Research Assistant University of Virginia Pediatrics Silver Spring, Maryland, United States
Background: The COVID-19 pandemic has contributed to the rise in youth mental health symptomatology. Underlying social inequities, economic impacts, and differential access to health care contribute to disparities in youth psychological distress. Primary care settings present opportunities for enhanced detection and treatment of mental health issues; however, there are disparities in access to care and rates of screening, prescriptions, and referrals for mental health conditions. We hypothesize that these disparities mirror disparities in the socio-economic impacts of the COVID-19 pandemic. The electronic health record presents unique opportunities as well as challenges to better understand pediatric mental health disparities. Objective: To characterize the effect of COVID-19 on the mental health of pediatric populations in primary care settings surrounding the Charlottesville, VA area. To evaluate the strengths and challenges of using electronic health records to study temporal trends in pediatric mental health. Design/Methods: This is an IRB-approved, retrospective study of the pediatric population (n=10,866) that visited three primary care sites at an academic medical center before (2017-2019) and during the COVID-19 pandemic (2020-2022). We used SlicerDicer in Epic to collect data from pediatric wellness and sick visits, including patient health questionnaire (PHQ-9) results, diagnoses of common mental health disorders, corresponding psychotropic medication prescriptions, and patient demographics. Data are currently being analyzed for each time period individually as well as comparatively. Logistic regression was used to compare the demographic and social characteristics of the two cohorts with respect to the proportion of pediatric patients receiving a mental health diagnosis, to assess the differences. The analysis of diagnoses and prescriptions is expected to be completed by Nov 30, and the analysis of PHQ-9 scores by Dec 31. Our data will demonstrate differential changes in mental health symptoms, diagnoses, and treatments among pediatric patients in central Virginia.
