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Considerations for Behavioral Health Integration Program Implementation in Pediatric Primary Care Settings: A

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Pediatric primary care clinicians found the Behavioral Health Integration Program (BHIP) helpful for integrating behavioral health (BH) care. Key barriers and facilitators involved practice structures, culture, and financial aspects of BH integration.

Keywords:
behavioral health integrationimplementationprimary care

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Area of Science:

  • Pediatric primary care
  • Behavioral health integration
  • Implementation science

Background:

  • 16% of US children have behavioral health (BH) disorders, yet less than half receive adequate care.
  • Integrated BH programs in primary care can bridge this care gap.
  • This study explores clinician experiences with a novel BH integration program.

Purpose of the Study:

  • To understand pediatric primary care clinicians' experiences with the Behavioral Health Integration Program (BHIP).
  • To identify barriers and facilitators for implementing BH integration programs in pediatric primary care.

Main Methods:

  • Qualitative study using semi-structured interviews with 31 clinicians.
  • Utilized the Consolidated Framework for Implementation Research (CFIR) as a theoretical framework.
  • Employed inductive and deductive analysis based on constructivist grounded theory.

Main Results:

  • Most clinicians supported BH integration and found BHIP facilitated it.
  • Barriers and facilitators primarily related to CFIR's Inner and Outer setting domains.
  • Key themes included BH care delivery/finance, practice structure, culture, and clinician impact.

Conclusions:

  • BHIP effectively supported BH integration across diverse settings.
  • Recommendations include enhanced BH clinician training and context-specific tailoring.
  • Advocacy is needed to address structural barriers to BH care delivery.