Objective The coronavirus disease 2019 pandemic (COVID-19) may increase pediatric mental health needs due to its social, economic, and public health threats, especially among Black, Indigenous, and People of Color and those served within disadvantaged communities. COVID-19 protocols have resulted in increased provision of telehealth in integrated primary care (IPC) but little is known about pediatric telehealth IPC utilization during the pandemic for diverse and traditionally underserved groups. Methods A comparative study was conducted to explore variability between in-person (pre-COVID-19; n = 106) and telehealth (mid-COVID-19; n = 120) IPC consultation utilization among children 1–19 years old served through a large, inner-city primary care clinic. Logistic regression modeling was used to examine the association between service delivery modality (i.e., in-person vs. telehealth) and attendance, referral concerns, and several sociodemographic variables. Results Service delivery modality and attendance, referral concerns, and race/ethnicity were significantly associated. The odds of non-attendance were greater for children scheduled for telehealth, the odds of children with internalizing problems being scheduled for telehealth were greater than those with externalizing problems, and the odds of Black children being scheduled for telehealth were less compared to White children. Conclusion Though telehealth has helped provide IPC continuity during COVID-19, findings from this study show troubling preliminary data regarding reduced attendance, increased internalizing concerns, and disparities in scheduling for Black patients. Specific actions to monitor and address these early but alarming indications of telehealth and Covid-19 related behavioral health disparities are discussed.

中文翻译：

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COVID-19、远程医疗和儿科综合初级保健：服务使用的差异

目标 2019 年冠状病毒病 (COVID-19) 大流行可能会增加儿科心理健康需求，因为它对社会、经济和公共卫生造成威胁，尤其是在黑人、土著和有色人种以及弱势社区服务的人群中。COVID-19 协议已导致在综合初级保健 (IPC) 中提供更多的远程医疗服务，但在大流行期间对不同且传统上服务不足的群体的儿科远程医疗 IPC 使用情况知之甚少。方法 进行了一项比较研究，以探讨在 1-19 岁通过一个大型的市中心初级保健诊所。逻辑回归模型用于检查服务提供方式（即面对面与远程医疗）与出勤率、转诊问题和几个社会人口变量之间的关联。结果 服务提供方式和出勤率、转诊问题和种族/民族显着相关。计划进行远程医疗的儿童缺勤率更高，有内化问题的儿童被计划接受远程医疗的可能性大于有外化问题的儿童，黑人儿童被计划接受远程医疗的可能性低于白人儿童。结论 尽管远程医疗有助于在 COVID-19 期间提供 IPC 连续性，但本研究的结果显示出令人不安的初步数据，即出勤率降低、内化担忧增加、以及黑人患者的日程安排上的差异。讨论了监测和解决远程医疗和 Covid-19 相关行为健康差异的这些早期但令人担忧的迹象的具体行动。