@article{
 title = {Outcomes of a Partnered Facilitation Strategy to Implement Primary Care-Mental Health},
 type = {article},
 year = {2014},
 identifiers = {[object Object]},
 month = {10},
 day = {30},
 city = {VA Mental Health Quality Enhancement Research Initiative, North Little Rock, AR, USA, joann.kirchner@va.gov.},
 id = {ef390aeb-5372-303b-8e25-5f4a60ff2621},
 created = {2016-08-21T22:17:53.000Z},
 file_attached = {false},
 profile_id = {217ced55-4c79-38dc-838b-4b5ea8df5597},
 group_id = {408d37d9-5f1b-3398-a9f5-5c1a487116d4},
 last_modified = {2017-03-14T09:54:45.334Z},
 read = {false},
 starred = {false},
 authored = {false},
 confirmed = {true},
 hidden = {false},
 source_type = {JOUR},
 notes = {ID: 74085; LR: 20141031; JID: 8605834; aheadofprint},
 folder_uuids = {a237acd1-03cc-4528-a1f9-3f429ff289a2},
 private_publication = {false},
 abstract = {BACKGROUND: Implementing new programs and practices is challenging, even when they are mandated. Implementation Facilitation (IF) strategies that focus on partnering with sites show promise for addressing these challenges. OBJECTIVE: Our aim was to evaluate the effectiveness of an external/internal IF strategy within the context of a Department of Veterans Affairs (VA) mandate of Primary Care-Mental Health Integration (PC-MHI). DESIGN: This was a quasi-experimental, Hybrid Type III study. Generalized estimating equations assessed differences across sites. PARTICIPANTS: Patients and providers at seven VA primary care clinics receiving the IF intervention and national support and seven matched comparison clinics receiving national support only participated in the study. INTERVENTION: We used a highly partnered IF strategy incorporating evidence-based implementation interventions. MAIN MEASURES: We evaluated the IF strategy using VA administrative data and RE-AIM framework measures for two 6-month periods. KEY RESULTS: Evaluation of RE-AIM measures from the first 6-month period indicated that PC patients at IF clinics had nine times the odds (OR=8.93, p<0.001) of also being seen in PC-MHI (Reach) compared to patients at non-IF clinics. PC providers at IF clinics had seven times the odds (OR=7.12, p=0.029) of referring patients to PC-MHI (Adoption) than providers at non-IF clinics, and a greater proportion of providers' patients at IF clinics were referred to PC-MHI (Adoption) compared to non-IF clinics (beta=0.027, p<0.001). Compared to PC patients at non-IF sites, patients at IF clinics did not have lower odds (OR=1.34, p=0.232) of being referred for first-time mental health specialty clinic visits (Effectiveness), or higher odds (OR=1.90, p=0.350) of receiving same-day access (Implementation). Assessment of program sustainability (Maintenance) was conducted by repeating this analysis for a second 6-month time period. Maintenance analyses results were similar to the earlier period. CONCLUSION: The addition of a highly partnered IF strategy to national level support resulted in greater Reach and Adoption of the mandated PC-MHI initiative, thereby increasing patient access to VA mental health care.},
 bibtype = {article},
 author = {Kirchner, J E and Ritchie, M J and Pitcock, J A and Parker, L E and Curran, G M and Fortney, J C},
 journal = {Journal of general internal medicine}
}

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Implementation Facilitation (IF) strategies that focus on partnering with sites show promise for addressing these challenges. OBJECTIVE: Our aim was to evaluate the effectiveness of an external/internal IF strategy within the context of a Department of Veterans Affairs (VA) mandate of Primary Care-Mental Health Integration (PC-MHI). DESIGN: This was a quasi-experimental, Hybrid Type III study. Generalized estimating equations assessed differences across sites. PARTICIPANTS: Patients and providers at seven VA primary care clinics receiving the IF intervention and national support and seven matched comparison clinics receiving national support only participated in the study. INTERVENTION: We used a highly partnered IF strategy incorporating evidence-based implementation interventions. MAIN MEASURES: We evaluated the IF strategy using VA administrative data and RE-AIM framework measures for two 6-month periods. 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