# Leveraging the Extension of Community Health-Outcomes (ECHO) telementoring program to improve family-centered and equitable communication about early mental health risk in pediatric primary care

> **NIH NIH P50** · NORTHWESTERN UNIVERSITY · 2024 · $302,881

## Abstract

PROJECT SUMMARY — RESEARCH PROJECT 1 (RP1)
Mental health symptoms emerge as early as the preschool years, emphasizing the need for preventive
approaches that start in toddlerhood. Universal, parent-reported screening tools for toddlers in primary care can
improve early detection of mental health risk, facilitate preventive intervention, and reduce child mental health
inequities related to delayed care. For toddlers who screen at risk, multiple parenting programs for this age group
can improve behavioral control and prevent the development of mental health problems. However, families of
toddlers who screen positive (i.e., “at-risk”) can each be at a different stage in the process of problem recognition
and readiness for engagement in services—informed by their personal experiences and beliefs, cultural
background, and knowledge about development, mental health, and prevention. Furthermore, pediatric primary
are clinicians are rarely trained to discuss toddler mental health risk, and so rely primarily on their personal
perspectives and comfort levels, leaving them vulnerable to implicit bias. Effective and equitable communication
about early childhood mental health risk requires building clinician confidence to: (a) manage uncertainty in
prevention-oriented discussions about early childhood mental health; (b) employ anti-racist strategies for
minimizing bias in decisions about what and how to communicate; and (c) engage in family-centered
communication that considers families' cultural identities and experiences. Despite these challenges, there has
been little focus on how to help pediatric clinicians build confidence and competence to make decisions about
and communicate with families from diverse backgrounds about toddler mental health risk. The Mental Health
Earlier (MHE) ALACRITY Center Research Project 1 (RP1) addresses this gap through development and testing
of a telementoring program for primary care pediatric clinicians – Talking Early About Mental health for Equity
(TEAM4Equity) – to advance equitable implementation of toddler mental health risk screening in primary care.
Program development and delivery will occur in partnership with ECHO (Extension for Community Health
Outcomes) Chicago, a pioneering and widely disseminated program building workforce capacity in primary care
through case-based learning series over videoconferencing. Our goals with TEAM4Equity are to improve 1)
clinician self-efficacy for decision-making and communicating about toddler mental health risk and recommended
interventions, and thereby 2) families' trust and engagement with preventive mental health interventions. We will
achieve our goals by 1) Collaborate with pediatric clinicians and caregivers to iteratively refine the TEAM4Equity
ECHO series using human centered design methods; 2) Conduct a single-arm feasibility and acceptability test
of the TEAM4Equity curriculum- and case-based videoconferencing ECHO series; and 3) Pilot test the
TEAM4Equity ECHO series...

## Key facts

- **NIH application ID:** 10843630
- **Project number:** 1P50MH132502-01A1
- **Recipient organization:** NORTHWESTERN UNIVERSITY
- **Principal Investigator:** Andrea Spencer
- **Activity code:** P50 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $302,881
- **Award type:** 1
- **Project period:** 2024-09-12 → 2029-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10843630

## Citation

> US National Institutes of Health, RePORTER application 10843630, Leveraging the Extension of Community Health-Outcomes (ECHO) telementoring program to improve family-centered and equitable communication about early mental health risk in pediatric primary care (1P50MH132502-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10843630. Licensed CC0.

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