title: Organizational correlates of implementation of colocation of mental health and primary care in the Veterans Health Administration.
abstract: This study explored the role of organizational factors in the ability of Veterans Health Administration (VHA) clinics to implement colocated mental health care in primary care settings (PC-MH). The study used data from the VHA Clinical Practice Organizational Survey collected in 2007 from 225 clinic administrators across the United States. Clinic degree of implementation of PC-MH was the dependent variable, whereas independent variables included policies and procedures, organizational context, and leaders' perceptions of barriers to change. Pearson bivariate correlations and multivariable linear regression were used to test hypotheses. Results show that depression care training for primary care providers and clinics' flexibility and participation were both positively correlated with implementation of PC-MH. However, after accounting for other factors, regressions show that only training primary care providers in depression care was marginally associated with degree of implementation of PC-MH (p = 0.051). Given the importance of this topic for implementing integrated care as part of health care reform, these null findings underscore the need to improve theory and testing of more proximal measures of colocation in future work.
authors.affiliation: School of Social Work, University of Southern California, Los Angeles, CA, USA, erickgue@usc.edu.
authors.forename: Erick G
authors.initials: EG
authors.lastname: Guerrero
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Heslin
authors.forename: Evelyn
authors.initials: E
authors.lastname: Chang
authors.forename: Karissa
authors.initials: K
authors.lastname: Fenwick
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Yano
mesh_terms: D003156:Community Mental Health Services / Q000458:organization & administration*; D019033:Delivery of Health Care, Integrated; D003863:Depression / Q000628:therapy*; D003866:Depressive Disorder / Q000628:therapy*; D018166:Health Care Reform; D006801:Humans; D016014:Linear Models; D016134:Organizational Policy; D058007:Physicians, Primary Care / Q000193:education*; D011320:Primary Health Care / Q000458:organization & administration*; D014481:United States; D014493:United States Department of Veterans Affairs / Q000458:organization & administration*
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