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Sowa NA, Gaffney K, Sanders A, Murrell C. School-Based Tele-Behavioral Health: A Scoping Review of the Literature. THE JOURNAL OF SCHOOL HEALTH 2024; 94:571-580. [PMID: 38263701 DOI: 10.1111/josh.13435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/20/2023] [Accepted: 12/20/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND Telehealth utilization exploded during the COVID-19 pandemic, including within school-based health programs. School-based tele-behavioral health can help programs overcome barriers of access to care, but the current state and effectiveness of such programs are unknown. METHODS A scoping literature review was conducted. Studies were included if they described in-school behavioral health services delivered via telehealth for children ages 5 to 18. From the included studies, population, location, setting, intervention, telehealth modality, clinician type, and outcomes assessed were extracted. FINDINGS Eighteen studies met inclusion criteria. All described psychotherapy or medication management delivered by psychologists (n = 7) and/or psychiatrists (n = 11). Treatment included psychotherapy (N = 8), psychiatric consultation (N = 7), medication management (N = 4), crisis stabilization (N = 1), and caregiver education (N = 1). Eight studies provide qualitative or quantitative outcomes, with 4 examining clinical effectiveness. CONCLUSIONS Despite limited findings in the literature, school-based tele-behavioral health is feasible, effective, and acceptable for delivery of behavioral health care to children and adolescents.
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Affiliation(s)
- Nathaniel A Sowa
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Katie Gaffney
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Amanda Sanders
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Caroline Murrell
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Loomis AM, McLaughlin RX, Lyon M, Mitchell J. Infant and early childhood teleconsultation and training: Program description and feasibility outcomes from a statewide implementation. Infant Ment Health J 2024; 45:185-200. [PMID: 38230980 DOI: 10.1002/imhj.22101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/22/2023] [Accepted: 12/28/2023] [Indexed: 01/18/2024]
Abstract
To address high rates of mental health and developmental concerns facing young children ages 0-6 in the United States and internationally, providers across professional sectors need Infant and early childhood mental health (IECMH) training and support. The training and teleconsultation program (TTP) is a state-funded program developed in one Mountain West state in the United States to provide free IECMH training and teleconsultation to any provider working with young children. The TTP included access to webinars and individual or group consultation with licensed mental health providers. Webinars focused on increasing awareness and knowledge related to attachment and child development, supporting parents and caregivers, trauma-informed practice, supporting emotional health of staff and providers, and culturally responsive practices with infants, young children, and caregivers. Teleconsultation included case consultation, reflective individual and group supervision, and collaboration supports/referrals. During the 18-month evaluation period, 1568 unique providers engaged in either training or teleconsultation services, an average of 9% growth in new providers each month, with representation from all professional sectors and all state counties. This program demonstrates the feasibility and need for statewide training and teleconsultation programs to help meet the needs of providers who interact with and support young children and caregivers.
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Affiliation(s)
- Alysse M Loomis
- College of Social Work, University of Utah, Salt Lake City, Utah, USA
| | - Rose X McLaughlin
- Department of Psychology, University of Utah, Salt Lake City, Utah, USA
| | - McCall Lyon
- The Children's Center Utah, West Valley City, Utah, USA
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Carter AJ, Qu H, Reed RD, Killian AC, Kumar V, Hanaway M, Locke JE. Interpersonal Connections Are Important for Virtual Kidney Transplant Educational Program Development. Prog Transplant 2023; 33:301-309. [PMID: 37936413 PMCID: PMC10842874 DOI: 10.1177/15269248231212905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
Introduction: The Living Donor Navigator program is designed to mitigate disparities in living donor kidney transplantation, although geographic disparities in program participation were observed in the initial years of implementation. The purpose of this study was to understand participant perspectives regarding the use of a virtual option/alternative to expand program participation. Methods: Previous participants of the in-person navigator program were purposively sampled. Using the nominal group technique, a well-structured formative methodology to elicit participant perspectives, 2 meetings were conducted among transplant recipients and advocates (N = 13) to identify and prioritize responses to the question "What things would concern you about participating in a virtual and remote Living Donor Navigator program?" Findings: Mean participant age was 59.3 (9.3) years, and participants were 54% male and 62% white. Education levels varied from less than high school to master's degrees. Participants generated 70 unique responses, of which 36 (51.4%) received prioritization. The top 5 ranked responses of each nominal group technique meeting received approximately 50 percent (47.6% vs. 66.7%, respectively) of the total votes and described the potentially limited interpersonal connections, time conflicts, and differing content in a virtual navigator program compared to the in-person model. Discussion: These data suggest that previous participants were concerned with upholding the original design of the program, thus, virtual living donor kidney transplantation programs should aim to maintain interpersonal connections and consistency of content to ensure adequate programmatic engagement. Future research will focus on program fidelity independent of delivery modality.
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Affiliation(s)
- Alexis J. Carter
- Division of Transplantation, Department of Surgery, University of Alabama Comprehensive Transplant Institute, 510 20 Street South, FOT 749 Birmingham, Alabama 35294
| | - Haiyan Qu
- Division of Transplantation, Department of Surgery, University of Alabama Comprehensive Transplant Institute, 510 20 Street South, FOT 735 Birmingham, Alabama 35294
| | - Rhiannon D. Reed
- Division of Transplantation, Department of Surgery, University of Alabama Comprehensive Transplant Institute, 510 20 Street South, FOT 738 Birmingham, Alabama 35294
| | - A. Cozette Killian
- Division of Transplantation, Department of Surgery, University of Alabama Comprehensive Transplant Institute, 510 20 Street South, FOT 758 Birmingham, Alabama 35294
| | - Vineeta Kumar
- Division of Nephrology, Department of Medicine, University of Alabama Comprehensive Transplant Institute, 1900 University Boulevard, THT 643 Birmingham, Alabama 35233
| | - Michael Hanaway
- Division of Transplantation, Department of Surgery, University of Alabama Comprehensive Transplant Institute, 510 20 Street South, FOT 746 Birmingham, Alabama 35294
| | - Jayme E. Locke
- Division of Transplantation, Department of Surgery, University of Alabama Comprehensive Transplant Institute, 510 20 Street South, FOT 758 Birmingham, Alabama 35294
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Graves JM, Abshire DA, Mackelprang JL, Dilley JA, Amiri S, Chacon CM, Mason A. Geographic Disparities in the Availability of Mental Health Services in U.S. Public Schools. Am J Prev Med 2023; 64:1-8. [PMID: 36283908 PMCID: PMC9772127 DOI: 10.1016/j.amepre.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 08/31/2022] [Accepted: 09/06/2022] [Indexed: 02/05/2023]
Abstract
INTRODUCTION The purpose of this study was to examine geographic variation in the availability of and barriers to school-based mental health services. METHODS A weighted, nationally representative sample of U.S. public schools from the 2017-2018 School Survey on Crime and Safety was used. Schools reported the provision of diagnostic mental health assessments and/or treatment as well as factors that limited the provision of mental health services. Availability of mental health services and factors limiting service provision were examined across rurality, adjusting for school enrollment and grade level. The analysis was conducted in December 2021. RESULTS Half (51.2%) of schools reported providing mental health assessments, and 38.3% reported providing treatment. After adjusting for enrollment and grade level, rural schools were 19% less likely, town schools were 21% less likely, and suburban schools were 11% less likely to report providing mental health assessments than city schools. Only suburban schools were less likely than city schools to provide mental health treatment (incidence rate ratio=0.85; 95% CI=0.72, 1.00). Factors limiting the provision of services included inadequate access to professionals (70.9%) and inadequate funding (77.0%), which were most common among rural schools. CONCLUSIONS Significant inequities in school-based mental health services exist outside of urban areas.
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Affiliation(s)
- Janessa M Graves
- College of Nursing, Washington State University, Spokane, Washington.
| | | | | | - Julia A Dilley
- Program Design and Evaluation Services, Multnomah County/Oregon Public Health Division, Portland, Oregon
| | - Solmaz Amiri
- Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington
| | - Christina M Chacon
- College of Nursing, Washington State University, Tri-Cities, Richland, Washington
| | - Anne Mason
- College of Nursing, Washington State University, Spokane, Washington
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Ward MM, Bhagianadh D, Ullrich F, Merchant KAS, Mena C. Overview of School-Based Telehealth Network Grant Program Services Delivered to Students in Rural Schools. J Sch Nurs 2022:10598405221142498. [PMID: 36464799 DOI: 10.1177/10598405221142498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024] Open
Abstract
Telehealth can expand and enhance access to school-based health care, but its use has been relatively limited. Recognizing that school-based health care is still not reaching many students, the Health Resources and Services Administration (HRSA) funded the School Based Telehealth Network Grant Program to expand telehealth in rural school-based settings to help to increase the availability and use of these services. The 19 grantees delivered telehealth to over 200 schools across 17 states, choosing which services they would deliver and how. Looking across the services, these fell into three categories - primary/urgent care, behavioral health, and other more specialized services. The majority of grantees offered multiple telehealth services with the combination of behavioral health and primary/urgent care the most common. The current study adds to the literature by elucidating that telehealth in schools can address multiple clinical conditions through separate services even though doing so involves using various combinations of clinicians providing different services.
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Affiliation(s)
- Marcia M Ward
- Department of Health Management and Policy, University of Iowa, Iowa City, USA
| | - Divya Bhagianadh
- School of Social Work, 242612Rutgers University, New Brunswick, USA
| | - Fred Ullrich
- Department of Health Management and Policy, University of Iowa, Iowa City, USA
| | | | - Carlos Mena
- Office for the Advancement of Telehealth, 17225Health Resources and Services Administration, Rockville, USA
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Ward MM, Ullrich F, Merchant KAS, Carter KD, Bhagianadh D, Lacks M, Taylor E, Gordon J. Describing Changes in Telebehavioral Health Utilization and Services Delivery in Rural School Settings in Pre- and Early Stages of the COVID-19 Public Health Emergency. THE JOURNAL OF SCHOOL HEALTH 2022; 92:452-460. [PMID: 35195293 DOI: 10.1111/josh.13150] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 01/10/2022] [Accepted: 01/26/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Receiving treatment for behavioral health disorders remains problematic due to profound provider shortages. Telebehavioral health services are effective for providing quality care, but research literature on these services in schools is limited. METHODS Data were collected during Fall 2019 and Spring 2020 semesters on all students receiving telebehavioral health services from 15 school-based telehealth programs across the U.S. RESULTS From Fall 2019 to Spring 2020, 62 schools providing services during both periods increased the number of students served from 396 to 745, increased the average number of encounters per student from 2.4 to 4.1, increased the percentage of encounters delivered by clinical social workers, mental health counselors, and clinical psychologists (all p < .001), and increased the use of individual counseling, family counseling, and group counseling (all p < .001). Schools that initiated the service in Spring 2020 (n = 25) averaged 6.5 encounters for the 301 students receiving services, delivered mostly by clinical social workers or professional counselors, using individual counseling. CONCLUSION Overall, data indicate programs significantly increased both behavioral services provided to their ongoing schools and increased the number of schools served. Undoubtedly telebehavioral health care delivery provided a swift and necessary response to the challenges posed by the growing pandemic threat.
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Affiliation(s)
- Marcia M Ward
- Department of Health Management and Policy, CPHB - N236, University of Iowa, Iowa City, IA, 52242, USA
| | - Fred Ullrich
- Department of Health Management and Policy, CPHB - N226, University of Iowa, Iowa City, IA, 52242, USA
| | - Kimberly A S Merchant
- Department of Health Management and Policy, CPHB - N242, University of Iowa, Iowa City, IA, 52242, USA
| | - Knute D Carter
- Department of Biostatistics, CPHB - N318, University of Iowa, Iowa City, IA, 52242, USA
| | - Divya Bhagianadh
- Department of Health Management and Policy, CPHB - N200, University of Iowa, Iowa City, IA, 52242, USA
| | - Meghan Lacks
- Brody School of Medicine, Department of Family Medicine, East Carolina University, 101 Heart Drive, Mail Stop 654, Greenville, NC, 27834, USA
| | - Erika Taylor
- Brody School of Medicine, Department of Family Medicine, East Carolina University, 101 Heart Drive. Mail Stop 654, Greenville, NC, 27834, USA
| | - Jennifer Gordon
- School Based Telehealth Initiative (SBTI), Bay Rivers Telehealth Alliance, 618 Hospital Road, Tappahannock, VA, 22560, USA
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