Strategies for Implementing Integrated Behavioral Health into Health Centers

Article Figures & Data

Table 1.

Definition of Proctor’s Implementation Outcomes Framework Adapted to the Study’s Demonstration Project

Domain	Definition
Acceptability	Perception among implementation stakeholders whether the Cherokee Model was agreeable, palatable, or satisfactory.
Adoption	Intention, initial decision, or action to employ the Cherokee Model.
Appropriateness	Perceived fit, relevance, or compatibility of the Cherokee Model for the health center, including the staff and patients.
Cost	Financial impact of an implementation effort.
Feasibility	Extent (e.g., low, medium, high) to which the Cherokee Model can be successfully carried out given resources.
Fidelity	Extent to which the Cherokee Model can be implemented as it was intended by the Model developers.
Penetration	Integration of the Cherokee Model into the health center and its subsystems.
Sustainability	Extent to which the Cherokee Model is maintained or institutionalized within the health center’s ongoing, stable operations.

Table 2.

Interview Participant Characteristics (n = 18)

Characteristic	n (%)
Participant role
Primary care clinician (MD, DO)	7 (38.9)
Behavioral health provider (LCSW, DNP, APN, RN)	11 (61.1)
Type of organization
Federally qualified health center	5 (50.0)
Community health center	5 (50.0)
Gender identity
Male	5 (27.8)
Female	12 (66.7)
Transgender	1 (5.5)
Ethnicity
Hispanic/Latino	2 (11.1)
Non-Hispanic/Latino	16 (88.9)
Race
White	13 (72.2)
Black	1 (5.6)
Asian	1 (5.6)
Other	3 (16.6)
Years at current organization
1 to 5	6 (33.3)
6 to 10	2 (11.1)
11 to 15	3 (16.7)
16 to 20	4 (22.2)
More than 20	3 (16.7)

Abbreviations: APN, advanced practice nurse; DNP, doctor of nursing practice; DO, doctor of osteopathic medicine; LCSW, licensed clinical social worker; MD, doctor of medicine; RN, registered nurse.