ArticleJournal of the American Academy of Child and Adolescent Psychiatry2023
Widening Racial Disparities During COVID-19 Telemedicine Transition: A Study of Child Mental Health Services at Two Large Children's Hospitals.
Article in Journal of the American Academy of Child and Adolescent Psychiatry, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Telehealth Use and Health Equity for Mental Health and Substance Use Disorder During the COVID-19 Pandemic: A Systematic Review.Telemedicine journal and e-health : the official journal of the American Telemedicine Association · 2024Pooled it
- Location of Crisis Service Delivery for Medicaid-Enrolled Youths With Behavioral Health Conditions.Psychiatric services (Washington, D.C.) · 2026Article
- Multidisciplinary Telehealth for Pediatric Developmental and Mental Health Care in Rural and Remote Australia: Interview Study Among Caregivers and Service Providers.JMIR pediatrics and parenting · 2026Article
- Ethical Norms, Challenges, and Associated Factors in Telemental Health: Perspectives from Psychiatric and Psychological Professionals in China.Healthcare (Basel, Switzerland) · 2026Article
- A Team-Based Partner-Driven Model for Delivering Outpatient Exposure Treatment for Pediatric Anxiety and Obsessive-Compulsive Disorder.JAACAP open · 2025Article
- Mental Telehealth Utilization Patterns Among High School Students from Racial and Ethnic Minority Backgrounds Affected by Violence and Substance Use.Journal of racial and ethnic health disparities · 2025Article
- Trends in mental health care and telehealth use across area deprivation: An analysis of electronic health records from 2016 to 2024.PNAS nexus · 2025Article
- Community and Patient Features and Health Care Point of Entry for Pediatric Concussion.JAMA network open · 2024Article
- Digital and Hybrid Pediatric and Youth Mental Health Program Implementation Challenges During the Pandemic: Literature Review With a Knowledge Translation and Theoretical Lens Analysis.JMIR pediatrics and parenting · 2024Review
- COVID-19 Modifications in Public Home- and Community-Based Services for Children with Mental Health Needs.Administration and policy in mental health · 2024Article
- The Effects of Social Determinants of Health on Child and Family Mental Health: Implications of the COVID-19 Pandemic and Beyond.Current psychiatry reports · 2023Review
- Editorial: The Impact of the COVID-19 Pandemic on Racial Disparities in Pediatric Mental Health.Journal of the American Academy of Child and Adolescent Psychiatry · 2023Article
- Interrupted Time Series Analysis: Patient Characteristics and Rates of Opioid-Use-Disorder-Related Emergency Department Visits in the Los Angeles County Public Hospital System during COVID-19.Healthcare (Basel, Switzerland) · 2023Article
- Promoting racial equity in digital health: applying a cross-disciplinary equity framework.NPJ digital medicine · 2023Article
- The Evolving Landscape of Using Telehealth to Address Pediatric Mental Health in a Postpandemic Era.Academic pediatricsReview
Corrections and comments
- Commented on by
Authors and funding
12 authors at 4 institutions in 1 country.
Funding
Abstract
objectiveTo examine whether racial disparities in access to pediatric mental health care were affected during the COVID-19 telemedicine transition at both The Children's Hospital of Philadelphia (CHOP) and Boston Children's Hospital (BCH).
methodElectronic health records were queried for all unique outpatient visits from a pre-pandemic period in 2019 and a within-pandemic period in 2020. Changes in the proportion of patients were compared based on insurance status, clinic location, and racial identification. Hypotheses were tested via logistic regression analyses.
resultsAt CHOP, from 2019 to 2020, the proportion of racially minoritized patients significantly declined within a 1-month period from 62% to 51%, whereas the proportion of White-identifying patients increased from 38% to 49% (β = 0.47; z = 3.60; p =.0003), after controlling for insurance status and clinic location. At BCH, the proportion of racially minoritized patients significantly declined within a longer 6-month period between 2019 and 2020, from 62% to 59%, whereas the proportion of White-identifying patients increased from 38% to 41% (β = 0.13; z = 2.8; p = .006), after controlling for insurance status.
conclusionAt CHOP and BCH, the COVID-19 telemedicine transition exacerbated pre-existing racial disparities in pediatric mental health services. Our findings suggest that racially minoritized patients receiving services in urban areas may be particularly at risk for losing access when telemedicine is implemented. Although there are limitations to this racial dichotomization, examining differences between White and racially minoritized patients can highlight ways in which White-identifying individuals have disproportionately received enhanced access to healthcare resources.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.