Robles Brenda, Kwak Hannah, Kuo Tony
Research Group On Statistics, Econometrics, and Health (GRECS), University of Girona, Carrer de la Universitat de Girona 10, Campus de Montilivi, Girona, 17003, Spain.
Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
Int J Behav Med. 2025 Jun;32(3):463-475. doi: 10.1007/s12529-024-10259-5. Epub 2024 Feb 22.
Behavioral health services (BHS) can help improve and treat mental and emotional health problems. Yet, attitudinal and/or structural barriers often prevent individuals from accessing and benefiting from these services. Positive provider-patient interactions in healthcare, encompassing patient comfort with a primary care provider (PCP), which is often enhanced by shared decision-making, may mitigate the stigma associated with seeing a mental health professional; this may improve BHS utilization among patients who need these services. However, few studies have examined how patient comfort with a PCP, often through shared decision-making, may influence patients' BHS utilization in the real world. This study sought to address this gap in practice.
Multivariable regression analyses, using weighted data from an internet panel survey of Los Angeles County adults (n = 749), were carried out to examine the associations between patient comfort with a PCP and three measures of BHS utilization. Subsequent analyses were conducted to explore the extent to which shared decision-making moderated these associations.
Participants who reported an intermediate or high comfort level with a provider had higher odds of reporting that they were likely to see (aOR = 2.10 and 3.84, respectively) and get advice (aOR = 2.75 and 4.76, respectively) from a mental health professional compared to participants who reported a low comfort level. Although shared decision-making influenced participants' likelihood of seeing and getting advice from a mental health professional, it was not a statistically significant moderator in these associations.
Building stronger relationships with patients may improve BHS utilization, a provider practice that is likely underutilized.
行为健康服务(BHS)有助于改善和治疗心理与情绪健康问题。然而,态度和/或结构障碍常常阻碍个体获得这些服务并从中受益。医疗保健中积极的医患互动,包括患者对初级保健提供者(PCP)的舒适度,这通常通过共同决策得到增强,可能会减轻与寻求心理健康专业人员帮助相关的污名化;这可能会提高有这些服务需求的患者对BHS的利用率。然而,很少有研究探讨患者对PCP的舒适度(通常通过共同决策)在现实世界中如何影响患者对BHS的利用率。本研究旨在填补这一实践空白。
使用来自对洛杉矶县成年人进行的互联网小组调查的加权数据(n = 749)进行多变量回归分析,以检验患者对PCP的舒适度与BHS利用率的三项指标之间的关联。随后进行分析,以探讨共同决策在多大程度上调节了这些关联。
与报告舒适度低的参与者相比,报告对提供者有中等或高舒适度的参与者更有可能表示他们可能会去看心理健康专业人员(调整后比值比分别为2.10和3.84)并获得建议(调整后比值比分别为2.75和4.76)。尽管共同决策影响了参与者去看心理健康专业人员并获得建议的可能性,但在这些关联中它不是一个具有统计学意义的调节因素。
与患者建立更紧密的关系可能会提高BHS的利用率,这是一种可能未得到充分利用的提供者实践。