Families Systems & Health最新文献_第6页

Facilitators and challenges of implementing an integrated behavioral health model: An exploratory qualitative analysis of a New Jersey demonstration project. 实施综合行为健康模型的促进因素和挑战：新泽西州示范项目的探索性定性分析。

IF 1 4区医学

Families Systems & Health Pub Date : 2026-03-01 Epub Date: 2025-06-05 DOI: 10.1037/fsh0000988

Rebecca A Klege, Jennifer C Berko, Theresa Menders, Charu Verma, Ann M Nguyen

{"title":"Facilitators and challenges of implementing an integrated behavioral health model: An exploratory qualitative analysis of a New Jersey demonstration project.","authors":"Rebecca A Klege, Jennifer C Berko, Theresa Menders, Charu Verma, Ann M Nguyen","doi":"10.1037/fsh0000988","DOIUrl":"10.1037/fsh0000988","url":null,"abstract":"Introduction: Despite strong evidence supporting integrated behavioral health (IBH), implementing the Primary Care Behavioral Health (PCBH) model remains challenging, particularly in safety-net settings like Federally Qualified Health Centers (FQHCs) and Community Health Centers (CHCs). This study examines facilitators and barriers to PCBH adoption during a New Jersey-based demonstration project funded by The Nicholson Foundation (2013-2019).Method: We conducted semistructured interviews with 18 behavioral health and primary care staff from 10 FQHCs/CHCs between June and September 2022. A thematic analysis using both inductive and deductive approaches guided our interpretation.Results: Five key facilitators emerged: (a) external system support, (b) leadership champions driving workflow redesign, (c) positive provider attitudes toward change, (d) comprehensive PCBH training for all staff, and (e) visibility of behavioral health consultants. Major challenges included: (a) lack of resources and standardized training materials, (b) difficulty recruiting and retaining behavioral health professionals, and (c) complex billing processes that delay revenue generation.Discussion: While PCBH implementation is complex, critical enablers can support success in FQHCs/CHCs. As PCBH gains traction in healthcare systems, insights from this study can inform future efforts, particularly in underserved settings aiming to integrate behavioral health into primary care. (PsycInfo Database Record (c) 2026 APA, all rights reserved).","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":" ","pages":"14-28"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Review of Ethics of Medical AI. 医学人工智能伦理学综述。

IF 1.2 4区医学

Families Systems & Health Pub Date : 2026-03-01 DOI: 10.1037/fsh0001040

Muhammed Parviz

引用次数: 0

Drawing toward empathy-Physician communication. 吸引移情-医生沟通。

IF 1.2 4区医学

Families Systems & Health Pub Date : 2026-03-01 DOI: 10.1037/fsh0001026

Kristin Watkins

引用次数: 0

In our words: Patient reports of the utility of primary care behavioral health services. 用我们的话说患者对初级保健行为健康服务效用的报告。

IF 1 4区医学

Families Systems & Health Pub Date : 2026-03-01 Epub Date: 2025-02-17 DOI: 10.1037/fsh0000956

Emily L Allen, Alyssa J Hartley, Ana J Bridges

{"title":"In our words: Patient reports of the utility of primary care behavioral health services.","authors":"Emily L Allen, Alyssa J Hartley, Ana J Bridges","doi":"10.1037/fsh0000956","DOIUrl":"10.1037/fsh0000956","url":null,"abstract":"Background: The primary care behavioral health (PCBH) model of integrated care has been successfully implemented and evaluated in diverse settings. The most common metrics of PCBH service outcomes include provider and patient satisfaction, patient symptom changes, provider productivity, and utilization rates. Missing is the broader perspective of the patient. To address this gap, we solicited qualitative feedback from PCBH patients about the benefits of PCBH services.Method: Primary care patients (n = 135; Mage = 28.31, 52.6% White, 25.9% Hispanic/Latinx, 72.6% female) seen by six behavioral health interns at two primary care clinics over a 13-month period responded to an open-ended question about what they found most helpful about that day's session.Results: Roughly half of patient responses about PCBH session benefits encompassed nonspecific aspects of therapy (49.6%), while nearly two-thirds (63.0%) mentioned specific therapeutic techniques delivered by clinicians in session as most helpful. In terms of nonspecific benefits of PCBH, many patients described benefitting from having space to talk, receiving validation, and instillation of hope. Specific aspects of treatment patients reported were helpful included skill building, resource sharing, goal setting/treatment planning, psychoeducation/guidance, and specific cognitive behavioral therapy techniques.Conclusion: PCBH relies on both nonspecific relational components and special therapy techniques; both are useful to patients, and neither is frequently included in routine evaluations of the effectiveness of PCBH and other models of integrated care. Our findings support the benefits of including patient input when conducting outcome monitoring within the PCBH model. (PsycInfo Database Record (c) 2026 APA, all rights reserved).","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":" ","pages":"29-37"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Improved pediatric behavioral health appointment scheduling in an integrated primary care program. 在综合初级保健计划中改进儿科行为健康预约安排。

IF 1 4区医学

Families Systems & Health Pub Date : 2026-03-01 Epub Date: 2025-05-05 DOI: 10.1037/fsh0000985

Anjali D Sapkal, Jasmine R Holt, Devin P Adams, Hilary M Bowers, Vanessa Sarabia, Alissa Jae Lazo-Kim, Jason Schweitzer, Andrew Richardson, Anne Bird, Kathryn A Hollenbach

{"title":"Improved pediatric behavioral health appointment scheduling in an integrated primary care program.","authors":"Anjali D Sapkal, Jasmine R Holt, Devin P Adams, Hilary M Bowers, Vanessa Sarabia, Alissa Jae Lazo-Kim, Jason Schweitzer, Andrew Richardson, Anne Bird, Kathryn A Hollenbach","doi":"10.1037/fsh0000985","DOIUrl":"10.1037/fsh0000985","url":null,"abstract":"Introduction: To better understand appointment scheduling for pediatric behavioral health (BH) referrals, we examined appointment scheduling behavior among patients with and without access to primary care mental health integration (PCMHI).Method: A prospective cohort study compared PCMHI and non-PCMHI pediatric patients with BH referrals from January 17, 2022, to June 10, 2022. Six pediatric primary care clinics affiliated with a southern California Children's Hospital were studied: two PCMHI and four non-PCMHI clinics with similar patient demographic characteristics. BH referrals at PCMHI clinics are directly referred to the embedded integrated health therapists. Non-PCMHI clinics referred patients to community BH services. Data were collected from electronic health record abstraction and telephone interviews.Results: PCMHI (n = 471) and non-PCMHI (n = 97) groups did not differ significantly in patient characteristics. About 87.3% (n = 172) of PCMHI patients eligible for an integrated health therapist initial BH appointment scheduled their appointment within 14 days compared to 9.2% (n = 7) of the non-PCMHI patients (χ² = 148.2, p < .001). There was no difference in median days to initial BH appointment between the cohorts, PCMHI: 21 (interquartile range = 15, 27.5) and non-PCMHI: 23 (interquartile range = 13, 35), p = .71. Primary reasons for not scheduling initial BH appointments were similar for both groups and included confusion about the referral and patient/parent busy schedules.Conclusion: Patients in the PCMHI cohort were more likely to schedule their initial BH appointment compared to the non-PCMHI cohort. (PsycInfo Database Record (c) 2026 APA, all rights reserved).","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":" ","pages":"3-13"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

How they are making it work: Behavioral health consultant perspectives on the integration of behavioral health into primary care. 他们是如何工作的：行为健康顾问对将行为健康纳入初级保健的看法。

IF 1.2 4区医学

Families Systems & Health Pub Date : 2026-03-01 Epub Date: 2026-04-09 DOI: 10.1037/fsh0001034

Megha Gupta, Alexandra McGarry Williams, Lisa Mikesell, Benjamin F Crabtree, Ann M Nguyen

{"title":"How they are making it work: Behavioral health consultant perspectives on the integration of behavioral health into primary care.","authors":"Megha Gupta, Alexandra McGarry Williams, Lisa Mikesell, Benjamin F Crabtree, Ann M Nguyen","doi":"10.1037/fsh0001034","DOIUrl":"10.1037/fsh0001034","url":null,"abstract":"Purpose: Integrated behavioral health (IBH) embeds behavioral health services into primary care settings. Despite evidence of its cost and clinical effectiveness, IBH has had limited widespread implementation. As on-the-ground providers, it is important to understand how behavioral health consultants (BHCs) perceive the state of IBH implementation and to identify key strategies they use to overcome IBH implementation challenges.Method: We conducted qualitative, in-depth interviews with 10 BHCs in different care settings in New Jersey. Interviewees were identified using purposeful, snowball sampling. During data collection, immersion-crystallization review was used to assess thematic saturation, with an editing analysis style conducted in a group setting to identify themes.Results: IBH requires a hard-fought paradigm shift, and the established (biomedical) paradigm remains. BHCs reported continually learning and adapting to \"make it work\" within this paradigm using four key strategies: (a) Changing the mindset of one physician at a time, (b) saying \"yes\" to tasks beyond the role's expectations until trust has been established, (c) proactively identifying patients who may benefit from IBH services, and (d) being physically visible to physicians and staff.Conclusions: Widespread IBH requires a paradigm shift, one in which biomedical and behavioral health are equitably considered as health care. Future physicians need to be socialized to the IBH philosophy early in their training. IBH training should also be offered as continuing education for practicing physicians. Finally, leaders in the field of IBH need to make the BHC role less ambiguous. (PsycInfo Database Record (c) 2026 APA, all rights reserved).","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":" ","pages":"50-66"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Quality improvement study of collaborative care model services at a federally qualified health center: A uniform data system-informed approach. 联邦合格医疗中心协作护理模式服务的质量改进研究：统一的数据系统知情方法。

IF 1 4区医学

Families Systems & Health Pub Date : 2026-03-01 Epub Date: 2025-02-10 DOI: 10.1037/fsh0000955

Amber Flanigan-Bodrick, Phyllis Solomon

{"title":"Quality improvement study of collaborative care model services at a federally qualified health center: A uniform data system-informed approach.","authors":"Amber Flanigan-Bodrick, Phyllis Solomon","doi":"10.1037/fsh0000955","DOIUrl":"10.1037/fsh0000955","url":null,"abstract":"Introduction: The Collaborative Care Model (CoCM) is an evidenced based approach to integrating behavioral health into primary care to improve depression outcomes. This quality improvement study explores the utility of implementing CoCM with fidelity at a federally qualified health center to improve depression remission outcomes based on Uniform Data System metrics. Uniform Data System defines depression remission as Patient Health Questionnaire-9 (PHQ-9) score below 5 at 12 months ± 60 days after initial positive depression screening.Method: This study used the CoCM registry and medical record data to generate a sample of 251 patients between 2021 and 2022. PHQ-9 was employed to evaluate depression outcomes. Multiple regression and repeated measures t tests were used for hypothesis testing.Results: The sample consisted of almost three-quarters of women and over half African American with a mean age of 40. CoCM was associated with a 12.60-point reduction in PHQ-9 scores between enrollment and follow-up at 12 months ± 60 days. A 1-point increase in fidelity was associated with a ∼4-point lower PHQ-9 score at posttest, and 1-point increase in treatment adherence was related to a 1-point decrease. Each 25 additional days of enrollment was associated with ∼1/2 point decrease.Discussion: CoCM delivered with fidelity can support federally qualified health centers in improving depression remission rates at 12 months ± 60 days after initial positive depression screen. Fidelity, treatment adherence, length of enrollment, and time in care can positively impact outcomes. Further research is needed to evaluate additional study variables including psychopharmacology, psychiatric, and medical conditions in depression outcomes. (PsycInfo Database Record (c) 2026 APA, all rights reserved).","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":" ","pages":"38-49"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Empathy in medical practice. 医疗实践中的同理心。

IF 1.2 4区医学

Families Systems & Health Pub Date : 2026-03-01 DOI: 10.1037/fsh0001012

Mikal Fikremariam

引用次数: 0

Family-centered decision making in living liver transplantation: Analyzing the tripartite physician-patient-family model in Taiwan. 以家庭为中心的活体肝移植决策：台湾医师-患者-家庭三方模式分析。

IF 1 4区医学

Families Systems & Health Pub Date : 2025-12-01 Epub Date: 2025-08-21 DOI: 10.1037/fsh0001013

Ching Fang Wu, Shih-Chieh Fang, Ching Ying Huang, Chen-Wei Yang, Fu-Sheng Tsai, Yih-Jyh Lin, Yi-Hsiu Lin

{"title":"Family-centered decision making in living liver transplantation: Analyzing the tripartite physician-patient-family model in Taiwan.","authors":"Ching Fang Wu, Shih-Chieh Fang, Ching Ying Huang, Chen-Wei Yang, Fu-Sheng Tsai, Yih-Jyh Lin, Yi-Hsiu Lin","doi":"10.1037/fsh0001013","DOIUrl":"10.1037/fsh0001013","url":null,"abstract":"Introduction: Living donor liver transplantation (LDLT) necessitates effective shared decision making (SDM) to ensure optimal outcomes. Traditional models focus on the physician-patient dyad; however, in Taiwan, family involvement is integral to the decision-making process. This study addresses the gap by proposing a tripartite model that incorporates physicians, patients, and family members to capture the cultural nuances influencing LDLT decisions.Method: A retrospective chart review was conducted on 105 LDLT cases from the Transplant Surgery Department at National Cheng Kung University Hospital (2015-2022). The study employed thematic analysis to examine qualitative data extracted from medical records, including medical, psychiatric, and social evaluations, thereby identifying key themes in the decision-making process.Results: Analysis revealed that LDLT decision making in Taiwan is predominantly family-centered. Three main themes emerged: the initiation of SDM by physicians and primary caregivers, a comprehensive risk assessment process integrating both clinical and psychosocial perspectives, and a final decision-making stage driven by collective family consensus. These findings highlight the complex interplay between medical factors and familial dynamics in donor selection and transplant outcomes.Discussion: The study extends traditional binary decision-making models by highlighting the critical role of family involvement in LDLT. The tripartite framework not only reflects Taiwan's cultural context but also offers valuable insights for improving clinical practices and health care policies. Integrating family-centered approaches into SDM processes may enhance patient safety, promote ethical practices, and ultimately lead to better transplant outcomes. (PsycInfo Database Record (c) 2026 APA, all rights reserved).","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":" ","pages":"708-723"},"PeriodicalIF":1.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A preoperative relational screener and associations with weight loss: A pilot feasibility study. 术前相关筛查与减肥的关系：一项试点可行性研究。

IF 1 4区医学

Families Systems & Health Pub Date : 2025-12-01 Epub Date: 2025-04-17 DOI: 10.1037/fsh0000967

Haley M Kiser, Keeley J Pratt, Ashleigh Pona, Lindsay Breslin, LeeAnn Swager

{"title":"A preoperative relational screener and associations with weight loss: A pilot feasibility study.","authors":"Haley M Kiser, Keeley J Pratt, Ashleigh Pona, Lindsay Breslin, LeeAnn Swager","doi":"10.1037/fsh0000967","DOIUrl":"10.1037/fsh0000967","url":null,"abstract":"Introduction: Family factors and stressful life events are reasons for not proceeding immediately with metabolic and bariatric surgery, yet there is no formal screening for these factors during routine preoperative psychological evaluation. This pilot study determined the feasibility of implementing a preoperative relational screener and referral to a behavioral health consultation, and associations between relational factors with 12-month weight loss.Method: Preoperative patients (N = 137) were asked to participate. Feasibility was noted by interest, completion of screener, screening as impaired on the relational measures, and completion of consultation. For patients proceeding to surgery, five models were conducted to determine changes in percent total weight loss (%TWL) over 12 months, based on the interaction with visits and screening as impaired, family functioning, stressful life events, death of a close friend or relative, and major financial crisis.Results: Sixty-seven patients were interested; 57 completed the screener (85.1%, 79% female, 72% White); 43 screened (75.4%) as impaired on ≥ 1 assessment and were eligible for the consultation, 21 patients (48.8%) completed the consultation. Patients who screened as impaired had poorer %TWL (p = .013) compared to patients who did not. Patients with ≥ 1 stressful life event had poorer %TWL compared to those who did not experience any (p = .008), including the top two endorsed events-death of a close friend (p ≤ .001) or a major financial crisis (p = .009).Conclusion: The relational screener provides additional information about patients' psychosocial needs and challenges before surgery. This is critical considering the majority of participants screened as impaired on at least one assessment. (PsycInfo Database Record (c) 2026 APA, all rights reserved).","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":" ","pages":"654-666"},"PeriodicalIF":1.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0