Adapting a preschool disruptive behavior group for the underserved in pediatric primary care practice.

Abstract

While behavioral parent training (BPT) is the first line treatment for preschool aged children with disruptive behavior, only a fraction of families receive these therapies. The integration of BPT within the pediatric primary care (PPC) setting is a promising way to address this need, as the PPC setting is the first and only point of contact for most children diagnosed with mental health disorders. We piloted a clinical innovation by implementing an adapted BPT group in an urban, academic, PPC practice, serving a low-income, predominantly Black population. Using a formative program development approach and a cultural adaptation framework, structural and cultural adaptations to the program were implemented to increase engagement and adaptability of the group to meet the needs of our PPC population. Learnings indicated that these adaptations were feasible and acceptable to families. Specifically, they were effective in engaging families and transforming the practice of primary care providers. Our work offers a case example to guide efforts to thoughtfully and effectively adapt evidence-based interventions for disruptive behavior in primary care settings. These processes provide one strategy to ameliorate behavioral health disparities in diverse, racial/ethnic minority populations. (PsycInfo Database Record (c) 2022 APA, all rights reserved).