ackground and Goal: Integrated behavioral health (IBH), which combines behavioral health and primary care, improves patient outcomes and experience. This study evaluated whether a tailored, toolkit-based intervention could improve IBH and patient outcomes in primary care practices serving patients with multiple chronic medical and behavioral health conditions.
Study Approach: The study used a cluster randomized controlled trial design. Practices were randomized into two groups. The intervention arm received a comprehensive toolkit that included four components: workbooks to guide the quality improvement project, online education tailored to specific practice personnel roles, an online learning community to facilitate collaboration, and remote coaching provided by a trained quality improvement professional paired with a psychologist experienced in IBH. The control arm continued with their usual IBH services without receiving additional support.
Main Results: A total of 42 practices were randomized in the study.
Practices completing more intervention stages showed significant improvements in IBH integration, particularly in workflows, integration methods, and patient identification.
No significant clinically relevant differences were found in patient health outcomes—including depression, anxiety, fatigue, sleep disturbance, pain, pain interference, and physical function—between the intervention and control groups.
Why It Matters: A practice-centered, flexible intervention may help primary care practices tailor behavioral health integration to their specific needs and lead to better systems of care.
Intervention Stage Completion and Behavioral Health Outcomes: An Integrated Behavioral Health and Primary Care Randomized Pragmatic Trial
Kari A. Stephens, PhD, et al
Department of Family Medicine, University of Washington, Seattle, Washington
