Exploratory Factor Analysis of a Patient-Facing PCBH Adherence Measure: The PPAQ-Patient

Area of Science:

• Health Services Research
• Primary Care
• Mental Health Services

Background:

• Model adherence is crucial for evaluating the fidelity of integrated care programs.
• Existing adherence evaluations in primary care settings primarily focus on system and provider factors.
• Integrated primary care models embed mental health services within primary care clinics, requiring specific adherence assessments.

Purpose of the Study:

• To preliminarily evaluate a novel patient-facing measure, the Primary Care Behavioral Health Provider Adherence Questionnaire-Patient Version (PPAQ-Patient).
• To determine if the PPAQ-Patient can offer insights into adherence to the Primary Care Behavioral Health (PCBH) model.
• To assess patient perspectives on adherence to integrated mental health care.

Main Methods:

• Survey data were collected from 281 veterans receiving PCBH care.
• Exploratory factor analyses were employed to evaluate the data structure of the PPAQ-Patient.
• The study examined the feasibility of using patient self-report to assess adherence.

Main Results:

• Preliminary findings suggest a 19-item measure across three temporally-referenced subscales.
• These subscales appear to feasibly capture patient perspectives on PCBH adherence.
• The results indicate that patient views can reflect adherence at different treatment stages.

Conclusions:

• The PPAQ-Patient shows potential as a tool for assessing adherence to the PCBH model from a patient's viewpoint.
• Further refinement of the PPAQ-Patient measure is warranted.
• Patient-reported outcomes can provide valuable data on the implementation of integrated care models.