Integrated Behavioral Health Care in Family Medicine Residencies

Jacobs, Christine; Brieler, Jay; Salas, Joanne; Betancourt, Renée M; Cronholm, Peter F.

doi:10.22454/fammed.2018.639260

Cited by 11 publications

(6 citation statements)

References 8 publications

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“…Programs that use a longitudinal BH curriculum could overcome some of the barriers associated with a “one-time” rotational training design. 20 Faculty instructors may consider conducting a needs assessment prior to implementing a structured IBH curriculum for their residents. Assessment results may reveal barriers like the ones listed above; faculty can resolve challenges prior to the start of the training to increase the success of competency development.…”

Section: Discussionmentioning

confidence: 99%

Preparing residents to practice integrated behavioral health care: Multi-site feasibility study of a competency-based curriculum

Martin

Banks

Myerholtz

et al. 2022

Int J Psychiatry Med

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Objective Workforce development is essential for the dissemination of team-based integrated behavioral healthcare. There is limited literature on training family medicine residents to function within an integrated behavioral health (IBH) system. The purpose of this pilot study was to assess the feasibility and value of an IBH competency-based curriculum for family medicine residents across multiple programs. Methods Residency programs were recruited using professional listservs and networks to test a competency-based, multi-modal curriculum for preparing residents to practice IBH in primary care. Faculty instructors who led the workshop were invited to complete semi-structured interviews to examine the feasibility and appropriateness of the curriculum. Interview data were analyzed using thematic analysis to identify, analyze, and report patterns. Residents completed a survey of perceived IBH skill and knowledge before and after training. A paired-sample t-test was used to determine significant differences pre- and post-training. Results All five instructors completed interviews. Results suggest IBH training is valuable. Instructors gave specific feedback on online modules, implementation flexibility, and adjusting faculty development to differing levels of experience. Nineteen of forty residents (48%) completed anonymous pre-, post-, and retrospective-training surveys. Residents reported an increase in competence after training. Conclusion The results of this pilot suggest that IBH training implementation is feasible, desirable, timely, and may improve resident ability to work on an IBH team. Training should accommodate variations in program structure and faculty expertise.

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Section: Discussionmentioning

confidence: 99%

Preparing residents to practice integrated behavioral health care: Multi-site feasibility study of a competency-based curriculum

Martin

Banks

Myerholtz

et al. 2022

Int J Psychiatry Med

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“…(A noted benefit of having a behavioral health counselor in your clinic is the opportunity for informal briefings on patient progress. 33,34 ) Following each visit with Joe, you make sure to complete documentation on (1) tobacco/e-cigarette use assessment, (2) diagnoses, (3) discussion of benefits of quitting, (4) assessment of readiness to quit, (5) creation and support of a quit plan, and (6) connection with a behavioral health counselor and…”

Section: The Casementioning

confidence: 99%

Youth e-cigarette use: Assessing for, and halting, the hidden habit

Leavens¹,

Freedy²

2021

The Journal of Family Practice

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Youth e-cigarette use: Assessing for, and halting, the hidden habit Using a checklist to establish patients' level of dependence and combining behavioral therapy with nicotine replacement products can help users to quit. THE CASEJoe, an 18-year-old, has been your patient for many years and has an uncomplicated medical history. He presents for his preparticipation sports examination for the upcoming high school baseball season. Joe's mother, who arrives at the office with him, tells you she's worried because she found an e-cigarette in his backpack last week. Joe says that many of the kids at his school vape and he tried it a while back and now vapes "a lot."After talking further with Joe, you realize that he is vaping every day, using a 5% nicotine pod. Based on previous consults with the behavioral health counselor in your clinic, you know that this level of vaping is about the same as smoking 1 pack of cigarettes per day in terms of nicotine exposure. Joe states that he often vapes in the bathroom at school because he cannot concentrate in class if he doesn't vape. He also reports that he had previously used 1 pod per week but had recently started vaping more to help with his cravings.You assess his withdrawal symptoms and learn that he feels on edge when he is not able to vape and that he vapes heavily before going into school because he knows he will not be able to vape again until his third passing period.

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“…13 Literature on BH integration in primary care residency and nonresidency settings is scarce and tends to be limited to samples of selective, high-performing practices. 14 For instance, in the 2017 Council of Academic Family Medicine Educational Research Alliance (CERA) survey completed by program directors, Jacobs et al 15 found that about one-third of the family medicine residency programs practiced full BH integration and nearly half had BH services colocated within their clinics. Family medicine residency programs with high levels of BH integration reported using a variety of behavioral professionals and services.…”

Section: Introductionmentioning

confidence: 99%

Integrated Behavioral Health in Primary Care Residency and Nonresidency Practices

Mollis

West

et al. 2023

Fam Med

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Background and Objectives: Integrated behavioral health (BH) is becoming a preferred model of care for primary care because it improves patient outcomes and satisfaction. Little is known about whether residency practices are consistently modeling this preferred care model relative to real-world nonresidency practices. The study compared levels of BH integration, patient health outcomes, and satisfaction with care between residency practices and nonresidency practices with colocated BH providers. Methods: Baseline data were collected in 2018-2019 from 44 practices and their adult patients with chronic conditions participating in a cluster-randomized, pragmatic trial to improve BH integration. The sample included 18 (40.9%) residency and 26 (59.1%) nonresidency practices, with 1,817 (45.3%) patients from residency practices and 2,190 (54.7%) patients from nonresidency practices. Outcomes including BH integration levels (the Practice Integration Profile), patient health outcomes (the PROMIS-29), and patient satisfaction with care (the Consultation and Relational Empathy scale) were compared between residency and nonresidency practices using multivariate regression analyses. Results: No differences were found between BH integration levels, patient health outcomes, and patient satisfaction with care between residency and nonresidency practices. In a sample of primary care practices with colocated BH providers, residencies had BH integration and patient outcomes similar to real-world practices. Conclusions: Primary care practices with residency programs reported comparable levels of BH integration, patient health outcomes, and patient satisfaction compared to practices without residency programs. Both types of practices require interventions and resources to help them overcome challenges associated with dissemination of high levels of BH integration.

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Integrated Behavioral Health Care in Family Medicine Residencies

Cited by 11 publications

References 8 publications

Preparing residents to practice integrated behavioral health care: Multi-site feasibility study of a competency-based curriculum

Preparing residents to practice integrated behavioral health care: Multi-site feasibility study of a competency-based curriculum

Youth e-cigarette use: Assessing for, and halting, the hidden habit

Integrated Behavioral Health in Primary Care Residency and Nonresidency Practices

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