Defense Date


Document Type


Degree Name

Doctor of Philosophy


Clinical Psychology

First Advisor

Heather Jones

Second Advisor

Bruce Rybarczyk

Third Advisor

Terri Sullivan

Fourth Advisor

Jennifer Rohan

Fifth Advisor

Stephanie Crewe


Mental health problems (e.g., attention, externalizing, internalizing) are commonly observed in youth and are often associated with significant impairment and an increased need for mental health services. Conceptual frameworks, such as Andersen’s Behavioral Model of Health Service Utilization, have proposed that several individual determinants (e.g., predisposing, enabling, and need factors) may influence service use for mental health problems among youth. Despite the glaring need for mental health treatment among youth with mental health problems, studies indicate that many affected youths do not receive mental health care. Integrated pediatric primary care (IPPC) settings provide an ideal setting for youth and families to receive adequate evidence-based services to assess and treat mental health problems. Guided by Andersen’s Behavioral Model of Health Service Utilization, the present study sought to examine individual factors associated with behavioral health service utilization in an urban, mid-Atlantic IPPC clinic. The study (N = 403; Mage = 10.74, SD = 3.67 years; 50.6% female) identified two distinct subgroups (“Significant Comorbid Problems” and “Predominantly Internalizing”) and significant predictors (age, gender) of subgroup membership. Although there were no significant differences in behavioral health service use between the two groups, the study found that older youth in the “Significant Comorbid Problems” subgroup were associated with higher behavioral health service use, whereas females in the “Predominantly Internalizing” subgroup were associated with higher behavioral health service use. Results of the present study provide support for factors associated with IPPC behavioral health service use among a mostly racial/ethnic minoritized, urban sample of youth and families.


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