TY - JOUR
AU - A. P. Srinivasan
AU - M. Venegas
AU - R. S. Akins
AU - Garcia E. Fernandez
AU - A. C. Stahmer
A1 - 
AB - OBJECTIVE: To identify key barriers and facilitators to designing and implementing collaborative care (CC) for children with developmental disabilities (DD) in safety-net primary care. METHODS: This pre-implementation qualitative study involved semi-structured interviews with safety-net primary care leaders. Using purposive and respondent-driven sampling, interviews were conducted with 16 leaders across 9 safety-net organizations in Northern California between August 2024 and January 2025. Key Consolidated Framework for Implementation Research (CFIR) constructs guided data collection. Data were analyzed using the Rapid Assessment Process and validated through structured member checking. RESULTS: Leaders from 8 of 9 organizations reported existing integrated behavioral health programs staffed by mental health counselors and/or psychiatrists, but nearly all noted that these programs did not address the specific needs of children with DD. When asked about developing a CC intervention for this population, leaders identified implementation barriers and facilitators that mapped to CFIR inner and outer setting domains. Four themes were distilled: inner setting barriers (space and cost), inner setting facilitators (perceived clinical need among leadership), outer setting barriers (restrictive Medicaid reimbursement policies and limited performance measurement pressure), and outer setting facilitators (alternative financing mechanisms). CONCLUSION: Safety-net leaders indicate a clinical need for CC models specifically for children with DD, but implementation success will depend on addressing space, financing, and policy barriers through targeted implementation strategies.
AD - Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, University of California, Davis, Sacramento, CA.; MIND Institute, University of California, Davis, Sacramento, CA.; University of California, Davis School of Medicine, Sacramento, CA.; Division of General Pediatrics, Department of Pediatrics, University of California, Davis, Sacramento, CA; and.; Department of Psychiatry, University of California, Davis, Sacramento, CA.
AN - 41880188
BT - J Dev Behav Pediatr
C5 - Education & Workforce; Healthcare Disparities
DA - Mar 25
DO - 10.1097/dbp.0000000000001476
DP - NLM
ET - 20260325
JF - J Dev Behav Pediatr
LA - eng
N2 - OBJECTIVE: To identify key barriers and facilitators to designing and implementing collaborative care (CC) for children with developmental disabilities (DD) in safety-net primary care. METHODS: This pre-implementation qualitative study involved semi-structured interviews with safety-net primary care leaders. Using purposive and respondent-driven sampling, interviews were conducted with 16 leaders across 9 safety-net organizations in Northern California between August 2024 and January 2025. Key Consolidated Framework for Implementation Research (CFIR) constructs guided data collection. Data were analyzed using the Rapid Assessment Process and validated through structured member checking. RESULTS: Leaders from 8 of 9 organizations reported existing integrated behavioral health programs staffed by mental health counselors and/or psychiatrists, but nearly all noted that these programs did not address the specific needs of children with DD. When asked about developing a CC intervention for this population, leaders identified implementation barriers and facilitators that mapped to CFIR inner and outer setting domains. Four themes were distilled: inner setting barriers (space and cost), inner setting facilitators (perceived clinical need among leadership), outer setting barriers (restrictive Medicaid reimbursement policies and limited performance measurement pressure), and outer setting facilitators (alternative financing mechanisms). CONCLUSION: Safety-net leaders indicate a clinical need for CC models specifically for children with DD, but implementation success will depend on addressing space, financing, and policy barriers through targeted implementation strategies.
PY - 2026
SN - 0196-206x
ST - Safety-Net Leadership Perspectives on Collaborative Care for Children With Developmental Disabilities
T1 - Safety-Net Leadership Perspectives on Collaborative Care for Children With Developmental Disabilities
T2 - J Dev Behav Pediatr
TI - Safety-Net Leadership Perspectives on Collaborative Care for Children With Developmental Disabilities
U1 - Education & Workforce; Healthcare Disparities
U3 - 10.1097/dbp.0000000000001476
VO - 0196-206x
Y1 - 2026
ER -