Evidence map›Paper›PMID 39870540›Full record

Trial reportAnnals of family medicine2025

Intervention Stage Completion and Behavioral Health Outcomes: An Integrated Behavioral Health and Primary Care Randomized Pragmatic Trial.

Kari A Stephens, Constance van Eeghen, Zihan Zheng, Tracy Anastas, Kris Pui Kwan Ma, Maria G Prado, Jessica Clifton, Gail Rose, Daniel Mullin, Kwun C G Chan and 1 more

Abstract readPragmatic Clinical TrialRandomized Controlled Trial
In one paragraph

Trial report in Annals of family medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Kari A StephensDepartment of Family Medicine, University of Washington, Seattle, Washington kstephen@uw.edu.
Constance van EeghenDepartment of Medicine, University of Vermont, Burlington, Vermont.
Zihan ZhengDepartment of Family Medicine, University of Washington, Seattle, Washington.
Tracy AnastasDepartment of Family Medicine, University of Washington, Seattle, Washington.
Kris Pui Kwan MaDepartment of Family Medicine, University of Washington, Seattle, Washington.
Maria G PradoDepartment of Family Medicine, University of Washington, Seattle, Washington.
Jessica CliftonDepartment of Medicine, University of Vermont, Burlington, Vermont.
Gail RoseDepartment of Psychiatry, University of Vermont, Burlington, Vermont.
Daniel MullinDepartment of Family Medicine and Community Health, UMass Chan Medical School, Worcester, Massachusetts.
Kwun C G ChanDepartment of Biostatistics, University of Washington, Seattle, Washington.
Rodger KesslerDepartment of Family Medicine, University of Colorado, Denver, Colorado.

Funding

Transform Dissemination and Implementation Science in CTSA ProgramsUL1TR002319 · NCATS · UNIVERSITY OF WASHINGTON · PI John K. Amory · 2017 to 2026
$100.0M
Psychiatry Primary Care NRSA T-32 AwardT32MH020021 · NIMH · UNIVERSITY OF WASHINGTON · PI JOHN C. FORTNEY, JURGEN UNUTZER · 1998 to 2026
$5.6M
NCATS NIH HHS UL1 TR002319NIMH NIH HHS T32 MH020021
6 · The paper itself

Abstract

purposeWe performed a pragmatic, cluster randomized controlled trial of a comprehensive practice-level, multistage practice transformation intervention aiming to increase behavioral health integration in primary care practices and improve patient outcomes. We examined associations between completion of intervention stages and patient outcomes across a heterogeneous national sample of primary care practices.

methodsForty-two primary care practices across the United States with colocated behavioral health and 2,945 patients with multiple chronic medical and behavioral health conditions completed surveys at baseline, midpoint, and 2-year follow-up. We examined effects of intervention on patient health and primary care integration outcomes using multilevel mixed-effects models, controlling for baseline outcome measurements.

resultsNo differences were found associated with the number of intervention stages completed and patient health outcomes including depression, anxiety, fatigue, sleep disturbance, pain, pain interference, social participation, and physical function. However, the completion of each intervention stage was associated with increases in Practice Integration Profile domain scores and confirmed with modeling using multiple imputation for the following: workflow 3.5 (95% CI, 0.9 to 6.1), integration methods 4.6 (95% CI, 1.5 to 7.6), patient identification 2.9 (95% CI, 0.9 to 5.0), and total integration 2.7 (95% CI, 0.7 to 4.7).

conclusionA practice-centric flexible practice transformation intervention improved integration of behavioral health in primary care across heterogeneous primary care practices treating patients with multiple chronic conditions when accounting for completion of intervention stages. Interventions that allow practices to flexibly improve care have the potential to help complex patient populations. Future research is needed to determine how to best target patient health outcomes at the population level.

Indexed as

Delivery of Health Care, IntegratedPrimary Health CareAdultBehavioral MedicineFemaleHumansMaleMiddle AgedUnited Statesintegrated behavioral healthmultiple chronic conditionsprimary care

Identifiers

PMID39870540
PMCPMC11772036

What OpenQuestion holds

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Registered trials

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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.