title: US Air Force Behavioral Health Optimization Program: team members' satisfaction and barriers to care.
abstract: Research has shown significant contribution of integrated behavioural health care; however, less is known about the perceptions of primary care providers towards behavioural health professionals.
  
  
  
  The current study examined barriers to care and satisfaction with integrated behavioural health care from the perspective of primary care team members.
  
  
  
  This study utilized archival data from 42 treatment facilities as part of ongoing program evaluation of the Air Force Medical Service's Behavioral Health Optimization Program.
  
  
  
  This study was conducted in a large managed health care organization for active duty military and their families, with specific clinic settings that varied considerably in regards to geographic location, population diversity and size of patient empanelment.
  
  
  
  De-identified archival data on 534 primary care team members were examined.
  
  
  
  Team members at larger facilities rated access and acuity concerns as greater barriers than those from smaller facilities (t(533) = 2.57, P < 0.05). Primary Care Managers (PCMs) not only identified more barriers to integrated care (β = -0.07, P < 0.01) but also found services more helpful to the primary care team (t(362.52) = 1.97, P = 0.05). Barriers to care negatively impacted perceived helpfulness of integrated care services for patients (β = -0.12, P < 0.01) and team members, particularly among non-PCMs (β = -0.11, P < 0.01).
  
  
  
  Findings highlight the potential benefits of targeted training that differs in facilities of larger empanelment and is mindful of team members' individual roles in a Patient Centered Medical Home. In particular, although generally few barriers were perceived, given the impact these barriers have on perception of care, efforts should be made to decrease perceived barriers to integrated behavioural health care among non-PCM team members.
authors.affiliation: Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA, ryan.landoll@usuhs.edu.
authors.forename: Ryan R
authors.initials: RR
authors.lastname: Landoll
authors.affiliation: Squadron Officer School, Air University, Maxwell AFB, Montgomery, AL, USA and.
authors.forename: Matthew K
authors.initials: MK
authors.lastname: Nielsen
authors.affiliation: Family Health Clinic, 35th Medical Group, Misawa Air Base, Misawa, Japan.
authors.forename: Kathryn K
authors.initials: KK
authors.lastname: Waggoner
mesh_terms: D000337:Aerospace Medicine / Q000458:organization & administration*; D001291:Attitude of Health Personnel; D001524:Behavioral Medicine / Q000458:organization & administration*; D003430:Cross-Sectional Studies; D019033:Delivery of Health Care, Integrated; D006297:Health Services Accessibility; D006801:Humans; D033183:Interdisciplinary Communication; D008329:Managed Care Programs; D058749:Military Facilities; D008889:Military Personnel / Q000523:psychology*; D018802:Patient-Centered Care; D011320:Primary Health Care / Q000458:organization & administration*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014481:United States
keywords: Integrated care; Patient Centered Medical Home; provider satisfaction.