The Effect of Addressing Children’s Early Life Social Needs on Behavioral Health
2023 Award: $39,900
In October 2021, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association declared a national emergency in child and adolescent mental health. Early life adverse childhood experiences increase risk for the of mental illness throughout the life course. This project will study how NC Integrated Care for Kids, a novel integrated care management program aimed at children with complex medical and social needs, affects the behavioral health of children up to age 5. This study is the first step in a research agenda to understand how whole health interventions could alter children’s behavioral health trajectories.
Need/Problem: In 2019, more than 1 in 3 high school students reported persistent feelings of sadness or hopelessness, a more than 40% increase from 2009. Early life adverse childhood experiences, such as homelessness and hunger, increase risk for the development of mental illness in adolescence and adulthood. Early life integrated care management to address children’s physical, behavioral and social needs could improve behavioral health in the short- and long-term, but the complexity of such interventions makes them difficult to study in randomized controlled trials.
Grant Summary: NC Integrated Care for Kids (NC InCK) is a federally funded program to deliver comprehensive integrated care management to children covered by Medicaid or CHIP (Children’s Health Insurance Program) in five NC counties. Our study will recruit children up to 5 years old who receive NC InCK services and a comparison group of children with unmet needs in surrounding counties. Through repeated comprehensible behavioral assessments, this study will use “quasi-experimental methods” to estimate the effect of NC InCK services on children’s behavioral health over time. Quasi-experimental methods estimate effects of interventions using observational data without randomization.
Goals and Projected Outcomes: This study will provide preliminary data and feasibility testing of the effect of early life integrated care management on children’s behavioral health using a quasi-experimental approach. The project will also support the development of measures of quality and intensity of care management services. Data and experiences from this study will support additional funding to measure the effect of early life interventions on behavioral health.