A Cluster Randomized Trial of Primary Care Practice Redesign to Integrate Behavioral Health for Those Who Need It Most: Patients With Multiple Chronic Conditions.

Purpose: Patient outcomes can improve when primary care and behavioral health providers use a collaborative system of care, but integrating these services is difficult. We tested the effectiveness of a practice intervention for improving patient outcomes by enhancing integrated behavioral health (IBH) activities.

Methods: We conducted a pragmatic, cluster randomized controlled trial.

The Time Is Now: A Plan to Redesign Family Medicine Residency Education.

A new graduate medical education program in family medicine is urgently needed now. We propose an innovative plan to develop community-based, community-owned family medicine residency programs. The plan is founded on five guiding principles in which residencies will (1) transition to independent, community-owned organizations; (2) sustain comprehensiveness and generalism; (3) emphasize collaborative learning and interprofessional education; (4) develop local educators with national guidance; and (5) share resources, responsibilities, and learning.

Shared Language for Shared Work in Population Health.

People working on behalf of population health, community health, or public health often experience confusion or ambiguity in the meaning of these and other common terms-the similarities and differences and how they bear on the tasks and division of labor for care delivery and public health. Shared language must be clear enough to help, not hinder people working together as they ultimately come to mutual understanding of roles, responsibilities, and actions in their joint work. Based on an iterative lexicon development process, the authors developed and propose a definitional framework as an aid to navigating among related population and community health terms.

Nomination of Parinda Khatri for Don Bloch Award, 2020.

This article focuses on Parinda Khatri, PhD, who was nominated for the annual Don Bloch Award. This award is the quintessential organizational award for members who have advanced the field of collaborative care, and who show intellectual, behavioral, and relational qualities. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A step at a time.

In this issue of are two articles that inch us on our winding way forward as we try to help people become healthier. This article takes stock of where we are now, starting from the start, equipped with three of our foundational guiding principles, and sighting our polestar to see what our best next moves might be. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Mixed method evaluation of Relational Team Development (RELATED) to improve team-based care for complex patients with mental illness in primary care.

Background: Patients with mental illness are frequently treated in primary care, where Primary Care Providers (PCPs) report feeling ill-equipped to manage their care. Team-based models of care improve outcomes for patients with mental illness, but multiple barriers limit adoption. Barriers include practical issues and psychosocial factors associated with the reorganization of care.

Without Wasting a Word: Extreme Improvements in Efficiency and Accuracy Using Computerized Adaptive Testing for Mental Health Disorders (CAT-MH).

Purpose Of Review: We review recent literature on the adaptive assessment of complex mental health disorders and provide a detailed comparison of classical test theory and adaptive testing based on multidimensional item response theory.

Recent Findings: Adaptive tests for a wide variety of mental health traits (e.g.

Outcomes of Integrated Behavioral Health with Primary Care.

Background: Integrating behavioral health and primary care is beneficial to patients and health systems. However, for integration to be widely adopted, studies demonstrating its benefits in community practices are needed. The objective of this study was to evaluate effect of integrated care, adapted to local contexts, on depression severity and patients' experience of care.

Development and initial validation of primary care provider mental illness management and team-based care self-efficacy scales.

Objective: Develop and validate self-efficacy scales for primary care provider (PCP) mental illness management and team-based care participation.

Study Design And Setting: We developed three self-efficacy scales: team-based care (TBC), mental illness management (MIM), and chronic medical illness (CMI). We developed the scales using Bandura's Social Cognitive Theory as a guide.

Implementation of behavioral health interventions in real world scenarios: Managing complex change.

Introduction: A practice embarks on a radical reformulation of how care is designed and delivered when it decides to integrate medical and behavioral health care for its patients and success depends on managing complex change in a complex system. We examined the ways change is managed when integrating behavioral health and medical care.

Method: Observational cross-case comparative study of 19 primary care and community mental health practices.

Primary care providers' experiences caring for complex patients in primary care: a qualitative study.

Background: Complex patients are increasingly common in primary care and often have poor clinical outcomes. Healthcare system barriers to effective care for complex patients have been previously described, but less is known about the potential impact and meaning of caring for complex patients on a daily basis for primary care providers (PCPs). Our objective was to describe PCPs' experiences providing care for complex patients, including their experiences of health system barriers and facilitators and their strategies to enhance provision of effective care.

A Plan for Useful and Timely Family Medicine and Primary Care Research.

Our nation's health care system is changing. Nowhere is this more evident than in primary care, where fundamental improvements are necessary if we are to achieve the Triple Aim. Such improvements are possible if we can put useful and timely information into the hands of stakeholders to enable practical decision-making.

Integrating Behavioral Health and Primary Care: Consulting, Coordinating and Collaborating Among Professionals.

Purpose: This paper sought to describe how clinicians from different backgrounds interact to deliver integrated behavioral and primary health care, and the contextual factors that shape such interactions.

Methods: This was a comparative case study in which a multidisciplinary team used an immersion-crystallization approach to analyze data from observations of practice operations, interviews with practice members, and implementation diaries. The observed practices were drawn from 2 studies: Advancing Care Together, a demonstration project of 11 practices located in Colorado; and the Integration Workforce Study, consisting of 8 practices located across the United States.

Inspiration and instruction: Commentary on C. J. Peek's study of Don Bloch's legacy.

Comments on the article "Don Bloch's vision for Collaborative Family Health Care: Progress and next steps" by C. J. Peek (see record 2015-25290-002).

Research and evaluation in the transformation of primary care.

Across the United States, primary care practices are engaged in demonstration projects and quality improvement efforts aimed at integrating behavioral health and primary care. Efforts to make sustainable changes at the frontline of care have identified new research and evaluation needs. These efforts enable clinics and larger health care communities to learn from demonstration projects regarding what works and what does not when integrating mental health, substance use, and primary care under realistic circumstances.

Integrating primary care and behavioral health with four special populations: Children with special needs, people with serious mental illness, refugees, and deaf people.

Special patient populations can present unique opportunities and challenges to integrating primary care and behavioral health services. This article focuses on four special populations: children with special needs, persons with severe and persistent mental illness, refugees, and deaf people who communicate via sign language. The current state of primary care and behavioral health collaboration regarding each of these four populations is examined via Doherty, McDaniel, and Baird's (1996) five-level collaboration model.

An introduction to primary care and psychology.

The health care system in the United States has been less effective and more expensive than it needs to be, but the organizational and political will to address these shortcomings is beginning to emerge. These changes are particularly noticeable in primary care, at the heart of an improved health care system. The value of primary care turns on its comprehensiveness, which means that behavioral health care-health behavior change, mental health care, management of psychological symptoms and psychosocial distress, and attention to substance abuse-must be woven into the fabric of primary care practice.

Primary care physician perceptions on caring for complex patients with medical and mental illness.

Background: Mental illness is common and associated with poor outcomes for co-occurring medical illness. Since primary care physicians manage the treatment of complex patients with both mental and medical illnesses, their perspectives on the care of these patients is vital to improving clinical outcomes.

Objective: To examine physician perceptions of patient, physician and system factors that affect the care of complex patients with mental and medical illness.