Peer‐to‐Peer Family Navigators in Primary Care: Enhancing Child Mental Health Outcomes

Research ObjectiveOnly 1 in 5 US children with a psychiatric or substance use disorder receives treatment. To investigate the impact of pediatric integrated care, including peer‐to‐peer family support, on identification and engagement of children in an urban safety‐net system.Study DesignWe conducted a prospective, non‐randomized trial comparing clinical functioning and health services utilization outcomes between youths receiving CPM and those receiving usual care. Youths were referred by their pediatricians for child psychiatry evaluation. Each youth’s family was given the option to participate in the 12‐month study following evaluation. Follow‐up observations take place at 6 and 12 months following baseline. Study participants received a multi‐disciplinary, integrated care team evaluation, including peer‐to‐peer parents in the primary care clinic. Claims and electronic medical record data provide information on utilization. We used propensity score weights to balance participants on baseline characteristics and estimated multivariate generalized estimating equations with a difference‐in‐differences framework to produce doubly‐robust estimates of relative pre‐post changes for CPM vs. usual care accounting for clustering of observations within participants.Population StudiedIn the highly diverse population served by this urban safety‐net system, barriers such as stigma, language, and geography create access disparities. Study sample = 171 CPM youth and 290 Controls. All were primary care pediatric patients ages 2 to 17. CPM youth mean age = 10 years; 48.54% identify as female. Study sample families earn