Assessment of Patient Engangement in Pediatric Mental Health Calls in Mothers of Young Children Since COVID-19 with Improvement Solutions




Jafferji, Fatema
Fathima, Afra


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Purpose: COVID-19 restrictions led to a rise in telehealth visits. To combat the issue of limited in-person visits, Pediatric Mental Health Calls (PMHC) were created to bridge the gap and provide continued mental health support to UNTHSC Pediatric patients and their caregivers during the pandemic and beyond. Patient engagement was analyzed to gain a better understanding of the impact of PMHC during COVID-19 in 2020 and 2021-22 and to provide improvement for future calls.

Methods: PMHC was completed by HSC student volunteers. Quantitative analysis of patient involvement was made in mothers whose children were infants in 2020 and toddlers in 2021-2022. Patients no longer with UNTHSC clinic or phone numbers no longer in service were omitted from the count. Participation of these mothers (n=292) was assessed using the percentage of the total number of responses in open or close-ended questions (<5, ≧5, or no response at all) and the number of word sentences in open-ended questions (<5 in any category, ≧5 in 1 category, ≧5 in 3 categories). Analysis used chi-square test of independence. Statistical significance was set at p < 0.05. Additionally, Edinburg Postnatal Depression Scale (EPDS) phone screenings and referrals in mothers of infants were compared with early COVID-19 in 2020 to follow-ups in 2021-2022. In 2020, 199 out of 543 infant mothers who agreed to complete the EPDS screenings over the phone were compared to 229 out of 473 mothers of infants in 2021-2022. A comparison was also evaluated for 2020 (n=165) and 2021-2022 (n=190) postnatal mothers with an EPDS score of ≧10 indicating an increased risk for depression, thereby given referrals based on volunteer judgment.

Results: There was a positive response in patient engagement in early 2020 compared to 2021-2022. Chi square test showed a statistically significant decline in both the number of responses in open or closed-ended questions (<5, ≧5, with an increase in no response at all category) and in the number of word sentences in open-ended questions (<5 in any category, ≧5 in 1 category, ≧5 in 3 categories) in 2021-2022. In 2020, from the 199 infant mothers willing to complete the EPDS screening over the phone, 127 answered yes and 72 answered no. In 2021-2022, from the 229 infant mothers, 147 answered yes and 82 answered no. There was a drop in percentage in the number of referrals made for mothers of infants with an EPDS score of ≧10 in 2021-2022 when compared to 2020.

Discussion: Modifications of the PMHC are recommended to increase patient participation beyond the pandemic. Volunteers are encouraged to connect with patients using motivation and interpersonal interaction. Demographic data must be considered to assess patterns of patient engagement. Mothers should be educated on the data and the importance of completing EPDS screenings. Specific questions relevant to current concerns in the country affecting maternal and pediatric health should be focused upon. Alternatives should be suggested to patients who are less likely to respond.