D5 – What is the Primary Care Behavioral Health Model? A Logic Model Helping Us Define It

Summary

Primary Care Behavioral Health (PCBH) is a popular service delivery model of integrated care; however, a key limitation to its growth in practice and research is the lack of understanding for how to define PCBH and ensure fidelity. To date, a majority of research and clinical work has focused on defining PCBH primarily as the presence of an embedded behavioral health consultant (BHC)and characteristics of the appointments conducted by the BHC (e.g., appointment length and number of appointments). However, this approach ignores other elements thought to be essential to PCBH practice and allows for wide variation in PCBH implementation. Such practice variability significantly limits the ability to identify PCBH outcomes. This presentation will describe the importance of assessing PCBH fidelity and shares a logic model developed and subsequently refined using expert consensus methods. This logic model elaborates and defines the structural components, activities, outputs, and outcomes of PCBH across the clinic, primary care team, primary care provider, behavioral health consultant, and patient levels. The discussion will focus on how this comprehensive set of relevant fidelity indicators of PCBH can be utilized by administrators and clinicians to improve practice as well as allow researchers to add rigor to any investigation of PCBH impact on outcomes.