Helping Children in Underserved Areas

Data indicates that most children who need Developmental, Behavioral, and Mental Health (DB/MH) services do not receive the help they may need. Access to DB/MH services is often severely limited since there is a lack of communication and coordination between specialty and primary care providers.

If specialty providers would be able to deliver the services needed to remote sites from a central location, then large number of children across multiple small but conveniently located primary care clinics would gain access to DB/MH providers.

A multi-site Los Angeles area community clinic consortium called the North East Valley Health Corporation (NEVHC) www.nevhc.org is  working to effectively incorporate the use of telehealth to integrate pediatric DB/MH services into primary care for low-income, publicly insured children.

With the Patient Centered Outcome Research Institute www.pcori.org as a collaborator along with the University of California Los Angeles www.ucla.edu, ClinicalTrials.gov has posted a study not yet open for participant recruitment titled “Using Telehealth to Deliver Mental Health Services in Primary Care Settings for Children in Underserved Areas (NCT02396576).

To initiate the clinical trial for Project Year one, interviews will be conducted with parents, clinicians, and staff at NEVHC to discuss the delivery of primary care to children requiring DB/MH services based on potential telehealth-based patient visits. The data gathered will be used to help develop a customized a telehealth delivery system to be integrated into primary care settings.

During Project Years two and three, the investigators will conduct a cluster Randomized Controlled Trial (RCT) to examine whether a telehealth developmental, behavioral, and mental health delivery model can be an effective, efficient, and family-centered way to provide integrated DB/MH services to children in low income communities.

The developmental behavioral services in the telehealth-based patient visit will be provided by a Developmental Behavioral Pediatrician (DBP) housed at UCLA from Children’s Hospital in Los Angeles www.chla.org.

Providers will communicate via telehealth but therapy visits and the initial psychiatric assessment for medications are in person but follow-up psychiatric visits are done via telehealth. Providers use telehealth to communicate with each other about patient care and to discuss coordination issues that include diagnostic decisions, and management strategies.

For more information, go to https://clinicaltrials.gov. The Principal Investigator for the Clinical Trial (NCT02396576) is Tumaini R. Coker Assistant Professor UCLA or email Lorena Porras-Javier at LPorras@mednet.ucla.edu.

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