title: Development and validation of a measure of primary care behavioral health integration.
abstract: BACKGROUND
  We developed the Practice Integration Profile (PIP) to measure the degree of behavioral health integration in clinical practices with a focus on primary care (PC). Its 30 items, completed by providers, managers, and staff, provide an overall score and 6 domain scores derived from the Lexicon of Collaborative Care. We describe its history and psychometric properties.
  
  
  METHODS
  The PIP was tested in a convenience sample of practices. Linear regression compared scores across integration exemplars, PC with behavioral services, PC without behavioral services, and community mental health centers without PC. An additional sample rated 4 scenarios describing practices with varying degrees of integration.
  
  
  RESULTS
  One hundred sixty-nine surveys were returned. Mean domain scores ran from 49 to 65. The mean total score was 55 (median 58; range 0-100) with high internal consistency (Cronbach's alpha = .95). The lowest total scores were for PC without behavioral health (27), followed by community mental health centers (44), PC with behavioral health (60), and the exemplars (86; p < .001). Eleven respondents rerated their practices 37 to 194 days later. The mean change was + 1.5 (standard deviation = 11.1). Scenario scores were highly correlated with the degree of integration each scenario was designed to represent (Spearman's ρ = -0.71; P = 0.0005).
  
  
  CONCLUSIONS
  These data suggest that the PIP is useful, has face, content, and internal validity, and distinguishes among types of practices with known variations in integration. We discuss how the PIP may support practices and policymakers in their integration efforts and researchers assessing the degree to which integration affects patient health outcomes. (PsycINFO Database Record
authors.affiliation: Department of Family Medicine, University of Vermont College of Medicine.
authors.forename: Rodger S
authors.initials: RS
authors.lastname: Kessler
authors.affiliation: New Directions Behavioral Health.
authors.forename: Andrea
authors.initials: A
authors.lastname: Auxier
authors.affiliation: Department of Family Medicine, University of Vermont College of Medicine.
authors.forename: Juvena R
authors.initials: JR
authors.lastname: Hitt
authors.affiliation: Arizona State University.
authors.forename: C R
authors.initials: CR
authors.lastname: Macchi
authors.affiliation: Department of Family Medicine and Community Health, University of Massachusetts Medical School.
authors.forename: Daniel
authors.identifier: 0000-0001-7121-9403
authors.initials: D
authors.lastname: Mullin
authors.affiliation: Department of Family Medicine, University of Vermont College of Medicine.
authors.forename: Constance
authors.initials: C
authors.lastname: van Eeghen
authors.affiliation: Department of Family Medicine, University of Vermont College of Medicine.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Littenberg
mesh_terms: D001524:Behavioral Medicine / Q000145:classification* / Q000379:methods; D006801:Humans; D016014:Linear Models; D008605:Mental Health Services / Q000145:classification; D011320:Primary Health Care / Q000145:classification / Q000379:methods* / Q000639:trends; D016730:Program Development / Q000379:methods*; D015397:Program Evaluation / Q000379:methods*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D014481:United States