G3 – A Novel Example of Using Mixed Methodology and Participatory Action Research to Examine Patient Experiences with PCBH at an FQHC

Summary

There is growing emphasis on utilizing novel methodological approaches to evaluate the primary care behavioral health model (PCBH; Hunter et al., 2018). In this project, we used mixed methodology guided by a participatory action research framework (PAR; Baum, MacDougall, & Smith, 2006) to examine patient experiences of PCBH at a Federally Qualified Health Center (FQHC) in an urban community. One hundred eighty-six adult patients (M age = 44.2, 72.6% female, 42.5% black) completed a survey, which included general satisfaction with health care (i.e., the Patient Satisfaction Questionnaire-18, PSQ-18; Marshall & Hays, 1994), satisfaction with integrated services at the clinic, and patient experience of integration. Twelve patients also participated in four separate focus groups which sought to obtain more specific feedback on strengths and weaknesses of the clinic’s model of care. The survey data indicated fairly high levels of satisfaction with the PCBH model, as indicated by the PSQ-18 (M = 65.7, SD = 12.1). Race was the only significant predictor of satisfaction. The focus groups were analyzed via thematic analysis (Braun & Clarke, 2006) and 8 themes emerged related to strengths (convenience, affordability, health improvements, positive provider interactions, available resources, overall satisfaction) and challenges (issues with outside referrals, infrastructure challenges). While the quantitative and qualitative data were fairly consistent, the focus group content highlighted portions of PCBH that are particularly relevant to a lower income and higher needs population. The results can also be reviewed within the context of a PAR framework and the attempt to involve community partners throughout the implementation and evaluation process. This project highlights the use of unique methodology to evaluate PCBH with a diverse and underserved population.