Cargando…

Adaptation of the collaborative care model to integrate behavioral health care into a low-barrier HIV clinic

BACKGROUND: The collaborative care management (CoCM) model is an evidence-based intervention for integrating behavioral health care into nonpsychiatric settings. CoCM has been extensively studied in primary care clinics, but implementation in nonconventional clinics, such as those tailored to provid...

Descripción completa

Detalles Bibliográficos
Autores principales: Dombrowski, Julia C., Halliday, Scott, Tsui, Judith I., Rao, Deepa, Sherr, Kenneth, Ramchandani, Meena S., Emerson, Ramona, Fleming, Mark, Wood, Teagan, Chwastiak, Lydia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10123894/
https://www.ncbi.nlm.nih.gov/pubmed/37790178
http://dx.doi.org/10.1177/26334895231167105
_version_ 1785029745753194496
author Dombrowski, Julia C.
Halliday, Scott
Tsui, Judith I.
Rao, Deepa
Sherr, Kenneth
Ramchandani, Meena S.
Emerson, Ramona
Fleming, Mark
Wood, Teagan
Chwastiak, Lydia
author_facet Dombrowski, Julia C.
Halliday, Scott
Tsui, Judith I.
Rao, Deepa
Sherr, Kenneth
Ramchandani, Meena S.
Emerson, Ramona
Fleming, Mark
Wood, Teagan
Chwastiak, Lydia
author_sort Dombrowski, Julia C.
collection PubMed
description BACKGROUND: The collaborative care management (CoCM) model is an evidence-based intervention for integrating behavioral health care into nonpsychiatric settings. CoCM has been extensively studied in primary care clinics, but implementation in nonconventional clinics, such as those tailored to provide care for high-need, complex patients, has not been well described. METHOD: We adapted CoCM for a low-barrier HIV clinic that provides walk-in medical care for a patient population with high levels of mental illness, substance use, and housing instability. The Exploration, Preparation, Implementation, and Sustainment model guided implementation activities and support through the phases of implementing CoCM. The Framework for Reporting Adaptations and Modifications to Evidence-Based Interventions guided our documentation of adaptations to process-of-care elements and structural elements of CoCM. We used a multicomponent strategy to implement the adapted CoCM model. In this article, we describe our experience through the first 6 months of implementation. RESULTS: The key contextual factors necessitating adaptation of the CoCM model were the clinic team structure, lack of scheduled appointments, high complexity of the patient population, and time constraints with competing priorities for patient care, all of which required substantial flexibility in the model. The process-of-care elements were adapted to improve the fit of the intervention with the context, but the core structural elements of CoCM were maintained. CONCLUSIONS: The CoCM model can be adapted for a setting that requires more flexibility than the usual primary care clinic while maintaining the core elements of the intervention.
format Online
Article
Text
id pubmed-10123894
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-101238942023-10-03 Adaptation of the collaborative care model to integrate behavioral health care into a low-barrier HIV clinic Dombrowski, Julia C. Halliday, Scott Tsui, Judith I. Rao, Deepa Sherr, Kenneth Ramchandani, Meena S. Emerson, Ramona Fleming, Mark Wood, Teagan Chwastiak, Lydia Implement Res Pract Practical Implementation Report BACKGROUND: The collaborative care management (CoCM) model is an evidence-based intervention for integrating behavioral health care into nonpsychiatric settings. CoCM has been extensively studied in primary care clinics, but implementation in nonconventional clinics, such as those tailored to provide care for high-need, complex patients, has not been well described. METHOD: We adapted CoCM for a low-barrier HIV clinic that provides walk-in medical care for a patient population with high levels of mental illness, substance use, and housing instability. The Exploration, Preparation, Implementation, and Sustainment model guided implementation activities and support through the phases of implementing CoCM. The Framework for Reporting Adaptations and Modifications to Evidence-Based Interventions guided our documentation of adaptations to process-of-care elements and structural elements of CoCM. We used a multicomponent strategy to implement the adapted CoCM model. In this article, we describe our experience through the first 6 months of implementation. RESULTS: The key contextual factors necessitating adaptation of the CoCM model were the clinic team structure, lack of scheduled appointments, high complexity of the patient population, and time constraints with competing priorities for patient care, all of which required substantial flexibility in the model. The process-of-care elements were adapted to improve the fit of the intervention with the context, but the core structural elements of CoCM were maintained. CONCLUSIONS: The CoCM model can be adapted for a setting that requires more flexibility than the usual primary care clinic while maintaining the core elements of the intervention. SAGE Publications 2023-04-17 /pmc/articles/PMC10123894/ /pubmed/37790178 http://dx.doi.org/10.1177/26334895231167105 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Practical Implementation Report
Dombrowski, Julia C.
Halliday, Scott
Tsui, Judith I.
Rao, Deepa
Sherr, Kenneth
Ramchandani, Meena S.
Emerson, Ramona
Fleming, Mark
Wood, Teagan
Chwastiak, Lydia
Adaptation of the collaborative care model to integrate behavioral health care into a low-barrier HIV clinic
title Adaptation of the collaborative care model to integrate behavioral health care into a low-barrier HIV clinic
title_full Adaptation of the collaborative care model to integrate behavioral health care into a low-barrier HIV clinic
title_fullStr Adaptation of the collaborative care model to integrate behavioral health care into a low-barrier HIV clinic
title_full_unstemmed Adaptation of the collaborative care model to integrate behavioral health care into a low-barrier HIV clinic
title_short Adaptation of the collaborative care model to integrate behavioral health care into a low-barrier HIV clinic
title_sort adaptation of the collaborative care model to integrate behavioral health care into a low-barrier hiv clinic
topic Practical Implementation Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10123894/
https://www.ncbi.nlm.nih.gov/pubmed/37790178
http://dx.doi.org/10.1177/26334895231167105
work_keys_str_mv AT dombrowskijuliac adaptationofthecollaborativecaremodeltointegratebehavioralhealthcareintoalowbarrierhivclinic
AT hallidayscott adaptationofthecollaborativecaremodeltointegratebehavioralhealthcareintoalowbarrierhivclinic
AT tsuijudithi adaptationofthecollaborativecaremodeltointegratebehavioralhealthcareintoalowbarrierhivclinic
AT raodeepa adaptationofthecollaborativecaremodeltointegratebehavioralhealthcareintoalowbarrierhivclinic
AT sherrkenneth adaptationofthecollaborativecaremodeltointegratebehavioralhealthcareintoalowbarrierhivclinic
AT ramchandanimeenas adaptationofthecollaborativecaremodeltointegratebehavioralhealthcareintoalowbarrierhivclinic
AT emersonramona adaptationofthecollaborativecaremodeltointegratebehavioralhealthcareintoalowbarrierhivclinic
AT flemingmark adaptationofthecollaborativecaremodeltointegratebehavioralhealthcareintoalowbarrierhivclinic
AT woodteagan adaptationofthecollaborativecaremodeltointegratebehavioralhealthcareintoalowbarrierhivclinic
AT chwastiaklydia adaptationofthecollaborativecaremodeltointegratebehavioralhealthcareintoalowbarrierhivclinic