TY - JOUR
AU - J. Santos
AU - A. Acevedo-Morales
AU - L. Jones
AU - C. Camplain
AU - S. Babbitt
AU - C. N. Keene
AU - T. Bautista
AU - J. A. Baldwin
A1 - 
AB - Background/Objectives: Integrating behavioral health and primary care services is a national public health priority in the US, especially in underserved settings like northern Arizona. This healthcare delivery model is crucial to meet the mental and physical health needs of people with SU/SUDs, particularly those belonging to culturally diverse populations. In collaboration with a behavioral health center in northern Arizona, the current study aimed to assess the perspectives of providers and administrative staff on the implementation of integrated primary care (IPC) services for people with SU/SUDs. Methods: In February 2023, twelve healthcare providers and administrative staff from diverse educational backgrounds were recruited using purposive sampling to capture a range of perspectives on IPC implementation at the behavioral health center. Participants completed individual, semi-structured interviews conducted via Zoom, which were audio recorded and lasted approximately 30 min. The interview recordings were transcribed verbatim using Trint Software, and analyzed on Google Docs using applied thematic analysis. Two researchers coded the transcripts, iteratively developing and refining themes through multiple cycles of review and team discussions. Additional team members provided feedback and verified the themes, with consensus reached through collaborative meetings. This rigorous, iterative approach ensured the reliability and validity of the final thematic framework. Results: We found that IPC supports SU/SUDs recovery by providing holistic care that integrates medical, mental health, and addiction services while addressing social and co-occurring needs. It fosters an empathetic environment where clients do not need to repeatedly disclose their SU/SUDs, improves access to preventive care, and offers continuous support and education. Implementation barriers included workforce shortages, limited internal communication, and insufficient interdisciplinary training. Gaps in culturally centered care were identified, including reliance on Western models, limited representation of Native American and sexual and gender minority staff, and inconsistent use of inclusive practices such as pronouns, traditional healing, and trauma-informed approaches. Additionally, community partnerships with multisectoral organizations help clients access supportive resources beyond the facility, including vision care, clothing, and dental services. Conclusions: The implementation of IPC was seen as important to support the behavioral health center in northern Arizona to foster an empathetic environment where clients with SU/SUDs can have their mental, physical, and social needs addressed, either within the facility or through community partnerships, thereby supporting their recovery. However, progress is hindered by barriers such as workforce shortages, limited internal communication, and insufficient interdisciplinary care training. Additionally, despite regular cultural competency training, gaps remain in culturally centered care for underserved populations, particularly Native American and sexual and gender minority clients.
AD - Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ 85004, USA.; Center for Community Health and Engaged Research, Northern Arizona University, Flagstaff, AZ 86011, USA.; School of Nursing, Universidade Federal de Sergipe, Aracaju 49015, SE, Brazil.; Department of Clinical Psychology, Northern Arizona University, Flagstaff, AZ 86011, USA.; Department of Applied Health Science, School of Public Health-Bloomington, Indiana University, Bloomington, IN 47407, USA.; Community Health Advisor, Flagstaff, AZ 86001, USA.; Kauffman and Associates, Incorporated, Flagstaff, AZ 75215, USA.; College of Education and Human Sciences, University of New Mexico, Albuquerque, NM 87106, USA.
AN - 41373267
BT - Healthcare (Basel)
C5 - Healthcare Disparities; Education & Workforce
CP - 23
DA - Nov 25
DO - 10.3390/healthcare13233050
DP - NLM
ET - 20251125
IS - 23
JF - Healthcare (Basel)
LA - eng
N2 - Background/Objectives: Integrating behavioral health and primary care services is a national public health priority in the US, especially in underserved settings like northern Arizona. This healthcare delivery model is crucial to meet the mental and physical health needs of people with SU/SUDs, particularly those belonging to culturally diverse populations. In collaboration with a behavioral health center in northern Arizona, the current study aimed to assess the perspectives of providers and administrative staff on the implementation of integrated primary care (IPC) services for people with SU/SUDs. Methods: In February 2023, twelve healthcare providers and administrative staff from diverse educational backgrounds were recruited using purposive sampling to capture a range of perspectives on IPC implementation at the behavioral health center. Participants completed individual, semi-structured interviews conducted via Zoom, which were audio recorded and lasted approximately 30 min. The interview recordings were transcribed verbatim using Trint Software, and analyzed on Google Docs using applied thematic analysis. Two researchers coded the transcripts, iteratively developing and refining themes through multiple cycles of review and team discussions. Additional team members provided feedback and verified the themes, with consensus reached through collaborative meetings. This rigorous, iterative approach ensured the reliability and validity of the final thematic framework. Results: We found that IPC supports SU/SUDs recovery by providing holistic care that integrates medical, mental health, and addiction services while addressing social and co-occurring needs. It fosters an empathetic environment where clients do not need to repeatedly disclose their SU/SUDs, improves access to preventive care, and offers continuous support and education. Implementation barriers included workforce shortages, limited internal communication, and insufficient interdisciplinary training. Gaps in culturally centered care were identified, including reliance on Western models, limited representation of Native American and sexual and gender minority staff, and inconsistent use of inclusive practices such as pronouns, traditional healing, and trauma-informed approaches. Additionally, community partnerships with multisectoral organizations help clients access supportive resources beyond the facility, including vision care, clothing, and dental services. Conclusions: The implementation of IPC was seen as important to support the behavioral health center in northern Arizona to foster an empathetic environment where clients with SU/SUDs can have their mental, physical, and social needs addressed, either within the facility or through community partnerships, thereby supporting their recovery. However, progress is hindered by barriers such as workforce shortages, limited internal communication, and insufficient interdisciplinary care training. Additionally, despite regular cultural competency training, gaps remain in culturally centered care for underserved populations, particularly Native American and sexual and gender minority clients.
PY - 2025
SN - 2227-9032 (Print); 2227-9032
ST - Integrating Primary Care Services into a Rural Behavioral Health Facility in Northern Arizona: Perspectives of Healthcare Providers and Administrative Staff
T1 - Integrating Primary Care Services into a Rural Behavioral Health Facility in Northern Arizona: Perspectives of Healthcare Providers and Administrative Staff
T2 - Healthcare (Basel)
TI - Integrating Primary Care Services into a Rural Behavioral Health Facility in Northern Arizona: Perspectives of Healthcare Providers and Administrative Staff
U1 - Healthcare Disparities; Education & Workforce
U3 - 10.3390/healthcare13233050
VL - 13
VO - 2227-9032 (Print); 2227-9032
Y1 - 2025
ER -