ArticleJournal of the American Board of Family Medicine : JABFM
Understanding Care Integration from the Ground Up: Five Organizing Constructs that Shape Integrated Practices.
Abstract readComparative Study
In one paragraph
Article in Journal of the American Board of Family Medicine : JABFM. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 1 of them a synthesis that pooled it.
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40citing papers in PubMed, 1 pooled it
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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.
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Who cites it
40 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The renewed Development Model for Integrated Care: a systematic review and model update.BMC health services research · 2025Pooled it
- Effectiveness of Integrating Suicide Care in Primary Care : Secondary Analysis of a Stepped-Wedge, Cluster Randomized Implementation Trial.Annals of internal medicine · 2024Trial
- Degree of Behavioral Health Integration and Patient Outcomes.Journal of the American Board of Family Medicine : JABFMTrial
- The use of a validated competency framework to guide the implementation of integrated care into the curriculum and accreditation of health and social care professionals in Australia.BMC medical education · 2026Article
- Multi-center retrospective analysis of potentially non-urgent emergency department visits in Israel using a nationwide dataset.BMC health services research · 2026Article
- Medicare Accountable Care Organization Treatment of Serious Mental Illness: Associations Between Behavioral Health Integration Activities and Outcomes.Medical care · 2025Article
- Econometric evaluation of implementing a behavioral health integration intervention in primary care settings.Translational behavioral medicine · 2023Article
- Collaborative Mental Health Care in Canada: Challenges, Opportunities and New Directions.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2023Article
- Integration of Diabetes and Depression Care Is Associated with Glucose Control in Midwestern Federally Qualified Health Centers.Journal of general internal medicine · 2021Article
- Article
- Dissemination of a telehealth cardiovascular risk service: The CVRS live protocol.Contemporary clinical trials · 2021Article
- A Multidisciplinary, Family-Oriented Approach to Caring for Parents After Miscarriage: The Integrated Behavioral Health Model of Care.Frontiers in public health · 2021Article
- Time and Organizational Cost for Facilitating Implementation of Primary Care Mental Health Integration.Journal of general internal medicine · 2020Article
- Moving from Care Coordination to Care Integration.Journal of general internal medicine · 2019Article
- Building Behavioral Health Homes: Clinician and Staff Perspectives on Creating Integrated Care Teams.The journal of behavioral health services & research · 2019Article
- Translating Research into Agile Development (TRIAD): Development of Electronic Health Record Tools for Primary Care Settings.Methods of information in medicine · 2019Article
- The Cost Effectiveness of Embedding a Behavioral Health Clinician into an Existing Primary Care Practice to Facilitate the Integration of Care: A Prospective, Case-Control Program Evaluation.Journal of clinical psychology in medical settings · 2019Article
- PACT ICU Model: Interprofessional Case Conferences for High-Risk/High-Need Patients.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2018Article
- Initiative to Minimize Pharmaceutical Risk in Older Veterans (IMPROVE) Polypharmacy Clinic.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2018Article
- Improving Chronic Disease Self-Management by Older Home Health Patients through Community Health Coaching.International journal of environmental research and public health · 2018Article
Corrections and comments
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Authors and funding
12 authors.
Deborah J CohenFrom the Departments of Family Medicine and of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland (DJC); Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston School of Public Health (BAB); Harold Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX (BAB); Oregon, Rural Practice-Based Research Network (MD); Department of Family Medicine, Oregon Health & Science University, Portland (MD, JH, RG, KC); Department of Epidemiology & Biostatistics, Sociology and the Case Comprehensive Cancer Center, and Clinical and Translational Science Collaborative, Case Western Reserve University, Cleveland, OH (KCS); Department of Family Medicine, University of Colorado School of Medicine, Aurora (LAG, BFM); Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA (WLM); Department of Family Medicine and Community Health, Rutgers-Robert Wood, Johnson Medical School, Somerset, NJ (BFC); Department of Health Policy and Management, Boston University School of Public, Health, Boston, MA (MJE) cohendj@ohsu.edu.
Bijal A BalasubramanianFrom the Departments of Family Medicine and of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland (DJC); Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston School of Public Health (BAB); Harold Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX (BAB); Oregon, Rural Practice-Based Research Network (MD); Department of Family Medicine, Oregon Health & Science University, Portland (MD, JH, RG, KC); Department of Epidemiology & Biostatistics, Sociology and the Case Comprehensive Cancer Center, and Clinical and Translational Science Collaborative, Case Western Reserve University, Cleveland, OH (KCS); Department of Family Medicine, University of Colorado School of Medicine, Aurora (LAG, BFM); Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA (WLM); Department of Family Medicine and Community Health, Rutgers-Robert Wood, Johnson Medical School, Somerset, NJ (BFC); Department of Health Policy and Management, Boston University School of Public, Health, Boston, MA (MJE).
Melinda DavisFrom the Departments of Family Medicine and of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland (DJC); Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston School of Public Health (BAB); Harold Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX (BAB); Oregon, Rural Practice-Based Research Network (MD); Department of Family Medicine, Oregon Health & Science University, Portland (MD, JH, RG, KC); Department of Epidemiology & Biostatistics, Sociology and the Case Comprehensive Cancer Center, and Clinical and Translational Science Collaborative, Case Western Reserve University, Cleveland, OH (KCS); Department of Family Medicine, University of Colorado School of Medicine, Aurora (LAG, BFM); Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA (WLM); Department of Family Medicine and Community Health, Rutgers-Robert Wood, Johnson Medical School, Somerset, NJ (BFC); Department of Health Policy and Management, Boston University School of Public, Health, Boston, MA (MJE).
Jennifer HallFrom the Departments of Family Medicine and of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland (DJC); Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston School of Public Health (BAB); Harold Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX (BAB); Oregon, Rural Practice-Based Research Network (MD); Department of Family Medicine, Oregon Health & Science University, Portland (MD, JH, RG, KC); Department of Epidemiology & Biostatistics, Sociology and the Case Comprehensive Cancer Center, and Clinical and Translational Science Collaborative, Case Western Reserve University, Cleveland, OH (KCS); Department of Family Medicine, University of Colorado School of Medicine, Aurora (LAG, BFM); Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA (WLM); Department of Family Medicine and Community Health, Rutgers-Robert Wood, Johnson Medical School, Somerset, NJ (BFC); Department of Health Policy and Management, Boston University School of Public, Health, Boston, MA (MJE).
Rose GunnFrom the Departments of Family Medicine and of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland (DJC); Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston School of Public Health (BAB); Harold Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX (BAB); Oregon, Rural Practice-Based Research Network (MD); Department of Family Medicine, Oregon Health & Science University, Portland (MD, JH, RG, KC); Department of Epidemiology & Biostatistics, Sociology and the Case Comprehensive Cancer Center, and Clinical and Translational Science Collaborative, Case Western Reserve University, Cleveland, OH (KCS); Department of Family Medicine, University of Colorado School of Medicine, Aurora (LAG, BFM); Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA (WLM); Department of Family Medicine and Community Health, Rutgers-Robert Wood, Johnson Medical School, Somerset, NJ (BFC); Department of Health Policy and Management, Boston University School of Public, Health, Boston, MA (MJE).
Kurt C StangeFrom the Departments of Family Medicine and of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland (DJC); Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston School of Public Health (BAB); Harold Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX (BAB); Oregon, Rural Practice-Based Research Network (MD); Department of Family Medicine, Oregon Health & Science University, Portland (MD, JH, RG, KC); Department of Epidemiology & Biostatistics, Sociology and the Case Comprehensive Cancer Center, and Clinical and Translational Science Collaborative, Case Western Reserve University, Cleveland, OH (KCS); Department of Family Medicine, University of Colorado School of Medicine, Aurora (LAG, BFM); Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA (WLM); Department of Family Medicine and Community Health, Rutgers-Robert Wood, Johnson Medical School, Somerset, NJ (BFC); Department of Health Policy and Management, Boston University School of Public, Health, Boston, MA (MJE).
Larry A GreenFrom the Departments of Family Medicine and of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland (DJC); Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston School of Public Health (BAB); Harold Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX (BAB); Oregon, Rural Practice-Based Research Network (MD); Department of Family Medicine, Oregon Health & Science University, Portland (MD, JH, RG, KC); Department of Epidemiology & Biostatistics, Sociology and the Case Comprehensive Cancer Center, and Clinical and Translational Science Collaborative, Case Western Reserve University, Cleveland, OH (KCS); Department of Family Medicine, University of Colorado School of Medicine, Aurora (LAG, BFM); Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA (WLM); Department of Family Medicine and Community Health, Rutgers-Robert Wood, Johnson Medical School, Somerset, NJ (BFC); Department of Health Policy and Management, Boston University School of Public, Health, Boston, MA (MJE).
William L MillerFrom the Departments of Family Medicine and of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland (DJC); Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston School of Public Health (BAB); Harold Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX (BAB); Oregon, Rural Practice-Based Research Network (MD); Department of Family Medicine, Oregon Health & Science University, Portland (MD, JH, RG, KC); Department of Epidemiology & Biostatistics, Sociology and the Case Comprehensive Cancer Center, and Clinical and Translational Science Collaborative, Case Western Reserve University, Cleveland, OH (KCS); Department of Family Medicine, University of Colorado School of Medicine, Aurora (LAG, BFM); Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA (WLM); Department of Family Medicine and Community Health, Rutgers-Robert Wood, Johnson Medical School, Somerset, NJ (BFC); Department of Health Policy and Management, Boston University School of Public, Health, Boston, MA (MJE).
Benjamin F CrabtreeFrom the Departments of Family Medicine and of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland (DJC); Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston School of Public Health (BAB); Harold Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX (BAB); Oregon, Rural Practice-Based Research Network (MD); Department of Family Medicine, Oregon Health & Science University, Portland (MD, JH, RG, KC); Department of Epidemiology & Biostatistics, Sociology and the Case Comprehensive Cancer Center, and Clinical and Translational Science Collaborative, Case Western Reserve University, Cleveland, OH (KCS); Department of Family Medicine, University of Colorado School of Medicine, Aurora (LAG, BFM); Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA (WLM); Department of Family Medicine and Community Health, Rutgers-Robert Wood, Johnson Medical School, Somerset, NJ (BFC); Department of Health Policy and Management, Boston University School of Public, Health, Boston, MA (MJE).
Mary Jane EnglandFrom the Departments of Family Medicine and of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland (DJC); Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston School of Public Health (BAB); Harold Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX (BAB); Oregon, Rural Practice-Based Research Network (MD); Department of Family Medicine, Oregon Health & Science University, Portland (MD, JH, RG, KC); Department of Epidemiology & Biostatistics, Sociology and the Case Comprehensive Cancer Center, and Clinical and Translational Science Collaborative, Case Western Reserve University, Cleveland, OH (KCS); Department of Family Medicine, University of Colorado School of Medicine, Aurora (LAG, BFM); Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA (WLM); Department of Family Medicine and Community Health, Rutgers-Robert Wood, Johnson Medical School, Somerset, NJ (BFC); Department of Health Policy and Management, Boston University School of Public, Health, Boston, MA (MJE).
Khaya ClarkFrom the Departments of Family Medicine and of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland (DJC); Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston School of Public Health (BAB); Harold Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX (BAB); Oregon, Rural Practice-Based Research Network (MD); Department of Family Medicine, Oregon Health & Science University, Portland (MD, JH, RG, KC); Department of Epidemiology & Biostatistics, Sociology and the Case Comprehensive Cancer Center, and Clinical and Translational Science Collaborative, Case Western Reserve University, Cleveland, OH (KCS); Department of Family Medicine, University of Colorado School of Medicine, Aurora (LAG, BFM); Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA (WLM); Department of Family Medicine and Community Health, Rutgers-Robert Wood, Johnson Medical School, Somerset, NJ (BFC); Department of Health Policy and Management, Boston University School of Public, Health, Boston, MA (MJE).
Benjamin F MillerFrom the Departments of Family Medicine and of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland (DJC); Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center, Houston School of Public Health (BAB); Harold Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX (BAB); Oregon, Rural Practice-Based Research Network (MD); Department of Family Medicine, Oregon Health & Science University, Portland (MD, JH, RG, KC); Department of Epidemiology & Biostatistics, Sociology and the Case Comprehensive Cancer Center, and Clinical and Translational Science Collaborative, Case Western Reserve University, Cleveland, OH (KCS); Department of Family Medicine, University of Colorado School of Medicine, Aurora (LAG, BFM); Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA (WLM); Department of Family Medicine and Community Health, Rutgers-Robert Wood, Johnson Medical School, Somerset, NJ (BFC); Department of Health Policy and Management, Boston University School of Public, Health, Boston, MA (MJE).
Funding
Oregon Patient Centered Outcomes Research K12 ProgramK12HS022981 · AHRQ · OREGON HEALTH & SCIENCE UNIVERSITY · PI GUISE, JEANNE-MARIE · 2014 to 2018
$4.1MAHRQ HHS 1 K12 HS022981 01AHRQ HHS K12 HS022981PHS HHS 8846.01-S01
Abstract
purposeTo provide empirical evidence on key organizing constructs shaping practical, real-world integration of behavior health and primary care to comprehensively address patients' medical, emotional, and behavioral health needs.
methodsIn a comparative case study using an immersion-crystallization approach, a multidisciplinary team analyzed data from observations of practice operations, interviews, and surveys of practice members, and implementation diaries. Practices were drawn from 2 studies of practices attempting to integrate behavioral health and primary care: Advancing Care Together, a demonstration project of 11 practices located in Colorado, and the Integration Workforce Study, a study of 8 practices across the United States.
resultsWe identified 5 key organizing constructs influencing integration of primary care and behavioral health: 1) Integration REACH (the extent to which the integration program was delivered to the identified target population), 2) establishment of continuum of care pathways addressing the location of care across the range of patient's severity of illness, 3) approach to patient transitions: referrals or warm handoffs, 4) location of the integration workforce, and 5) participants' mental model for integration. These constructs intertwine within an organization's historic and social context to produce locally adapted approaches to integrating care. Contextual factors, particularly practice type, influenced whether specialty mental health and substance use services were colocated within an organization.
conclusionInteraction among 5 organizing constructs and practice context produces diverse expressions of integrated care. These constructs provide a framework for understanding how primary care and behavioral health services can be integrated in routine practice.
Indexed as
Community Mental Health CentersCommunity Mental Health ServicesCritical PathwaysCross-Sectional StudiesDelivery of Health Care, IntegratedHumansLongitudinal StudiesMental DisordersPractice Management, MedicalPrimary Health CareReferral and ConsultationUnited StatesDelivery of Health CareIntegratedPractice-based ResearchPrimary Health Care
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