Integrating Evidence-Based Behavioral Health Technologies into Primary Care

Dartmouth SYNERGY Translational Program (Community-Based Research Core)

7/1/14 – 6/30/16

Sarah Lord, PhD; Lisa Marsch, PhD

Elliott Fisher, MD; Mark McGovern, PhD; Haiyi Xie, PhD; Ardis Olson, MD; Ben Crosier, PhD; Rebecca Horvath, BSN

This project engages community and academic partners in understanding needs and priorities among rural community health care systems around shifting health care systems (e.g., in light of ACA) – with a particular focus on integrating behavioral health and medical care in rural settings.

Behavioral health problems (addictions and mental health disorders, such as depression) are highly prevalent, especially in poor and disenfranchised populations. The great majority of these people (over 90%) receive no treatment. Behavioral health problems also complicate diagnosis, treatment, and outcomes for many chronic conditions, such as diabetes, obesity, heart failure, and cancer.  A sufficient workforce to address these problems does not exist – especially in rural communities.

Incorporating new health technologies could be a cost-effective solution.  New technology tools could be used in primary care to improve access, self-care, and outcomes, and to reduce costs and health disparities.  Yet, successful implementation and sustainability of any new intervention process, including a technology-based care approach, is strengthened by attention to pre-implementation readiness of the primary care community agencies and constituent stakeholders to adopt a technology treatment innovation in their system of care.

This two-year, 2-phased project includes mixed-methods formative research in year 1 to assess community priorities and readiness for technology-based behavioral health tools in primary care settings, followed by a demonstration implementation project of a technology-based behavioral health intervention within rural primary care settings in year 2.

This work will inform strategies for optimizing implementation outcomes when embedding technology-based behavioral health tools in rural primary care settings, supported by appropriate training/technical assistance.