Development and validation of a measure of primary care behavioral health integration
Center for Integrated Primary Care; Department of Family Medicine and Community Health
Behavioral Medicine | Health Psychology | Health Services Administration | Integrative Medicine | Mental and Social Health | Primary Care | Psychiatry and Psychology
INTRODUCTION: We developed the Practice Integration Profile (PIP) to measure the degree of behavioral health integration in clinical practices with a focus on primary care (PC). Its 30 items, completed by providers, managers, and staff, provide an overall score and 6 domain scores derived from the Lexicon of Collaborative Care. We describe its history and psychometric properties.
METHOD: The PIP was tested in a convenience sample of practices. Linear regression compared scores across integration exemplars, PC with behavioral services, PC without behavioral services, and community mental health centers without PC. An additional sample rated 4 scenarios describing practices with varying degrees of integration.
RESULTS: One hundred sixty-nine surveys were returned. Mean domain scores ran from 49 to 65. The mean total score was 55 (median 58; range 0-100) with high internal consistency (Cronbach's alpha = .95). The lowest total scores were for PC without behavioral health (27), followed by community mental health centers (44), PC with behavioral health (60), and the exemplars (86; p < .001). Eleven respondents rerated their practices 37 to 194 days later. The mean change was + 1.5 (standard deviation = 11.1). Scenario scores were highly correlated with the degree of integration each scenario was designed to represent (Spearman's rho = -0.71; P = 0.0005).
DISCUSSION: These data suggest that the PIP is useful, has face, content, and internal validity, and distinguishes among types of practices with known variations in integration. We discuss how the PIP may support practices and policymakers in their integration efforts and researchers assessing the degree to which integration affects patient health outcomes.
integrated care, measurement, methods, primary care
DOI of Published Version
Fam Syst Health. 2016 Dec;34(4):342-356. doi: 10.1037/fsh0000227. Epub 2016 Oct 13. Link to article on publisher's site
Families, systems and health : the journal of collaborative family healthcare
Kessler RS, Auxier A, Hitt JR, Macchi CR, Mullin DJ, van Eeghen C, Littenberg B. (2016). Development and validation of a measure of primary care behavioral health integration. Center for Integrated Primary Care Publications. https://doi.org/10.1037/fsh0000227. Retrieved from https://escholarship.umassmed.edu/cipc/34