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The Literature Collection contains over 10,000 references for published and grey literature on the integration of behavioral health and primary care. Learn More
Use the Search feature below to find references for your terms across the entire Literature Collection, or limit your searches by Authors, Keywords, or Titles and by Year, Type, or Topic. View your search results as displayed, or use the options to: Show more references per page; Sort references by Title or Date; and Refine your search criteria. Expand an individual reference to View Details. Full-text access to the literature may be available through a link to PubMed, a DOI, or a URL. References may also be exported for use in bibliographic software (e.g., EndNote, RefWorks, Zotero).
10858 Results
5424
Internal medicine residency training for unhealthy alcohol and other drug use: Recommendations for curriculum design
Type: Journal Article
Year: 2010
Publication Place: England
Abstract: BACKGROUND: Unhealthy substance use is the spectrum from use that risks harm, to use associated with problems, to the diagnosable conditions of substance abuse and dependence, often referred to as substance abuse disorders. Despite the prevalence and impact of unhealthy substance use, medical education in this area remains lacking, not providing physicians with the necessary expertise to effectively address one of the most common and costly health conditions. Medical educators have begun to address the need for physician training in unhealthy substance use, and formal curricula have been developed and evaluated, though broad integration into busy residency curricula remains a challenge. DISCUSSION: We review the development of unhealthy substance use related competencies, and describe a curriculum in unhealthy substance use that integrates these competencies into internal medicine resident physician training. We outline strategies to facilitate adoption of such curricula by the residency programs. This paper provides an outline for the actual implementation of the curriculum within the structure of a training program, with examples using common teaching venues. We describe and link the content to the core competencies mandated by the Accreditation Council for Graduate Medical Education, the formal accrediting body for residency training programs in the United States. Specific topics are recommended, with suggestions on how to integrate such teaching into existing internal medicine residency training program curricula. SUMMARY: Given the burden of disease and effective interventions available that can be delivered by internal medicine physicians, teaching about unhealthy substance use must be incorporated into internal medicine residency training, and can be done within existing teaching venues.
Topic(s):
Education & Workforce
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Reference Links: 
View the DOI record for Internal medicine residency training for unhealthy alcohol and other drug use: Recommendations for curriculum design
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View the PubMed citation for Internal medicine residency training for unhealthy alcohol and other drug use: Recommendations for curriculum design5425
International learning on increasing the value and effectiveness of primary care (I LIVE PC) New Zealand
Type: Journal Article
Year: 2012
Publication Place: United States
Abstract: New Zealand (NZ) has a central government-driven, tax-funded health system with the state as dominant payer. The NZ experience precedes and endorses the US concept of patient-centered medical homes providing population-based, nonepisodic care supported by network organizations. These networks provide administration, budget holding, incentivized programs, data feedback, peer review, education, human relations, and health information technology support and resources. Key elements include enrolled populations; an interdisciplinary team approach; health information technology interoperability and access between all providers as well as patients; devolution of hospital-based services into the community; intersectorial integration; blended payments (a combination of universal capitated funding, patient copayments, and targeted fee-for-service for specific items); and a balance of clinical, corporate, and community governance. In this article, we discuss reforms to NZ's primary care arrangements over the past 2 decades and reflect on the lessons learned, their relevance to the United States, and issues that remain to be resolved.
Topic(s):
Education & Workforce
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, HIT & Telehealth
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Reference Links:
View the DOI record for International learning on increasing the value and effectiveness of primary care (I LIVE PC) New Zealand
View DOI Record
View the PubMed citation for International learning on increasing the value and effectiveness of primary care (I LIVE PC) New Zealand5427
Internet tool box for rural GPs to access mental health services information
Type: Journal Article
Year: 2009
Publication Place: Australia
Abstract: INTRODUCTION: Rural GPs play a significant role in the mental health care of their patients. It is therefore crucial that they have access to reputable support and advice that enhances their existing knowledge. This article outlines a recent project initiated by the Australian rural Ballarat and District Division of General Practice (BDDGP) to develop and implement an online resource to facilitate local implementation and delivery of the 'Better Access to Mental Health Care' (BAMHC) program. This 12 month project was initiated in response to a request from local GPs for additional information about and support in using the BAMHC program. The project is the culmination of significant collaboration among key stakeholders that includes local GPs, GP advisors from BDDGP, BDDGP staff, and two University of Ballarat research centres (the Centre for Health Research and Practice, and the Centre for Electronic Commerce and Communication). This article documents the key stages involved in the project from initiation to implementation, and reports on the use of this resource 12 months after its launch. METHOD: The BDDGP represents 107 GPs and six GP registrars and covers a large rural/semi-rural area of 7300 km2 and a catchment population of more than 120,000. The format and design of the project entailed four distinct but interrelated stages of development: (1) developing the program specifications and localising it to the BDDGP catchment; (2) constructing a decision-making support tool with 7 sequential steps comprising key questions and links to detailed answers; (3) developing and populating an online service directory of local allied health professionals; and (4) constructing the website for easy access and navigation for GPs and other service providers. RESULTS: The website was publicly launched in December 2007 and is hosted by BDDGP. Since then it has received strong support. In the 12 months since its launch the website received regular and continuous visits (2847 visits/11,500 pages accessed). In addition, anecdotal evidence and other feedback (positive comments; requested changes to entries in the service directory from allied mental health professionals) indicate that the website is being recognised as an important resource of and hub for local information relating to the BAMHC program for GPs and allied health professionals. CONCLUSIONS: Integral to the website's success and sustainability is the close and continued monitoring and updating of the information provided. A formal, longitudinal evaluation 18 months to 2 years after the website's launch is recommended to provide a more rigorous assessment of the tool, and examine possible improvements. While the project does not address the problem of the supply of allied mental health providers in rural areas, it does provide assistance with responsive service system expansion and the provision of a localized tool for accessing appropriate information about mental health services.
Topic(s):
HIT & Telehealth
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, Measures
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Reference Links: View the PubMed citation for Internet tool box for rural GPs to access mental health services information
5428
Internet-Based Cognitive Behavioral Therapy for Chronic Fatigue Syndrome Integrated in Routine Clinical Care: Implementation Study
Type: Journal Article
Year: 2019
Publication Place: Canada
Topic(s):
Financing & Sustainability
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, Healthcare Disparities
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, HIT & Telehealth
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, Measures
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5429
Internet-based therapy for mild to moderate depression in Swedish primary care: short term results from the PRIM-NET randomized controlled trial
Type: Journal Article
Year: 2014
Publication Place: England
Abstract: Depression presents a serious condition for the individual and a major challenge to health care and society. Internet-based cognitive behavior therapy (ICBT) is a treatment option supported in several trials, but there is as yet a lack of effective studies of ICBT in "real world" primary care settings. We examined whether ICBT differed from treatment-as-usual (TAU) in reducing depressive symptoms after 3 months. TAU comprised of visits to general practitioner, registered nurse, antidepressant drugs, waiting list for, or psychotherapy, or combinations of these alternatives. Patients, aged >/= 18 years, who tentatively met criteria for mild to moderate depression at 16 primary care centers in the south-western region of Sweden were recruited and then assessed in a diagnostic interview. A total of 90 patients were randomized to either TAU or ICBT. The ICBT treatment included interactive elements online, a workbook, a CD with mindfulness and acceptance exercises, and minimal therapist contact. The treatment period lasted for 12 weeks after which both groups were assessed. The main outcome measure was Beck Depression Inventory-II (BDI-II). Additional measures were Montgomery Asberg Depression Rating Scale - self rating version (MADRS-S) and Beck Anxiety Inventory (BAI). The analyses revealed no significant difference between the two groups at post treatment, neither on BDI-II, MADRS-S, nor BAI. Twenty patients (56%) in the ICBT treatment completed all seven modules. Our findings suggest that ICBT may be successfully delivered in primary care and that the effectiveness, after 3 months, is at par with TAU.
Topic(s):
HIT & Telehealth
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5431
Interprofessional collaboration and integration as experienced by social workers in health care
Type: Journal Article
Year: 2016
Publication Place: United States
Abstract: Interprofessional collaboration in health care is gaining popularity. This secondary analysis focuses on social workers' experiences on interprofessional teams. The data revealed that social workers perceived overall collaboration as positive. However, concerns were made apparent regarding not having the opportunity to work to full scope and a lack of understanding of social work ideology from other professionals. Both factors seem to impede integration of and collaboration with social workers on health care teams. This study confirms the need to encourage and support health care providers to more fully understand the foundation, role, and efficacy of social work on interprofessional teams.
Topic(s):
Education & Workforce
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Reference Links:
View the DOI record for Interprofessional collaboration and integration as experienced by social workers in health care
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View the PubMed citation for Interprofessional collaboration and integration as experienced by social workers in health care5432
Interprofessional collaboration in primary health care organizations
Type: Journal Article
Year: 1991
Publication Place: ENGLAND
Topic(s):
Education & Workforce
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Reference Links: View the PubMed citation for Interprofessional collaboration in primary health care organizations
5433
Interprofessional collaboration in primary health care: a review of facilitators and barriers perceived by involved actors
Type: Journal Article
Year: 2014
Topic(s):
Education & Workforce
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5434
Interprofessional collaboration: Effects of practice-based interventions on professional practice and healthcare outcomes
Type: Journal Article
Year: 2009
Publication Place: England
Abstract: BACKGROUND: Poor interprofessional collaboration (IPC) can negatively affect the delivery of health services and patient care. Interventions that address IPC problems have the potential to improve professional practice and healthcare outcomes. OBJECTIVES: To assess the impact of practice-based interventions designed to change IPC, compared to no intervention or to an alternate intervention, on one or more of the following primary outcomes: patient satisfaction and/or the effectiveness and efficiency of the health care provided. Secondary outcomes include the degree of IPC achieved. SEARCH STRATEGY: We searched the Cochrane Effective Practice and Organisation of Care Group Specialised Register (2000-2007), MEDLINE (1950-2007) and CINAHL (1982-2007). We also handsearched the Journal of Interprofessional Care (1999 to 2007) and reference lists of the five included studies. SELECTION CRITERIA: Randomised controlled trials of practice-based IPC interventions that reported changes in objectively-measured or self-reported (by use of a validated instrument) patient/client outcomes and/or health status outcomes and/or healthcare process outcomes and/or measures of IPC. DATA COLLECTION AND ANALYSIS: At least two of the three reviewers independently assessed the eligibility of each potentially relevant study. One author extracted data from and assessed risk of bias of included studies, consulting with the other authors when necessary. A meta-analysis of study outcomes was not possible given the small number of included studies and their heterogeneity in relation to clinical settings, interventions and outcome measures. Consequently, we summarised the study data and presented the results in a narrative format. MAIN RESULTS: Five studies met the inclusion criteria; two studies examined interprofessional rounds, two studies examined interprofessional meetings, and one study examined externally facilitated interprofessional audit. One study on daily interdisciplinary rounds in inpatient medical wards at an acute care hospital showed a positive impact on length of stay and total charges, but another study on daily interdisciplinary rounds in a community hospital telemetry ward found no impact on length of stay. Monthly multidisciplinary team meetings improved prescribing of psychotropic drugs in nursing homes. Videoconferencing compared to audioconferencing multidisciplinary case conferences showed mixed results; there was a decreased number of case conferences per patient and shorter length of treatment, but no differences in occasions of service or the length of the conference. There was also no difference between the groups in the number of communications between health professionals recorded in the notes. Multidisciplinary meetings with an external facilitator, who used strategies to encourage collaborative working, was associated with increased audit activity and reported improvements to care. AUTHORS' CONCLUSIONS: In this updated review, we found five studies (four new studies) that met the inclusion criteria. The review suggests that practice-based IPC interventions can improve healthcare processes and outcomes, but due to the limitations in terms of the small number of studies, sample sizes, problems with conceptualising and measuring collaboration, and heterogeneity of interventions and settings, it is difficult to draw generalisable inferences about the key elements of IPC and its effectiveness. More rigorous, cluster randomised studies with an explicit focus on IPC and its measurement, are needed to provide better evidence of the impact of practice-based IPC interventions on professional practice and healthcare outcomes. These studies should include qualitative methods to provide insight into how the interventions affect collaboration and how improved collaboration contributes to changes in outcomes.
Topic(s):
Education & Workforce
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5438
Interprofessional education and working in mental health: In search of the evidence base
Type: Journal Article
Year: 2008
Publication Place: England
Abstract: AIM: To explore interprofessional attitudes arising from shared learning in mental health. BACKGROUND: Inter-professional education in healthcare is a priority area for improving team-working and communication. Many studies have attempted to evaluate its benefits and challenges, although few emanate from the mental health arena. However, producing evidence to link educational input with clinical outcomes is notoriously difficult. This project attempted to produce evidence for changes in interprofessional attitudes and stereotypes. METHOD(S): Mental health nursing students and clinical psychology trainees participated in inter-professional education. An evaluation tool was designed to evaluate the experience and outcomes, and to consider implications for interprofessional working. RESULTS: There was an increase in clarity regarding roles, approaches and resources, and how to collaborate in practice. There was no significant change in professional identity. Many challenges were identified, including differences in academic level, previous experience, expectations, assessment, motivation and effort. CONCLUSION: Despite the challenges, it remains important to offer collaboration with future mental health colleagues as a foundation for effective team-working. Recommendations are made for creating inter-professional education opportunities for diverse student groups. IMPLICATIONS FOR NURSING MANAGEMENT: Mental health professionals need to work effectively in multidisciplinary teams. Drawing on available guidance, managers should encourage and support team members to undertake shared learning where possible, both within clinical settings and through more formal educational provision. In this way, managers can facilitate collaborative relationships which will pay dividends for the provision of effective mental health care. This project adds to the limited knowledge currently available on interprofessional learning and attitudes within a mental health context.
Topic(s):
Education & Workforce
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Reference Links:
View the DOI record for Interprofessional education and working in mental health: In search of the evidence base
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View the PubMed citation for Interprofessional education and working in mental health: In search of the evidence base5440
Interprofessional education in academic family medicine teaching units: A functional program and culture
Type: Journal Article
Year: 2009
Publication Place: Canada
Abstract: PROBLEM ADDRESSED: The new family health teams (FHTs) in Ontario were designed to enable interprofessional collaborative practice in primary care; however, many health professionals have not been trained in an interprofessional environment. OBJECTIVE OF PROGRAM: To provide health professional learners with an interprofessional practice experience in primary care that models teamwork and collaborative practice skills. PROGRAM DESCRIPTION: The 2 academic teaching units of the FHT at McMaster University in Hamilton, Ont, employ 6 types of health professionals and provide learning environments for family medicine residents and students in a variety of health care professions. Learners engage in formal interprofessional education activities and mixed professional and learner clinical consultations. They are immersed in an established interprofessional practice environment, where all team members are valued and contribute collaboratively to patient care and clinic administration. Other contributors to the success of the program include the physical layout of the clinics, the electronic medical record communications system, and support from leadership for the additional clinical time commitment of delivering interprofessional education. CONCLUSION: This academic FHT has developed a program of interprofessional education based partly on planned activities and logistic enablers, and largely on immersing learners in a culture of long-standing interprofessional collaboration.
Topic(s):
Education & Workforce
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, HIT & Telehealth
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Reference Links: View the PubMed citation for Interprofessional education in academic family medicine teaching units: A functional program and culture