects of Cell Phone Use on Caregiver Supervision and Child Injury Risk.

OBJECTIVE: Unintentional injuries are the leading killer of children in the United States. Caregiver supervision decreases child injury risk; however, little research has examined the effects of distractions (e.g., cell phone use) on caregiver supervision and subsequent ability to protect children from injury. In particular, despite the prevalence of cell phone use, no research has examined the degree to which caregiver cell phone use may impair caregivers' ability to supervise their children effectively. The present study used a within-subjects design to examine whether caregiver cell phone use impacted caregiver vigilance and child engagement with potential hazards. METHODS: A total of 51 caregiver-child dyads were observed in a pseudo hazards room across three conditions (cell phone distraction, pen-and-paper distraction, no distraction) to examine the effects of cell phone use on caregiver vigilance and child behavior (i.e., engagement with hazards) related to injury risk. RESULTS: Caregiver vigilance was higher in the no distraction condition compared to the two distraction conditions (cell phone and pen-and-paper). Moreover, child engagement with hazards was lower in the no distraction condition than in the two distraction conditions. Although both distraction conditions impaired caregiver vigilance, caregivers were more impaired in the pen-and-paper condition compared to the cell phone condition. DISCUSSION: Regardless the form, distracting tasks (both cell phone use and pen-and-paper task) impacted both caregiver and child behavior associated with injury risk. It is important that professionals working with parents educate them about the risks of supervising children while distracted and encourage mindful supervision to ensure safety.

Engaging Parents and Health Care Stakeholders to Inform Development of a Behavioral Intervention Technology to Promote Pediatric Behavioral Health: Mixed Methods Study.

BACKGROUND: Despite effective psychosocial interventions, gaps in access to care persist for youth and families in need. Behavioral intervention technologies (BITs) that apply psychosocial intervention strategies using technological features represent a modality for targeted prevention that is promising for the transformation of primary care behavioral health by empowering parents to take charge of the behavioral health care of their children. To realize the potential of BITs for parents, research is needed to understand the status quo of parental self-help and parent-provider collaboration to address behavioral health challenges and unmet parental needs that could be addressed by BITs. OBJECTIVE: The aim of this study is to conduct foundational research with parents and health care stakeholders (HCS) to discover current practices and unmet needs related to common behavioral health challenges to inform the design, build, and testing of BITs to address these care gaps within a predominantly rural health system. METHODS: We conducted a convergent mixed-parallel study within a large, predominantly rural health system in which the BITs will be developed and implemented. We analyzed data from parent surveys (N=385) on current practices and preferences related to behavioral health topics to be addressed in BITs along with focus group data of 48 HCS in 9 clinics regarding internal and external contextual factors contributing to unmet parental needs and current practices. By comparing and relating the findings, we formed interpretations that will inform subsequent BIT development activities. RESULTS: Parents frequently endorsed several behavioral health topics, and several topics were relatively more or less frequently endorsed based on the child's age. The HCS suggested that BITs may connect families with evidence-based guidance sooner and indicated that a web-based platform aligns with how parents already seek behavioral health guidance. Areas of divergence between parents and HCS were related to internalizing problems and cross-cutting issues such as parenting stress, which may be more difficult for health care HCS to detect or address because of the time constraints of routine medical visits. CONCLUSIONS: These findings provide a rich understanding of the complexity involved in meeting parents' needs for behavioral health guidance in a primary care setting using BITs. User testing studies for BIT prototypes are needed to successfully design, build, and test effective BITs to empower parents to take charge of promoting the behavioral health of their children.