Understanding and Navigating the Unique Barriers Rural Primary Care Settings Face when Implementing Collaborative Care for Mental Health.

IF 1.8 4区医学 Q3 HEALTH POLICY & SERVICES

Community Mental Health Journal Pub Date : 2024-09-06 DOI:10.1007/s10597-024-01348-6

Elizabeth J Austin, Elsa S Briggs, Angel Cheung, Erin LePoire, Brittany E Blanchard, Amy M Bauer, Morhaf Al Achkar, Diane M Powers

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引用次数: 0

Abstract

Rural primary care (RPC) clinics may face unique barriers to implementing the Collaborative Care Model (CoCM). We used mixed methods to explore RPC staff and practice facilitator (PF) perspectives on CoCM implementation. PFs reported on barriers and facilitators experienced after each monthly meeting with clinics (n = 459 surveys across 23 clinics). Data were analyzed descriptively and informed qualitative interviews with a purposive sample (n = 11) of clinic staff and PFs. Interviews were analyzed using Rapid Assessment Process and triangulated with quantitative data. The most prominent barriers experienced were: (1) the COVID-19 pandemic, (2) limited availability of site staff to participate in implementation activities, and (3) hiring of new CoCM staff. Qualitative data further characterized the ways these barriers uniquely influenced RPC settings and promising implementation strategies. RPC settings face unique challenges to CoCM implementation, but several promising implementation strategies - when tailored to RPC contexts - may help.

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了解和驾驭农村初级保健机构在实施精神健康协作护理时所面临的独特障碍。

农村初级保健 (RPC) 诊所在实施协作护理模式 (CoCM) 时可能会面临独特的障碍。我们采用混合方法探讨了 RPC 员工和实践促进者 (PF) 对 CoCM 实施的看法。实践促进者在与诊所每月举行一次会议后报告了所遇到的障碍和促进因素（23 家诊所共 459 份调查问卷）。对数据进行了描述性分析，并在此基础上对诊所员工和 PF 进行了有目的的抽样定性访谈（n = 11）。访谈采用快速评估程序进行分析，并与定量数据进行三角测量。所遇到的最突出障碍是(1) COVID-19 大流行，(2) 参与实施活动的现场工作人员有限，以及 (3) 聘用新的 CoCM 工作人员。定性数据进一步说明了这些障碍对区域儿童保护中心的独特影响以及有前途的实施策略。区域儿童保护中心在实施 CoCM 方面面临着独特的挑战，但有几种可行的实施策略--如果适合区域儿童保护中心的情况--可能会有所帮助。

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来源期刊

Community Mental Health Journal Multiple-

CiteScore

5.30

自引率

3.70%

发文量

133

期刊介绍： Community Mental Health Journal focuses on the needs of people experiencing serious forms of psychological distress, as well as the structures established to address those needs. Areas of particular interest include critical examination of current paradigms of diagnosis and treatment, socio-structural determinants of mental health, social hierarchies within the public mental health systems, and the intersection of public mental health programs and social/racial justice and health equity. While this is the journal of the American Association for Community Psychiatry, we welcome manuscripts reflecting research from a range of disciplines on recovery-oriented services, public health policy, clinical delivery systems, advocacy, and emerging and innovative practices.