Point-of-Care Child Psychiatry Expertise: The Massachusetts Child Psychiatry Access Project.

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  • Additional Information
    • Source:
      Publisher: American Academy of Pediatrics Country of Publication: United States NLM ID: 0376422 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1098-4275 (Electronic) Linking ISSN: 00314005 NLM ISO Abbreviation: Pediatrics Subsets: MEDLINE
    • Publication Information:
      Publication: Elk Grove Village Il : American Academy of Pediatrics
      Original Publication: Springfield, Ill., Thomas.
    • Subject Terms:
    • Abstract:
      Objective: Since 2005, after a pilot program, the Massachusetts Child Psychiatry Access Project (MCPAP) has provided point-of-care psychiatry expertise and referral assistance by telephone to primary care providers. We examined its adoption and use and the practice characteristics associated with different adoption timelines and use patterns.
      Methods: We merged data on calls to MCPAP in 2005 to 2011 with practice data (enrollment year, panel size, regional team assignment). We categorized practices' days from enrollment to first call (adoption) (0-100, 101-365, > 365 days) and quartile of call frequency (use) (annual highest, middle, and lowest quartiles of number of calls per 1000 empanelled patients). We determined associations between adoption and use and practice characteristics using multivariate models.
      Results: Among 285 practices, adoption and use varied: 55% called 0 to 100 days from enrollment and 16% called >365 days from enrollment. Practices in the highest quartile of use made a mean 15.5 calls/year per 1000 patients, whereas the lowest quartile made 0.4 calls/year per 1000 patients. Adoption within 100 days was associated with enrollment during or after 2007 (odds ratio [OR] 4.09, 95% confidence interval [CI] 2.23-7.49) and assignment to the team at the pilot site (OR 4.42, 95% CI 2.16-9.04 for central Massachusetts). Highest-quartile use was associated with team assignment (OR 3.58, 95% CI 1.86-6.87 for central Massachusetts) and panel size (OR 0.10, 95% CI 0.03-0.31 for ≥ 10,000 vs < 2000 patients).
      Conclusions: Adoption and use of MCPAP varied widely. Timing of enrollment, assignment to the team from the program's pilot site, and panel size were associated with patterns of adoption and use. Findings may help other programs design effective implementation strategies.
      (Copyright © 2015 by the American Academy of Pediatrics.)
    • References:
      J Gen Intern Med. 2013 Jul;28(7):957-64. (PMID: 23371416)
      Ann Fam Med. 2013 May-Jun;11 Suppl 1:S60-7. (PMID: 23690388)
      J Atten Disord. 2015 Jul;19(7):569-77. (PMID: 23142852)
      Pediatrics. 2000 Jun;105(6):1313-21. (PMID: 10835074)
      Arch Pediatr Adolesc Med. 2002 Jun;156(6):592-8. (PMID: 12038893)
      BMJ. 2002 Oct 26;325(7370):961-4. (PMID: 12399352)
      Pediatrics. 2002 Dec;110(6):1169-76. (PMID: 12456915)
      Acad Psychiatry. 2003 Winter;27(4):277-82. (PMID: 14754851)
      Milbank Q. 2004;82(4):581-629. (PMID: 15595944)
      Pediatrics. 2005 Jan;115(1):e97-104. (PMID: 15629972)
      Arch Gen Psychiatry. 2005 Jun;62(6):603-13. (PMID: 15939838)
      Ambul Pediatr. 2005 Jul-Aug;5(4):201-8. (PMID: 16026184)
      Clin Pediatr (Phila). 2006 Jun;45(5):423-34. (PMID: 16891275)
      Clin Pediatr (Phila). 2006 Jul;45(6):537-43. (PMID: 16893859)
      J Am Acad Child Adolesc Psychiatry. 2006 Sep;45(9):1023-31. (PMID: 16840879)
      J Adolesc Health. 2007 May;40(5):433-9. (PMID: 17448401)
      Ambul Pediatr. 2008 Jan-Feb;8(1):11-7. (PMID: 18191776)
      J Am Acad Child Adolesc Psychiatry. 2008 Dec;47(12):1468-83. (PMID: 19034191)
      Acad Pediatr. 2009 Mar-Apr;9(2):123-7. (PMID: 19329104)
      J Pediatr. 2010 Jun;156(6):1011-5, 1015.e1. (PMID: 20227727)
      Pediatrics. 2010 Jun;125 Suppl 3:S69-74. (PMID: 20519564)
      J Am Acad Child Adolesc Psychiatry. 2010 Oct;49(10):1001-10. (PMID: 20855045)
      Pediatrics. 2010 Dec;126(6):1191-200. (PMID: 21059722)
      J Healthc Manag. 2011 May-Jun;56(3):183-97; discussion 197-8. (PMID: 21714373)
      Am J Psychiatry. 2011 Oct;168(10):1057-65. (PMID: 21799067)
      JAMA. 2011 Oct 12;306(14):1531-3. (PMID: 21990291)
      J Health Organ Manag. 2012;26(1):81-97. (PMID: 22524100)
      J Atten Disord. 2012 Nov;16(8):675-84. (PMID: 21976032)
      JAMA Pediatr. 2013 Feb;167(2):162-8. (PMID: 23247331)
      Health Serv Res. 2013 Apr;48(2 Pt 1):398-416. (PMID: 23034072)
      Clin Pediatr (Phila). 2013 Jun;52(6):557-67. (PMID: 23572448)
      JAMA Psychiatry. 2014 Jan;71(1):81-90. (PMID: 24285382)
    • Grant Information:
      K23 MH083885 United States MH NIMH NIH HHS; R25 MH080916 United States MH NIMH NIH HHS; K23MH083885 United States MH NIMH NIH HHS; R25MH080916 United States MH NIMH NIH HHS
    • Contributed Indexing:
      Keywords: community pediatrics; psychiatry/psychology
    • Publication Date:
      Date Created: 20150422 Date Completed: 20150716 Latest Revision: 20181202
    • Publication Date:
      20221213
    • Accession Number:
      PMC4411776
    • Accession Number:
      10.1542/peds.2014-0720
    • Accession Number:
      25896844