Learnings from the implementation of standardized content and processes for integrated behavioral health prevention visits.

Abstract

Integrated behavioral health (IBH) in pediatric primary care has spread significantly over the past two decades. However, a crucial component of advancing the state of science is articulating specific intervention models and their associated outcomes. Foundational to this research is the standardization of IBH interventions; however, limited scholarship exists. This is particularly true for IBH prevention (IBH-P) interventions, which pose unique challenges to standardization. The present study presents the development of a standardized IBH-P model, processes to ensure fidelity, and fidelity outcomes. The IBH-P model was delivered by psychologists in two large, diverse pediatric primary care clinics. Extant research and quality improvement processes supported the development of standardized criteria. Fidelity procedures were developed through an iterative process, resulting in two measures: provider self-rated fidelity and independent rater fidelity. These tools assessed fidelity to IBH-P visits and comparison of self and independently rated fidelity. Data from both self and independent ratings indicated 90.5% of items were completed across all visits. The agreement between independent rater coding and provider self-coding was high (87.5%). Results indicated a high level of concordance between provider self-ratings and independent coder ratings of fidelity. Findings suggest that a prevention-based, universal, standardized model of care with a psychosocially complex population was feasible to develop and adhere to. Learnings generated from this study may guide other programs seeking to develop standardization interventions and fidelity processes that can ensure high-quality, evidence-based care. (PsycInfo Database Record (c) 2023 APA, all rights reserved).