The Starting Early Starting Smart Integrated Services Model: Improving Access to Behavioral Health Services in the Pediatric Health Care Setting for At-Risk Families with Young Children

Journal of Child and Family Studies (Impact Factor: 1.42). 02/2010; 19(1):42-56. DOI: 10.1007/s10826-009-9280-z


We evaluated the Starting Early Starting Smart (SESS) national initiative to integrate behavioral health services (parenting,
mental health, and drug treatment) into the pediatric health care setting for families with young children. Data are presented
from five pediatric care (PC) sites, drawing from families at risk due to demographic and behavioral health factors, with
infants less than 12months of age (n=612). Families were randomly assigned to either the SESS program or a standard care Comparison group. We utilized longitudinal
analyses to estimate differences in utilization rates for parenting, mental health, and drug treatment over 6 follow-up time
points (3, 6, 9, 12, 15 and 18months). Our findings indicate that SESS caregiver participants were 4.6 times (p<0.001; CI=3.33–6.26) more likely to receive parenting services, 2.1 times (p<0.001; CI=1.48–2.86) more likely to receive outpatient mental health treatment, and 1.8 times (p=0.025; CI=1.08–3.14) more likely to receive drug treatment than Comparison group participants. Our results demonstrate
the success of the SESS program in coordinating and improving access to behavioral health services for high-risk caregivers
within the pediatric health care setting and highlight the importance of continuing to focus public health policy on the behavioral
health care needs of families with young children.

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    ABSTRACT: This study tested the effectiveness of the attachment-based program Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD; F. Juffer, M.J. Bakermans-Kranenburg, & M.H. van IJzendoorn, 2008) in decreasing harsh discipline of 43 mothers and their 1- to 4-year-old-children from severely deprived families. Based on previous studies, parenting stress was tested as a potential moderator of intervention effects on harsh discipline. Using a randomized control design, maternal harsh discipline was observed during home visits at the pretest and posttest, and mothers filled in questionnaires at both assessments. The VIPP-SD proved to be effective in decreasing maternal harsh discipline, but only for mothers who experienced higher levels of parenting stress at intake. These findings provide support for the program's ability to improve parenting in families who are most at risk for harsh parenting and for potentially maltreating child-parent interactions. The results are discussed in terms of the VIPP-SD elements most relevant to decreasing harsh discipline, and the challenges of parenting interventions in severely deprived populations. © 2014 Michigan Association for Infant Mental Health.
    Infant Mental Health Journal 11/2014; 35(6). DOI:10.1002/imhj.21464 · 0.61 Impact Factor

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