title: Understanding preventive health screening services use in persons with serious mental illness: how does integrated behavioral health primary care compare?
abstract: OBJECTIVE
  People with serious mental illness have reduced life expectancy, in large part due to reduced access to medical services and underutilization of preventive health services. This is a cross-sectional study that compared preventive services use in an integrated behavioral health primary care clinic (IBHPC) with two existing community mental health programs.
  
  
  METHODS
  Participants completed questionnaires about preventive health services use that contained 33 questions about demographic clinical information, and use of preventive health services, from October 2010 to December 2012. Services examined included mammogram, Papanicolaou Test, prostate specific antigen, digital rectal exam, fecal occult blood test, and flexible sigmoidoscopy or colonoscopy; blood pressure, height and weight, cholesterol, and blood sugar for diabetes; and influenza immunization, Hepatitis C Virus (HCV), and Human Immunodeficiency Virus (HIV) antibodies. A health service utilization score was developed and used as primary outcome for data analyses.
  
  
  RESULTS
  In the multivariate analyses female gender (p < 0.05), race/ethnicity (p = 0.01 for Asian, p = 0.04 for Hispanic/Latino, both compared to White), program type (p < 0.001), and having a primary care provider (p < 0.001) were significant predictors of higher services use. IBHPC was associated with higher overall service utilization compared to one community mental health program (p < 0.001) but was similar when compared another (p = 0.34). There was high variability in use of individual services among the clinical programs.
  
  
  CONCLUSIONS
  More studies are needed to examine the effectiveness of integrated care in improving use of health screening services. Characteristics of the clinic in relation to use of preventive services deserve further study.
authors: University of California at Davis glen.xiong@ucdmc.ucdavis.edu.
authors: Glen L
authors: GL
authors: Xiong
authors: University of California at Davis.
authors: Ana-Maria
authors: AM
authors: Iosif
authors: University of California at Davis.
authors: Shannon
authors: S
authors: Suo
authors: University of California at Davis.
authors: Robert M
authors: RM
authors: Mccarron
authors: University of California at Davis.
authors: Alan
authors: A
authors: Koike
authors: University of California at Davis.
authors: John
authors: J
authors: Onate
authors: University of California at Davis.
authors: Cameron S
authors: CS
authors: Carter
mesh_terms: D000328:Adult; D002140:California; D019033:Delivery of Health Care, Integrated / Q000706:statistics & numerical data*; D055088:Early Detection of Cancer / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology*; D008875:Middle Aged; D009098:Multiphasic Screening / Q000523:psychology* / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D014600:Utilization Review / Q000706:statistics & numerical data
keywords: bipolar disorder; health screening; health services use; preventive health; schizophrenia; serious mental illness