TY  - JOUR
AU  - Loo, Theoren
AU  - Altman, Myra
AU  - Grodberg, David
AU  - La Guardia, Jennifer
AU  - Bravata, Dena
PY  - 2024
DA  - 2024/8/26
TI  - Telebehavioral Health for Caregivers of Children With Behavioral Health Needs to Address Caregiver Strain: Cohort Study
JO  - JMIR Pediatr Parent
SP  - e59475
VL  - 7
KW  - adolescent
KW  - child
KW  - caregiver
KW  - family health
KW  - resilience
KW  - psychological
KW  - mental health
KW  - pediatric
KW  - pediatrics
KW  - paediatric
KW  - paediatrics
KW  - children
KW  - youth
KW  - adolescents
KW  - teen
KW  - teens
KW  - teenager
KW  - teenagers
KW  - strain
KW  - burden
KW  - caregiving
KW  - caregivers
KW  - carer
KW  - carers
KW  - informal care
KW  - family care
KW  - spousal care
KW  - telehealth
KW  - telemedicine
KW  - technology-enabled
KW  - mobile phone
AB  - Background: Behavioral health conditions among children have worsened over the past decade. Caregivers for children with behavioral health conditions are at risk for two types of caregiver strain: (1) an objective strain, that results directly from the child’s condition and (2) subjective strain, that arises from the caregiver’s feelings regarding these events. Objective: This study aimed to evaluate the impact of a technology-enabled pediatric and family behavioral health service on caregivers’ strain among a commercially insured population. We also explore the common symptom clusters of caregiver strain to better understand the caregiver presentation to inform future care planning. Methods: We examined changes in caregiver strain using the Caregiver Strain Questionnaire-Short Form 7 over the course of their child’s web-based behavioral health care between 2021 and 2023 using a pre-post study design. Common caregiver strain symptom clusters were identified using Ward hierarchical agglomerative clustering. Results: The majority of children were White 60.8% (1002/1647), female 53.6% (882/1647), and aged between 5 and 9 years (33.7%, 555/1647). Families fall broadly into 4 groups based on what drives caregiver strain the most, namely those experiencing (1) disrupted family relationships and time interruption, (2) missed work, (3) worried about their child’s future and feeling tired and sad, and (4) financial strain. Caregiver strain, which was associated with the child’s disease severity (P<.001), decreased significantly in all therapeutic groups. Conclusions: Web-based family-oriented behavioral health care can improve caregiver strain and reduce family and time disruptions, missed work, and financial strain. Sources of caregiver strain vary and may be overlooked when relying on the conventional scoring of the Caregiver Strain Questionnaire-Short Form 7. 
SN  - 2561-6722
UR  - https://pediatrics.jmir.org/2024/1/e59475
UR  - https://doi.org/10.2196/59475
DO  - 10.2196/59475
ID  - info:doi/10.2196/59475
ER  -