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This paper describes the (Sin Exclusión) Transdisciplinary Autism Assessment and Resources ([S]TAAR) model and presents early metrics tracking efficiency and equity in access to high-quality comprehensive autism evaluations for young children. Retrospective chart reviews over one year (08/2018–08/2019) with n = 173 children were reviewed. Through care coordination with community providers, the model was developed to meet local needs by increasing throughput of children (

INTRODUCTION Despite increased prevalence and identification of pediatric behavioral health concerns, families face many barriers when attempting to access behavioral health services. System navigators, or individuals experienced in navigating the health system, help to engage families in services by helping individuals overcome barriers for accessing care. However, limited research to date has systematically reviewed the implementation and effectiveness of navigation models in pediatric populations. METHOD We systematically reviewed published studies examining navigation models for pediatric populations (up to age 18) referred to behavioral health services. We searched PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO for studies that evaluated a navigation model and included service use outcomes. We aggregated data pertaining to characteristics of the study and navigation model, service use outcomes, and implementation outcomes. RESULTS Eight studies met inclusion criteria. Families who participated in navigation services were more likely to complete diagnostic assessments and received an increased dosage (e.g., time spent, services completed) of behavioral health treatments. There was notable variability across studies in terms of processes involved in the navigation models. DISCUSSION Findings indicate that system navigation is a promising method for improving service use for pediatric populations referred to behavioral health services. Future research may continue to examine the effectiveness and implementation of the model, to best understand its benefits and what processes may contribute to improved service outcomes. Public Significance Statement: This paper reviews the effectiveness of system navigator models, which are designed to engage children and families in behavioral health services. The interventions reviewed are associated with increased behavioral health service use in children and show promise as a method of overcoming barriers to accessing behavioral health care. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

INTRODUCTION Despite increasing evidence that use of the "common factors" and "common elements" approaches are effective in improving patient outcomes, and calls for pediatricians to address patient behavioral health concerns, little is known about pediatrician knowledge, perceptions, and use of these approaches. METHOD Pediatric chief residents from all 210 pediatric residency programs in the United States were surveyed to investigate their knowledge, attitudes, practices, and training related to use of engagement and treatment strategies that comprise the common factors and common elements approaches to delivering behavioral health care. RESULTS The usable response rate was 38%. Most respondents indicated they believe pediatricians should address behavioral health issues and that common factors and common elements would be useful and feasible in clinical practice. Most indicated low levels of familiarity with common factors and common elements and dissatisfaction with training in these areas. CONCLUSION Additional training and other implementation supports, such as dissemination of implementation guidelines and mechanisms for technical assistance, will be needed in order to increase pediatrician use of these approaches. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

In the United States, ethnic minority status and low socioeconomic status both confer greater risk of premature birth. These sociodemographic factors also contribute to a greater risk of postpartum depression, as does giving birth prematurely. Considering the known adverse effects of postpartum depression on children's development, NICU-based mental health services for these high-risk mothers is an important public health intervention. Although counseling and educational interventions in the NICU have been shown to decrease maternal depressive symptoms, these interventions require parental presence on the unit. Mothers of both low socioeconomic and ethnic minority status face systemic barriers that may prevent them from visiting their infants, such as lack of paid leave, transportation, and childcare. We propose directions for future research with the aim of increasing access to services. Directions include brief individual therapy, telehealth, and increasing the psychosocial support skills of other health professionals. Potential barriers to implementation are discussed.

INTRODUCTION Although primary care clinicians often refer children and families to community-based mental health services, a sizable number of patients do not make it to their 1st appointment. Engagement interventions delivered in primary care that focus on reducing structural and perceptual barriers to accessing care hold promise to improve this referral-to-service gap. To date, no review to characterize and summarize the effectiveness of such engagement interventions has been completed. METHOD We conducted a systematic review of pediatric mental health service engagement interventions delivered in primary care over the past 20 years using MEDLINE, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO. We narratively summarized the literature and conducted quality and risk of bias analyses. RESULTS Out of 948 records, 10 studies met inclusion criteria and were reviewed. A variety of engagement interventions were evaluated and demonstrated varying levels of effectiveness in improving service initiation, with the most promising approach being primary care mental health integration. Quality and risk of biases analyses demonstrated several methodological weaknesses of the included studies. DISCUSSION Currently, there is limited evidence for engagement interventions to improve the referral-to-service gap for children and families. More research is needed to develop and evaluate effective mental health engagement interventions, particularly for disadvantaged youth and families. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Introduction Primary care is a common access point for children and adolescents with depression and suicidality concerns. In this setting, pediatricians typically function as front-line providers given barriers that patients face in accessing mental health clinicians. Method This study surveyed chief residents from all pediatric residency programs in the United States (N = 214) to evaluate (a) their attitudes, knowledge, practices, and comfort in managing depression and suicidality concerns in primary care, and (b) the relationship between residency training processes and pediatric residents' practices, knowledge, and comfort related to identifying and managing depression and suicidality. Results The usable response rate was 37.6%. The large majority of respondents are involved in evaluation and management of depression and suicidality; yet many respondents reported a lack of knowledge and comfort in these roles. Conclusions Recommendations for pediatric residency program training processes are discussed, including the potential added value of colocating mental health clinicians into the primary care continuity training clinic. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Background Interagency collaboration between community and school settings is one mechanism to serve the complex needs of pediatric patients with autism spectrum disorder (ASD). Purpose We surveyed a national sample of community-based providers to examine their perspectives on interagency collaboration with school-based providers when serving pediatric patients with ASD. Method Medical and behavioral/mental health professionals practicing in community settings were recruited. Participants (N = 116) completed an online survey about their interagency collaboration experiences with schools. Results The majority of the sample reported engaging in interagency collaboration with school-based providers; however, the frequency was limited and was associated with the number of years working in the field. Community-based providers wanted more didactic and hands-on experiences in collaboration. Barriers and facilitators were related to schools' administration, school personnels’ training in ASD, information exchange, and delineating between identification systems. Discussion and conclusion Our findings highlight the importance of leadership support and the need for innovative training experiences to support school-community interagency collaboration.

Introduction Attention-deficit/hyperactivity disorder (ADHD) in children and adolescents is commonly managed in primary care. Changes in United States health care have led to the integration of behavioral health services within a patient's "medical home" to improve access to, engagement in, and continuity of quality health care. Despite proliferation of these integrated care models, no studies have specifically examined models for managing ADHD in children and adolescents within primary care. Method We searched PsycINFO, MEDLINE, and Google Scholar databases, and found 8 studies describing 6 integrated care models (i.e., combined psychosocial and medication treatments with coordination of care between primary care clinicians and behavioral health clinicians). We reviewed characteristics (i.e., settings, target populations, providers, levels of integration, evaluation and treatment approaches, and methods of interprofessional collaboration) and outcomes (i.e., access, outcomes, and acceptability) of these models. Results The 6 integrated care models demonstrate the potential to improve access to and acceptability of ADHD care for children and adolescents. The models also demonstrate that behavioral health clinicians can integrate at various levels within primary care to achieve superior clinical outcomes compared with nonintegrated models. Discussion We identified 6 effective integrated care models for addressing ADHD in children and adolescents that may be adaptable to local needs and internal capacities. We discuss results of these models with regard to their implications for clinical practice and research. (PsycINFO Database Record

The current study investigates the relationship between the protective factors of initiative, self-control, and attachment and their ability to predict levels of behavioral concern in a Head Start population (N=1885). Considerable research has found strong connections between protective factors and positive outcomes. However, little research has examined the unique contributions of multiple protective factors concurrently. Results of the current study indicate that when children have any one protective factor they are likely to have other protective factors. When considered individually, protective factors are predictive of low levels of behavior concern. Conversely, when all protective factors are considered together, only self-control predicts a lack of behavior concern. This implies that strength-based screeners can inform interventions that improve protective factors and may reduce behavioral problems in at-risk preschool populations.