Abstract：
Integrating behavioral health services into primary care has a strong evidence base, but how primary care training programs incorporate integrated behavioral health (IBH) into care delivery and training has not been well described. The goal of this study was to evaluate factors related to successful IBH implementation in family medicine (FM) residency programs and assess perspectives and attitudes on IBH among program leaders.
FM residency programs, all which are required to provide IBH training, were recruited from the American Academy of Family Physicians National Research Network. After completing eligibility screening that included the Integrated Practice Assessment Tool (IPAT) questionnaire, 14 training programs were included. Selected practices identified 3 staff in key roles to be interviewed: medical director or similar, behavioral health professional (BHP), and chief medical officer or similar.
Forty-one individuals from 14 FM training programs were interviewed. IPAT scores ranged from 4 (Close Collaboration Onsite) to 6 (Full Collaboration). Screening, outcome tracking, and treatment differed among and within practices. Use of curricula and trainee experience also varied with little standardization. Most participants described similar approaches to communication and collaboration between primary care clinicians and BHPs and believed that IBH should be standard practice. Participants reported space, staff, and billing support as critical for sustainability.
Delivery and training experiences in IBH varied widely despite recognition of the value and benefits to patients and care delivery processes. Standardizing resources and training and simplifying and assuring reimbursement for services may promote sustainable and high quality IBH implementation.
FM residency programs, all which are required to provide IBH training, were recruited from the American Academy of Family Physicians National Research Network. After completing eligibility screening that included the Integrated Practice Assessment Tool (IPAT) questionnaire, 14 training programs were included. Selected practices identified 3 staff in key roles to be interviewed: medical director or similar, behavioral health professional (BHP), and chief medical officer or similar.
Forty-one individuals from 14 FM training programs were interviewed. IPAT scores ranged from 4 (Close Collaboration Onsite) to 6 (Full Collaboration). Screening, outcome tracking, and treatment differed among and within practices. Use of curricula and trainee experience also varied with little standardization. Most participants described similar approaches to communication and collaboration between primary care clinicians and BHPs and believed that IBH should be standard practice. Participants reported space, staff, and billing support as critical for sustainability.
Delivery and training experiences in IBH varied widely despite recognition of the value and benefits to patients and care delivery processes. Standardizing resources and training and simplifying and assuring reimbursement for services may promote sustainable and high quality IBH implementation.
摘要：
背景：将行为健康服务纳入初级保健具有强大的证据基础，但初级护理培训计划如何将综合行为健康(IBH)纳入护理提供和培训中,尚未得到很好的描述.这项研究的目的是评估与家庭医学（FM）居住计划中成功实施IBH相关的因素，并评估计划领导者对IBH的看法和态度。
方法：FM居住计划，所有这些都需要提供IBH培训，从美国家庭医师学会国家研究网络招募。在完成包括综合实践评估工具(IPAT)问卷在内的资格筛选后，包括14个培训计划。选定的做法确定了3名关键角色的工作人员进行面试：医疗主任或类似人员，行为健康专业人士(BHP)，和首席医疗官或类似人员。
结果：采访了来自14个FM培训计划的41个人。IPAT评分范围从4（现场紧密合作）到6（全面合作）。筛选,结果跟踪,和治疗方法在实践之间和实践中有所不同。课程的使用和受训者的经验也各不相同，几乎没有标准化。大多数参与者描述了初级保健临床医生和BHP之间的类似沟通和合作方法，并认为IBH应该是标准做法。参与者报告了空间，工作人员,和计费支持对可持续发展至关重要。
结论：尽管人们认识到对患者和护理交付过程的价值和益处，但IBH的交付和培训经验差异很大。标准化资源和培训，简化和确保服务报销，可以促进可持续和高质量的IBH实施。
方法：FM居住计划，所有这些都需要提供IBH培训，从美国家庭医师学会国家研究网络招募。在完成包括综合实践评估工具(IPAT)问卷在内的资格筛选后，包括14个培训计划。选定的做法确定了3名关键角色的工作人员进行面试：医疗主任或类似人员，行为健康专业人士(BHP)，和首席医疗官或类似人员。
结果：采访了来自14个FM培训计划的41个人。IPAT评分范围从4（现场紧密合作）到6（全面合作）。筛选,结果跟踪,和治疗方法在实践之间和实践中有所不同。课程的使用和受训者的经验也各不相同，几乎没有标准化。大多数参与者描述了初级保健临床医生和BHP之间的类似沟通和合作方法，并认为IBH应该是标准做法。参与者报告了空间，工作人员,和计费支持对可持续发展至关重要。
结论：尽管人们认识到对患者和护理交付过程的价值和益处，但IBH的交付和培训经验差异很大。标准化资源和培训，简化和确保服务报销，可以促进可持续和高质量的IBH实施。
