Roderick Sarah S, Burdette Nelly, Hurwitz Debra, Yeracaris Pano
University of Massachusetts Medical School.
Care Transformation Collaborative of Rhode Island.
Fam Syst Health. 2017 Jun;35(2):227-237. doi: 10.1037/fsh0000273.
The purpose of this study was to assess the degree of behavioral health (BH) integration change in patient-centered medical homes (PCMHs) when using a practice facilitator (PF) specially trained in implementing integrated care and how a quasi-experimental design assists in this process.
Twelve PCMHs, 8 Federally Qualified Health Centers and 4 private practices, with varying degrees of BH services participated in this study. The degree of BH integration was assessed with a quasi-experimental design using the Maine Health Access Foundation's Site Self Assessment (MeHAF SSA) at baseline and after implementing site-specific BH services. The sites tracked completion of unique objectively measured goals being implemented using the Goal Attainment Scale (GAS) score.
At the conclusion of the study, sites saw a statistically significant increase in the level of BH integration from a baseline of 2.73 (SD = 0.44) to a postintervention score of 3.49 (SD = 0.22) with improvements from mild-moderate overall integration to moderate-advanced overall integration (p < .001). In addition, 10 out of the 12 sites achieved successful implementation of unique goals with assistance from the PF.
This study provides the first quasi-experimental/pretest-posttest evidence utilizing real-world data that the practice facilitation method is an effective solution toward increasing the degree of BH integration. This paper describes the real-world efforts to evaluate the degree of BH integration change in PCMHs when using a PF with content expertise in BH integration within primary care. (PsycINFO Database Record
本研究的目的是评估在使用经过实施综合护理专门培训的实践促进者（PF）时，以患者为中心的医疗之家（PCMH）中行为健康（BH）整合变化的程度，以及准实验设计如何在此过程中提供帮助。
12个PCMH，其中8个联邦合格健康中心和4个私人诊所，提供不同程度的BH服务，参与了本研究。在基线时以及实施特定场所的BH服务后，采用准实验设计，使用缅因州健康获取基金会的场所自我评估（MeHAF SSA）评估BH整合的程度。各场所跟踪使用目标达成量表（GAS）分数来衡量的独特客观测量目标的完成情况。
在研究结束时，各场所的BH整合水平从基线时的2.73（标准差 = 0.44）有统计学显著提高，干预后得分为3.49（标准差 = 0.22），从轻度 - 中度的整体整合改善为中度 - 高度的整体整合（p <.001）。此外，12个场所中的10个在PF的协助下成功实现了独特目标。
本研究提供了首个利用实际数据的准实验/前测 - 后测证据，表明实践促进方法是提高BH整合程度的有效解决方案。本文描述了在初级保健中使用具有BH整合内容专业知识的PF时，评估PCMH中BH整合变化程度的实际努力。（PsycINFO数据库记录
