ArticleImplementation science : IS2012
Implementation of the CALM intervention for anxiety disorders: a qualitative study.
Article in Implementation science : IS, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00347269 (Coordinated Anxiety Learning and Management), which is not on this map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Coordinated Anxiety Learning and Management (CALM): Improving Primary Care Anxiety Outcomes
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Enablers and barriers to implementing collaborative care for anxiety and depression: a systematic qualitative review.Implementation science : IS · 2016Pooled it
- How do care providers evaluate collaboration? - qualitative process evaluation of a cluster-randomized controlled trial of collaborative and stepped care for patients with mental disorders.BMC psychiatry · 2021Trial
- Trial
- Design of the Violence and Stress Assessment (ViStA) study: a randomized controlled trial of care management for PTSD among predominantly Latino patients in safety net health centers.Contemporary clinical trials · 2014Trial
- PRIME - A multilevel intervention for low back pain management in primary care: Protocol for an effectiveness-implementation hybrid type 1 cluster randomized controlled trial.Contemporary clinical trials communications · 2026Article
- Community-based Collaborative Care for Serious Mental Illness: A Rapid Qualitative Evidence Synthesis of Health Care Providers' Experiences and Perspectives.Community mental health journal · 2025Review
- Formative qualitative research to guide implementation of the Collaborative Care Model in a low-barrier HIV clinic.AIDS care · 2025Article
- Barriers and Facilitators of Implementing Cognitive Behavioral Therapy: A Systematic Review Based on the Consolidated Framework for Implementation.Scientifica · 2025Review
- Facilitators and barriers to providing affirming care for transgender patients in primary care practices in Arkansas.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2023Article
- A qualitative examination of the implementation of a perinatal collaborative care program.Primary health care research & development · 2022Article
- Strategies to improve access to cognitive behavioral therapies for anxiety disorders: A scoping review.PloS one · 2022Article
- Integrated behavioral health treatments: innovations to achieve population impact.Translational behavioral medicine · 2020Article
- Improving HPV vaccination using implementation strategies in community pharmacies: Pilot study protocol.Research in social & administrative pharmacy : RSAP · 2020Article
- Evaluation of Recruitment of Older Adults of Color into a Community-Based Chronic Disease Self-Management Wellness Pathway Program in Los Angeles County.Ethnicity & disease · 2020Article
- Article
- An introduction to effectiveness-implementation hybrid designs.Psychiatry research · 2019Article
- Sustainable implementation of early intervention for autism spectrum disorder through caregiver coaching: South African perspectives on barriers and facilitators.Pediatric medicine (Hong Kong, China) · 2019Article
- A quality improvement project aimed at adapting primary care to ensure the delivery of evidence-based psychotherapy for adult anxiety.BMJ open quality · 2018Article
- Evaluation of an implementation model: a national investigation of VA residential programs.Administration and policy in mental health · 2015Article
- Incentives and disincentives for the treatment of depression and anxiety: a scoping review.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2014Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundInvestigators recently tested the effectiveness of a collaborative-care intervention for anxiety disorders: Coordinated Anxiety Learning and Management(CALM) []) in 17 primary care clinics around the United States. Investigators also conducted a qualitative process evaluation. Key research questions were as follows: (1) What were the facilitators/barriers to implementing CALM? (2) What were the facilitators/barriers to sustaining CALM after the study was completed?
methodsKey informant interviews were conducted with 47 clinic staff members (18 primary care providers, 13 nurses, 8 clinic administrators, and 8 clinic staff) and 14 study-trained anxiety clinical specialists (ACSs) who coordinated the collaborative care and provided cognitive behavioral therapy. The interviews were semistructured and conducted by phone. Data were content analyzed with line-by-line analyses leading to the development and refinement of themes.
resultsSimilar themes emerged across stakeholders. Important facilitators to implementation included the perception of "low burden" to implement, provider satisfaction with the intervention, and frequent provider interaction with ACSs. Barriers to implementation included variable provider interest in mental health, high rates of part-time providers in clinics, and high social stressors of lower socioeconomic-status patients interfering with adherence. Key sustainability facilitators were if a clinic had already incorporated collaborative care for another disorder and presence of onsite mental health staff. The main barrier to sustainability was funding for the ACS.
conclusionsThe CALM intervention was relatively easy to incorporate during the effectiveness trial, and satisfaction was generally high. Numerous implementation and sustainability barriers could limit the reach and impact of widespread adoption. Findings should be interpreted with the knowledge that the ACSs in this study were provided and trained by the study. Future research should explore uptake of CALM and similar interventions without the aid of an effectiveness trial.
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Registered trials
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