ArticleJournal of general internal medicine2020
Time and Organizational Cost for Facilitating Implementation of Primary Care Mental Health Integration.
Article in Journal of general internal medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers.
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Who cites it
43 citing papers in PubMed, 74 citations in OpenAlex.
- Process evaluation of F@ce 2.0, a team-based, person-centred intervention for rehabilitation after stroke supported by ICT.BMC health services research · 2026Trial
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- Implementation of peer specialist services in VA primary care: a cluster randomized trial on the impact of external facilitation.Implementation science : IS · 2021Trial
- Acceptability of a complex team-based quality improvement intervention for transient ischemic attack: a mixed-methods study.BMC health services research · 2021Trial
- Implementation Evaluation of a Complex Intervention to Improve Timeliness of Care for Veterans with Transient Ischemic Attack.Journal of general internal medicine · 2021Trial
- Using Lean-Facilitation to Improve Quality of Hepatitis C Testing in Primary Care.Journal of general internal medicine · 2021Trial
- Implementing the collaborative chronic care model for mental health: a nonrandomized clinical trial.Implementation science communications · 2026Article
- Transitioning an implementation research intervention to a sustained clinical service: Telehealth primary care mental health integration implementation in Veterans Health Administration.Psychological services · 2025Article
- Development and preliminary testing of a culturally competent behaviour change intervention framework to enhance utilisation of sexual and reproductive health services among migrant adolescents in Ghana: an intervention design.International journal for equity in health · 2025Article
- Article
- Assessing implementation and health equity determinants to develop a facilitation plan for varied intensity posttraumatic stress disorder (PTSD) treatments in minority-serving institutions.Psychological services · 2025Article
- Relationships between internal facilitation processes and implementation outcomes among hospitals participating in a quality improvement collaborative to reduce cesarean births: a mixed-methods embedded case study.Implementation science communications · 2025Article
- Evaluating spoke facilitation costs of implementing TelePain in the Veterans Health Administration.Implementation science communications · 2025Article
- The "good enough" facilitator: elucidating the role of working alliance in the mechanism of facilitation.Implementation science communications · 2025Article
- Finding the right dose: a scoping review examining facilitation as an implementation strategy for evidence-based stroke care.Implementation science : IS · 2025Article
- Virtual practice facilitation as an implementation strategy for launching opioid safety committees for quality improvement in primary care: feasibility, acceptability, and intervention fidelity.BMC primary care · 2024Article
- Implementation of collaborative care for depression in VA HIV clinics: Translating Initiatives for Depression into Effective Solutions (HITIDES): protocol for a cluster-randomized type 3 hybrid effectiveness-implementation trial.Implementation science communications · 2024Article
- A microcosting approach for planning and implementing community-based mental health prevention program: what does it cost?Health economics review · 2024Article
- Getting to Fidelity: Consensus Development Process to Identify Core Activities of Implementation Facilitation.Global implementation research and applications · 2024Article
- Advancing healthcare equity through dissemination and implementation science.Health services research · 2023Review
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIntegrating mental health services into primary care settings is complex and challenging. Although facilitation strategies have successfully supported implementation of primary care mental health integration and other complex innovations, we know little about the time required or its cost.
objectiveTo examine the time and organizational cost of facilitating implementation of primary care mental health integration.
designDescriptive analysis.
participantsOne expert external facilitator and two internal regional facilitators who helped healthcare system stakeholders, e.g., leaders, managers, clinicians, and non-clinical staff, implement primary care mental health integration at eight clinics.
interventionImplementation facilitation tailored to the needs and resources of the setting and its stakeholders. MAIN MEASURES: We documented facilitators' and stakeholders' time and types of activities using a structured spreadsheet collected from facilitators on a weekly basis. We obtained travel costs and salary information. We conducted descriptive analysis of time data and estimated organizational cost. KEY
resultsThe external facilitator devoted 263 h (0.09 FTE), including travel, across all 8 clinics over 28 months. Internal facilitator time varied across networks (1792 h versus 1169 h), as well as clinics. Stakeholder participation time was similar across networks (1280.6 versus 1363.4 person hours) but the number of stakeholders varied (133 versus 199 stakeholders). The organizational cost of providing implementation facilitation also varied across networks ($263,490 versus $258,127). Stakeholder participation accounted for 35% of the cost of facilitation activities in one network and 47% of the cost in the other.
conclusionsAlthough facilitation can improve implementation of primary care mental health integration, it requires substantial organizational investments that may vary by site and implementation effort. Furthermore, the cost of using an external expert to transfer facilitation skills and build capacity for implementation efforts appears to be minimal.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.