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BMC Fam Pract. 2019 Sep 6;20(1):124. doi: 10.1186/s12875-019-1010-z.

Designing the relational team development intervention to improve management of mental health in primary care using iterative stakeholder engagement.

Author information

1
Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Academic Office 1; Mailstop B180; 12631 East 17th Ave, Aurora, CO, 80045, USA. danielle.loeb@cuanschutz.edu.
2
Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Academic Office 1; Mailstop B180; 12631 East 17th Ave, Aurora, CO, 80045, USA.
3
Indiana University School of Medicine, Indianapolis, IN, USA.
4
John Hopkins University School of Medicine, Baltimore, MD, USA.
5
Kaiser Permanente Institute for Health Research, Aurora, CO, USA.
6
Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA.
7
Department of Biostatistics & Informatics, Colorado School of Public Health; Department of Family Medicine, University of Colorado, Aurora, CO, USA.
8
Lowry Family Health Center, Denver Health, Denver, CO, USA.

Abstract

BACKGROUND:

Team-based models of care are efficacious in improving outcomes for patients with mental and physical illnesses. However, primary care clinics have been slow to adopt these models. We used iterative stakeholder engagement to develop an intervention to improve the implementation of team-based care for this complex population.

METHODS:

We developed the initial framework for Relational Team Development (RELATED) from a qualitative study of Primary Care Providers' (PCPs') experiences treating mental illness and a literature review of practice facilitation and psychology clinical supervision. Subsequently, we surveyed 900 Colorado PCPs to identify factors associated with PCP self-efficacy in management of mental illness and team-based care. We then conducted two focus groups for feedback on RELATED. Lastly, we convened an expert panel to refine the intervention.

RESULTS:

We developed RELATED, a two-part intervention delivered by a practice facilitator with a background in clinical psychology. The facilitator observes PCPs during patient visits and provides individualized coaching. Next, the facilitator guides the primary care team through a practice change activity with a focus on relational team dynamics.

CONCLUSION:

The iterative development of RELATED using stakeholder engagement offers a model for the development of interventions tailored to the needs of these stakeholders.

TRIAL REGISTRATION:

Not applicable.

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