Interdisciplinary behavioral health provider perceptions of implementing the Collaborative Chronic Care Model: an...

Area of Science:

• Healthcare Management
• Implementation Science
• Chronic Disease Management

Background:

• The Collaborative Chronic Care Model (CCM) is an evidence-based framework for structuring chronic health condition care.
• Understanding implementation influences is vital as CCM adoption grows in real-world settings.
• The Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework guided the assessment of these influences.

Purpose of the Study:

• To identify innovation-, recipient-, context-, and facilitation-related influences on CCM implementation.
• To assess the relationship between these influences and the implementation of each CCM element.

Main Methods:

• Semi-structured interviews were conducted with 31 interdisciplinary behavioral health providers at nine VA medical centers.
• The i-PARIHS constructs were used as a priori codes for directed content analysis.
• Data were analyzed for cross-coding by CCM element and i-PARIHS construct.

Main Results:

• Providers found the CCM enabling for comprehensive care but challenging to integrate with existing structures.
• Recipient authority and local leadership support were perceived as critical for successful implementation.
• Implementation facilitation was helpful, and key themes emerged at the intersection of i-PARIHS constructs and CCM elements.

Conclusions:

• Future CCM implementation should focus on strategic self-management support, staff collocation, updated community resource information, and clear care processes.
• Tailoring implementation efforts to address challenging CCM elements is crucial.
• Accounting for diverse influences across various care settings will improve CCM effectiveness.