(PS8-D94) Development and Implementation of Tele-pcit in Response to the COVID-19 Pandemic in a Largely Rural State

Largely poor and rural, the state of Mississippi has 2.97 million citizens (U.S. Census Bureau, 2019). The state leads in percent living below poverty level (19.6% vs U.S. 10.5%). The population largely lives in rural areas (51.2%; 4^th largest in U.S.). All 82 counties in the state of Mississippi are designated Mental Health Professional Shortage Areas (Health Resources & Services Administration [HRSA], 2018). Mississippi children and adults participate in evidence-based programs at lower rates than the U.S. average (HRSA, 2018), and the state scores lowest in quality of evidence-based practices and workforce availability (Harvard Law School Mississippi Delta [HLSMD] Project, 2014), which contributes to tremendous mental health inequities. The emergence of COVID-19 and its associated variants further exacerbated inequities across systems of care in a state plagued by a dearth of resources, especially behavioral health services. In the wake of the pandemic, children were required to complete school via distance learning, discontinue extracurricular activities, and isolate from peers and lose access to many services and resources, particularly those children with disabilities and living in poorer families. School closures negatively impacted child and adolescent mental health by increasing feelings of loneness and anxiety which in turn lead to a negative impact on children’s behavior. During school closures, mothers reported an increase in hyperactivity and lack of discipline in their children (Chaabane et al., 2021). Since the COVID-19 pandemic one study shows 70-90% of children had some aspects of their behavior that worsened (Panda et al., 2020). In response to the COVID-19 pandemic, which created physical and mental health emergencies, an existing Parent-Child Interaction Therapy (PCIT) program was converted to a Tele-PCIT program in an effort to meet the needs of children and families and expand access to care utilizing a dissemination and implementation framework. The aim of the study is to provide descriptive information about initial efforts to develop and implement Tele-PCIT in response to the COVID-19 pandemic in a largely rural state characterized by a high behavioral health need.