ArticleJournal of general internal medicine2026
Building Community Health Center Teams: Evaluating the Impact of Team Training.
Article in Journal of general internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHigh-performing teams anchored by quality improvement and practice transformation skills strengthen primary care by improving patient outcomes. Effective team-based care may be particularly valuable in medically underserved communities (MUCs).
objectiveTo evaluate the impact of a team-based training program that focused on quality improvement and practice transformation skills in community health centers (CHC) serving under-resourced communities across the Commonwealth of Massachusetts.
designThe Advancing Teams Program was delivered to CHC teams over 6 years (2016-2022). The evaluation used a mixed methods design to assess the program's impact.
participantsForty-seven interdisciplinary teams from CHCs serving MUCs in Massachusetts. The 327 individual participants included administrative staff, clinicians, and trainees. APPROACH: Evaluative data included participating CHC team and clinic demographics, pre-post evaluation of participants' perceptions of practice transformation using the Qualis Health Patient-Centered Medical Home Assessment (PCMH-A), and qualitative analysis of team improvement projects to identify themes related to project aims, practice transformation skills, and patient outcomes. KEY
resultsCHCs participating in the ATP program served under-resourced communities, with > 65% serving high levels of Medicaid and uninsured patients. Pre-post PCMH-A analysis indicated significant improvements (p < 0.05) in team members' perceptions of leadership engagement, team-based care, evidence-based practices, patient-centered interactions, access, and care coordination. The largest improvement was seen in patient-centered interactions (+ 1.04, p = 0.001), with ATP participation strongly associated with improved perceptions of encouraging patients to expand their role in decision-making, health-related behavior change, and self-management. Positive change in perceived leadership engagement predicted greater improvement in clinic functioning (β = 0.68, p < 0.001). Qualitative analysis showed that ATP teams successfully improved care in areas such as behavioral health, diabetes, substance abuse, and social determinants of health.
conclusionsATP is a promising approach to building primary care teams within under-resourced CHCs. Additional research should include evaluation of team quality and robust approaches to measuring improvement projects.
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