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The Arizona State University Doctor of Behavioral Health program in collaboration with multiple Banner Health primary care clinics will take part in a national study of integrated behavioral health under the University of Vermont (UVT) and Patient Centered Outcome Research Institute (PCORI) grant. The University of Vermont research group has been awarded a 40-site national trial by PCORI to assess the impact of degree of integration of behavioral health care on health and behavioral outcomes. The award is “Pragmatic Clinical Studies and Large Simple Trials to Evaluate Patient-Centered Outcomes” [Read the full PCORI announcement here http://www.pcori.org/research-results/2015/integrating-behavioral-health-and-primary-care ] This is a five-year study beginning in 2016 funded at $18,508,211. It compares co-location with integration of behavioral services in primary care. The UVT research team is led by the Primary Investigator Ben Littenberg M.D, Rodger Kessler, Ph.D., ABPP, Co-Principal Investigator, and Connie Van Eeghen Dr.PH., Co-Investigator.
Dr. Kessler is also a part-time faculty with the Arizona State University Doctor of Behavioral Health (DBH) program. Dr. Kessler’s role in the DBH program is to facilitate the development of a new applied clinical and management DBH research program. Consistent with the mission and vision of the DBH this research program will be focused on practical, feasible practice research designed to evaluate the value of integrated behavioral health programs in achieving the healthcare reform “Triple Aim” of improved patient experience of care, improved population health, and decreased cost of care. This direction is a natural evolution of the DBH longstanding focus on a curriculum that combines evidence-based integrated care practice, quality and performance improvement, business operations and entrepreneurship. The DBH curriculum is geared towards an inter-professional student body with a shared interest in developing integrated care programs that balance the needs for high-quality patient care with sound utilization, cost and financial analysis in order to leverage the critical role of integrated behavioral health in United States healthcare reform.
One aim of the study is to determine if increased integration of evidence-based behavioral treatment in an “integrated” model of care (behavioral health consultants specially trained to work in the primary care clinic as members of the primary care team) compared to “co-located” care (behavioral health consultants who work with or near primary care clinics in order to increase the chances a patient will follow-up on a primary care referral and make an appointment for behavioral care). The integrated care practices will be the active “intervention” in the study, while the “control” is co-location of a behavioral specialist within or near the primary clinic, but without increased integration. Another aim of the study is to determine if a structured consultation and training program for primary care practices leads to improved care processes and outcomes. A third aim is to determine contextual factors specific to the type of integrated behavioral care and the type of practice setting influence health outcomes.
The sites will be randomly assigned to either integrated or co-located models. The integrated care sites will receive a protocol-driven, evidence-based, stepped-care, data-driven structured process improvement support for practice re-design. The Arizona State University Doctor of Behavioral Health program, the University of Massachusetts Center for Integrated Care, and the Unviersity of Vermont School of Medicine are collaborating on the development of asynchronous training modules for the integrated care model. The three-stage structured improvement process includes preparation, design and implementation led by an on-site trained facilitator. An Integrated Behavioral Health ToolkitTM with over two-dozen clinical, operational, and financial strategies and tactics will guide the practices in each stage of process improvement.
PI for ASU Subcontract - Learning Module Development contact:
C.R. Macchi, PhD
University of Vermont contact:
The Doctor of Behavioral Health (DBH) program is one of five health-related professional training programs in a Substance Abuse and Mental Health Services Administration (SAMHSA) grant to develop workforce training and education on Screening, Brief Intervention and Referral (SBIRT). The Arizona State University SBIRT Training & Implementation Collaborative (ASU-STIC) brings together Social Work, Clinical Psychology, Nurse Practitioner, Counseling Psychology, and The Doctor of Behavioral Health. The Collaborative will develop professional training programs to enhance the knowledge, skills and abilities of our students to enter the workforce prepared to deliver SBIRT services in primary care and other medical settings. Through this program, students in the following health-related professional training programs will be exposed to, and develop, new knowledge and skills in SBIRT.
During the three year project the ASU-STIC will provide: 1) increased awareness of the SBIRT model to students through incorporating SBIRT curriculum into existing courses and training experiences; 2) expansion and cross-listing of existing ASU DBH courses in SBIRT, Motivational Interviewing, and Brief Interventions in Primary Care, and 3) field-based practice to students through field placement and practicum placements in local health care agencies. The project is expected to train nearly 500 students during the three-year project. In addition the project will provide education and skills training, technical assistance, and program consultation to practitioners in health care settings throughout Arizona through a strategic partnership with the SAMHSA-funded Pacific Southwest Addiction Technology Transfer Center (PSATCC). The project plan has been developed around the primary goals of enhancing the health care workforce by incorporating SBIRT into targeted academic programs at Arizona State University and to develop leadership skills in faculty, field instructors/preceptors, and site clinical supervisors to promote the implementation of SBIRT in health care settings. The project oversight will by provided by the ASU Center for Applied Behavioral Health Policy, in coordination with the five ASU health-profession related academic units and affiliated health care agencies that serve as field placement sites for our students. The project will be overseen by a council of Directors, comprised of the department heads of the relevant academic units, internship program leaders, and a representative of the state’s Medicaid agency.