Integrated Behavioral Health Increases Well-Child Visits and Immunizations in the First Year

Abstract

Objective: To assess whether integrated behavioral health (IBH) prevention encounters provided during well-child visits (WCVs) is associated with increased adherence to WCVs and timely immunizations in the first year.

Methods: Data were collected in an urban pediatric primary care clinic serving a low-income population and using the HealthySteps model. Subjects were 813 children who attended a newborn well-child visit between January 13, 2016 and August 8, 2017. Data from the electronic health record was extracted on attendance at six well-child visits in the first year of life, IBH prevention encounters by the HealthySteps specialist, completion of immunizations at 5 and 14 months, and demographics and social and clinical risk factors.

Results: After controlling for covariates, odds of attendance at 6, 9, and 12-month WCVs were significantly higher for those who had IBH prevention encounters at previous WCVs. Odds of immunization completion by 5 months was associated with number of IBH prevention encounters in the first 4 months (OR = 1.52, p = .001) but not immunization completion at 14 months (OR = 1.18, p = .059).

Conclusions: IBH prevention encounters were associated with increased adherence to WCVs in the first year and vaccine completion at 5 months of age. These findings are consistent with IBH having a broad positive effect on child health and health care through strong relational connections with families and providing value in addressing emotional and behavioral concerns in the context of WCVs.

Keywords: health behavior; health promotion and prevention; infancy and early childhood; primary care.