{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T00:15:37Z","timestamp":1772237737563,"version":"3.50.1"},"reference-count":31,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Pediatr Parent"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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\u2019s condition and (2) subjective strain, that arises from the caregiver\u2019s feelings regarding these events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to evaluate the impact of a technology-enabled pediatric and family behavioral health service on caregivers\u2019 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We examined changes in caregiver strain using the Caregiver Strain Questionnaire-Short Form 7 over the course of their child\u2019s 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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\u2019s future and feeling tired and sad, and (4) financial strain. Caregiver strain, which was associated with the child\u2019s disease severity (P&lt;.001), decreased significantly in all therapeutic groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/59475","type":"journal-article","created":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T09:00:36Z","timestamp":1724662836000},"page":"e59475","source":"Crossref","is-referenced-by-count":1,"title":["Telebehavioral Health for Caregivers of Children With Behavioral Health Needs to Address Caregiver Strain: Cohort Study"],"prefix":"10.2196","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4082-9131","authenticated-orcid":false,"given":"Theoren","family":"Loo","sequence":"first","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7634-9514","authenticated-orcid":false,"given":"Myra","family":"Altman","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1961-9252","authenticated-orcid":false,"given":"David","family":"Grodberg","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5782-1422","authenticated-orcid":false,"given":"Jennifer","family":"La Guardia","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4513-8279","authenticated-orcid":false,"given":"Dena","family":"Bravata","sequence":"additional","affiliation":[]}],"member":"1010","published-online":{"date-parts":[[2024,8,26]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.su7102a1"},{"key":"ref2","unstructured":"MurthyVHProtecting youth mental health: the U.S. Surgeon General's advisory20212024-07-13US Public Health Serviceshttps:\/\/www.hhs.gov\/sites\/default\/files\/surgeon-general-youth-mental-health-advisory.pdf"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6750a1"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1186\/s13034-020-00329-3"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1007\/s11414-006-9035-1"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1037\/h0079535"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1002\/dev.22013"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1177\/0192513X12440949"},{"key":"ref9","unstructured":"2022 Workforce health index2022-08-31Castlight Healthhttps:\/\/www.castlighthealth.com\/resource-center\/2022-whi\/"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.23.3135"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2021.01.030"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.2196\/37285"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.2196\/43600"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-0974"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-015-0982-9"},{"key":"ref17","unstructured":"Manual of the Peabody treatment progress battery2024-07-23VU e-Innovationshttp:\/\/vueinnovations.com\/overview-ptpb"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1007\/s10488-012-0412-1"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-0038"},{"key":"ref20","unstructured":"Chapter 12. 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