P3.008: Enhancing Mental and Behavioral Health Education in a Pediatric Residency Continuity Clinic: Pre- and Post- Curriculum Survey Results

Background: Mental and behavioral health (MBH) conditions are prevalent among the pediatric population, particularly adolescents and young adults, and with a shortage of MBH providers, there is a growing need to improve primary care resident training in MBH. We introduced an innovative, community-partnered curriculum titled, EMBRACE Peds. The goal of this 5-year project is to enhance the competence of primary care pediatricians in prevention, identification, diagnosis, treatment, and referrals of children, adolescents, and young adults with MBH conditions, in part by integrating a MBH professional into resident continuity clinic. The purpose of this study is to evaluate residents’ MBH knowledge, skills, attitudes, and self-efficacy.

Methods: An anonymous pre-MBH curriculum survey was administered to 110 residents via REDCap and readministered the following year after 1 year of curriculum. Differences between groups were assessed via Fisher’s Exact Test and Mann-Whitney U using SPSS.

Results: Seventeen residents participated in the pre-MBH curriculum survey and 11 the subsequent year. Based on the findings, the proportion of residents who reportedly referred patients with anxiety or depression to a community resource, 50% or more of the time over the past year, increased from pre-MBH curriculum (52.9% for anxiety and 58.8% for depression) to the following year after curriculum implemented (63.6% for anxiety and 63.6% for depression). Similar results were seen with residents who provided resources and guidance, 50% or more of the time, for anxiety (23.5% to 63.6%), depression (29.4% to 54.5%), and ADHD (12.5 % to 27.3%), with providing resources for anxiety showing a significant change (1-sided p<.05). Additional areas that demonstrated improvement included identifying suicidality (35.3% to 45.5%) and substance use risk factors (35.3% to 45.5%); and initiating first steps in substance use treatment (11.8% to 45.5%). Residents who completed the survey 1 year after the curriculum implementation had significant more confidence, on a scale of 1-5, in referring a patient with substance use to resources, (3.0 [2.5, 4.0]) compared to those who participated in the survey prior to curriculum implementation (2.0 [1.0, 3.0]. p< 0.05).

Conclusion: Since introducing an MBH curriculum, there were statistically significant increases in residents providing resources for anxiety and in their confidence in referring patients for substance use resources. Further examinations with a larger sample and in subsequent years are needed and additional efforts are recommended to expand MBH training and improve pediatricians’ comfort management MBH conditions in primary care.