Objective:
The purpose of this study was to (a) describe the development and implementation of Behavioral Health in Pediatric Populations:0–5 (BHIPP:0–5), an initiative designed to increase the capacity of primary care practices to deliver early childhood behavioral health (ECBH) integration activities; and (b) examine practice transformation changes in ECBH services for three types of primary care settings (federally qualified health care centers—FQHCs, private practices, nonprofit/community practices).
Methods:
BHIPP:0–5 pediatric psychologists and interdisciplinary TA professionals provided monthly technical assistance sessions and quarterly cohort learning collaboratives to nine diverse primary care practices. Changes in ECBH activity implementation were examined across and within three practice type groupings.
Results:
All BHIPP:0–5 practice types expanded their capacity to provide ECBH services from baseline to the end of Year 2. Prevention/health promotion activities evidenced the most growth (from 16% in baseline to 40% in Year 2). Practice types differed in implementation of ECBH services. FQHCs accounted for 75% of the total prevention/health promotion services, private practices provided the most case-based consultation/intervention (54%), and nonprofit/community practices accounted for 86% of the total care coordination/systems navigation services.
Conclusions:
Primary care settings are uniquely suited to address early childhood mental health in the context of routine care. The BHIPP:0–5 initiative supports practice transformation in early childhood behavioral health integration while simultaneously advancing systems-level policies and practices that promote high quality care, increase efficiency, improve utilization of preventive services, and decrease overall costs in alignment with health care systems goals.
Implications for Impact Statement
This study describes the development and implementation of a practice transformation initiative focused on early childhood behavioral health integration activities in a diverse group of primary care practices. The initiative was designed and delivered by pediatric psychologists in order to build the capacity of primary care settings to provide services aimed at addressing the complex needs of young children and their families. The data indicate that primary care practices successfully engaged in the initiative, benefitting from monthly technical assistance meetings and quarterly cohort learning collaboratives, and increased the amounts and types of early childhood services they provided to young children and their families.
