Table 1.

Intervention Components, Description, Frequency, and Timeline

Intervention Component	Who Provided Support	Description	Frequency and Timeline
Expert Training	Physician, BHC, and expert in implementing DD	Education for clinical teams in ADA recommendations and self-management support materials on the following topics: Psychosocial care, type 2 diabetes and DD training for all clinical roles delivered by a physician and DD expert BHC training about the role of the BHC in caring for patient with type 2 diabetes delivered by a clinical psychologist with expertise in integrated behavioral health and primary care	IC1 received these remotely March and May 2021 IC2 was given a recording of these trainings. We do not know if these were reviewed by IC2.
Facilitation	Practice Facilitator	Customized remote once-a-month meetings with an experienced practice facilitator using Bodenheimer’s Building Blocks framework and Plan Do Study Act (PDSA) cycles. Meeting topics were tailored to the clinic’s experience and aligned with ADA recommendations and included: Patient education materials for BH and self-management support Implementation of systematic screenings for DD, depression, anxiety Identifying changes in roles/responsibilities, new processes/workflows for screening and treatment Identify cross-functional practice team, train team in QI Proactive outreach to patients regarding DMII, self-management status, community and family needs Pre-visit planning and huddling, scheduling BHC visits with warm handoffs	IC1: December 2020-February 2022 IC2: June 2021-May 2022

Abbreviations: IC, Intervention clinic; BHC, Behavioral health clinician; DD, Diabetes distress; QI, Quality improvement; DMII, Type 2 Diabetes mellitus; ADA, American Diabetes Association.