Does behavioral health integration improve primary care providers' perceptions of health-care system functioning and their own knowledge?

Zallman, Leah; Joseph, Robert; O'Brien, Colleen; Benedetto, Emily; Grossman, Ellie; Arsenault, Lisa; Sayah, Assaad

doi:10.1016/j.genhosppsych.2017.03.005

Cited by 10 publications

(6 citation statements)

References 13 publications

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“…28 That the delivery of integrated care is challenging is not a surprise because much has been written about its burdens as well as its benefits. 2,7,8,21,44,54 But less attention has been paid to BHS providers of either adult 7,8,54 or pediatric services 2,21,44 who are often specialists in small numbers in these settings. To address these concerns, it seems critical to enhance the viability, effectiveness, and long-term stability of this important workforce to support the scale-up and sustainability of integrated pediatric health care.…”

Section: Discussionmentioning

confidence: 99%

“…The few existing surveys of adult or pediatric providers had samples of 39, 33 72, 34 and 84, 35 and later studies also had modest samples of 36 participants 2 and 89 participants, 8 with 2 exceptions (n = 305, 381) that obtained 3 samples collected over a 3-year period. 7,36 Based on these sample sizes, we sought to recruit a minimal sample of 250 surveys.…”

Section: Methodsmentioning

confidence: 99%

Section: Benefits and Challenges Of Integrated Pediatric Health Carementioning

confidence: 99%

“…6 Integration may also promote continuity of care by increasing the capacity of the indigenous workforce to engage families and deliver services, and reduce the risks for adverse family outcomes (eg, threats to child safety, need for more intensive services or placement). 7,8 Providers have also benefited from the addition of interventions targeting BH problems in pediatric practice settings. 9,10 These benefits include enhancing population health within the practice among children who experience behavioral and emotional dysfunction and making available decision support guidelines for managing BH conditions (eg, how to help a caregiver who is uncertain about the benefits or side effects of medication).…”

mentioning

confidence: 99%

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Integrated Pediatric Health Care in Pennsylvania: A Survey of Primary Care and Behavioral Health Providers

Kolko

Torres²,

Rumbarger³

et al. 2018

Clin Pediatr (Phila)

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This study reports on a statewide survey of medical and behavioral health professionals to advance the knowledge base on the benefits and obstacles to delivering integrated pediatric health care. Surveys distributed in 3 statewide provider networks were completed by 110 behavioral health specialists (BHSs) and 111 primary care physicians (PCPs). Survey content documented their perceptions about key services, benefits, barriers, and needed opportunities related to integrated care. Factor analyses identified 8 factors, and other items were examined individually. We compared responses by specialty group (BHS vs PCP) and integrated care experience (no vs yes). The findings revealed differences across domains by specialty subgroup. In several cases, BHS (vs PCP) respondents, especially those with integrated care experience, reported lower benefits, higher barriers, and fewer resource requests. The implications of these results for enhancing care integration development, delivery, training, and research are discussed along with the study’s limitations and empirical literature.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Benefits and Challenges Of Integrated Pediatric Health Carementioning

confidence: 99%

mentioning

confidence: 99%

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Integrated Pediatric Health Care in Pennsylvania: A Survey of Primary Care and Behavioral Health Providers

Kolko

Torres²,

Rumbarger³

et al. 2018

Clin Pediatr (Phila)

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“…In this study, we sought to provide early clinical data from both the patient and clinician perspective on the usage and integration of mental health apps in a busy integrated BH care service at Cambridge Health Alliance (CHA), a safety net healthcare system that includes three community hospitals and 12 Primary Care (PC) clinics which serve nearly 150,000 ethnically and socioeconomically diverse patients in the greater Boston area (19). The healthcare system had implemented an integrated model of care, based on the collaborative care model (20) and Screening, Brief Intervention and Referral to Treatment (SBIRT) (21), to support screening, assessment, and treatment of behavioral health conditions in primary care clinics.…”

Section: Introductionmentioning

confidence: 99%

Augmenting Mental Health in Primary Care: A 1-Year Study of Deploying Smartphone Apps in a Multi-site Primary Care/Behavioral Health Integration Program

et al. 2019

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Background: Integrating behavioral health (BH) services into primary care is an evidence-based intervention that can increase access to care, improve patient outcomes, and decrease costs. Digital technology, including smartphone apps, has the potential to augment and extend the reach of these integrated behavioral health services through self-management support impacting lifestyle behaviors. To date, the feasibility and acceptability of using mental health mobile apps within an integrated primary care setting has not yet been explored as part of routine clinical care. Objectives: The objectives of this study were to (a) test the feasibility of using mental health applications to augment integrated primary care services; (b) solicit feedback from patients and providers to guide implementation, and (c) develop a mental health apps toolkit for system-wide dissemination. Methods: Cambridge Health Alliance (CHA) is a safety-net healthcare system that includes three community hospitals and 12 Primary Care (PC) clinics serving nearly 150,000 ethnically and socioeconomically diverse patients around Boston. To select and disseminate mental health apps, a four-phase implementation was undertaken: (1) Evaluation of mental health mobile applications (2) Development of an apps toolkit with stakeholder input, (3) Conducting initial pilot at six primary care locations, and (4) Rolling out the app toolkit across 12 primary care sites and conducting 1-year follow-up survey. Results: Among BH providers, 24 (75%) responded to the follow-up survey and 19 (83%) indicated they use apps as part of their clinical care. Anxiety was the most common condition for which app use was recommended by providers, and 10 (42%) expressed interest in further developing their knowledge of mental health apps. Among patients, 35 (65%) of participants provided feedback; 23 (66%) reported the tools to be helpful, especially for managing stress and anxiety. Conclusions: Our findings indicate mental health apps are applicable and relevant to patients within integrated primary care settings in safety-net health systems. Behavioral health providers perceive the clinical value of using these tools as part of patient care, but require training to increase their comfort-level and confidence applying these tools with patients. To increase provider and patient engagement, mobile apps must be accessible, simple, intuitive and directly relevant to patients' treatment needs.

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Collaborative Treatment with Primary Care

Lloyd¹,

Newland²

2021

Child and Adolescent Behavioral Health

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Does behavioral health integration improve primary care providers' perceptions of health-care system functioning and their own knowledge?

Cited by 10 publications

References 13 publications

Integrated Pediatric Health Care in Pennsylvania: A Survey of Primary Care and Behavioral Health Providers

Integrated Pediatric Health Care in Pennsylvania: A Survey of Primary Care and Behavioral Health Providers

Augmenting Mental Health in Primary Care: A 1-Year Study of Deploying Smartphone Apps in a Multi-site Primary Care/Behavioral Health Integration Program

Collaborative Treatment with Primary Care

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