Physician Utilization of a Universal Psychosocial Screening Protocol in Pediatric Primary Care

Clin Pediatr (Phila). 2019 Aug;58(9):957-969. doi: 10.1177/0009922819845878. Epub 2019 Apr 29.

Abstract

This study evaluated physicians' utilization of a universal psychosocial screening protocol within a pediatric primary care setting. Pediatricians (n = 20) adopted a multitiered screening algorithm using the Pediatric Symptom Checklist-17 (PSC-17) within well-child checkups (WCC) for children, ages 7 and 11 years. Descriptive analyses were performed to evaluate the initial 3 years of physician screening protocol implementation to: (1) determine frequency and proportion of use and (2) examine patient outcomes associated with accessing behavioral health care. Physicians frequently initiated the protocol, administering the PSC-17 within 3678 WCC encounters, with frequency progressively increasing over the 3-year period. Results highlighted elements of screener utilization, cost-effectiveness, screening algorithm fidelity, and prevalence of psychosocial concerns identified. Secondary implementation challenges were observed after initial screening, specific to implementation of prescribed follow-up procedures. Primary care behavioral health collaborations appear helpful for improving universal screening utilization and cost-effectiveness, and for ensuring children with psychosocial problems are identified early and directed to follow-up care as needed.

Keywords: Pediatric Symptom Checklist-17; behavioral health; pediatric primary care; universal screening.

MeSH terms

  • Algorithms
  • Child
  • Child Behavior Disorders / diagnosis*
  • Female
  • Humans
  • Male
  • Pediatrics / methods*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Primary Health Care / methods*
  • Surveys and Questionnaires*