Leveraging Community Health Workers in Extending Pediatric Telebehavioral Health Care in Rural Communities: Evaluation Design and Methods

Objective: The pandemic exacerbated and intensified pediatric behavioral health and access needs in rural and underserved areas due to long-standing workforce shortages, lack of resources, and multigenerational poverty and trauma. Kansas is a predominantly rural and frontier state with 94% of counties designated as mental health professional shortage areas. Innovation: The Telehealth ROCKS (THR) program is among the first of its kind to increase the behavioral health workforce capacity by integrating trained school-based community health workers (CHWs) directly into rural communities. CHWs facilitate the coordination of behavioral health appointments and access to social determinants of health needs. Methods and Results: We plan to assess the implementation, clinical outcomes, quality of care, and access to care through a mixed-methods design to evaluate the process and impact of expanding the rural behavioral health workforce via CHWs. Preliminary program data suggest CHWs have supported over 90 students/families around social determinants of health in the first 6 months. Conclusion: The THR program aims to bring childserving systems of care together, cultivate relationships with rural communities, empower and increase workforce capacity in health care and education, and build trust to enhance acceptance and thus program sustainability. Public Significance Statement This program uses an innovative approach to expand behavioral health workforce capacity by integrating school-based community health workers to coordinate access to social determinants of health and behavioral health appointments for students and families. By evaluating how healthcare-community partnerships can effectively address social determinants of health through technology-enabled and community-based strategies, we aim to create a sustainable model to be replicated in other rural communities.