title: Implementation of an acceptance- and mindfulness-based group for depression and anxiety in primary care: Initial outcomes.
abstract: BACKGROUND
  Depression and anxiety disorders are highly prevalent among primary care patients. Group visits provide a way of delivering interventions to multiple patients at the same time. Group visits for depression and anxiety present an opportunity to expand the reach of behavioral health services for primary care patients. The goal of the current study was to evaluate the implementation of an acceptance and mindfulness-based group for primary care patients with depression and anxiety.
  
  
  METHODS
  Adult family medicine patients with Patient Health Questionnaire-9 (PHQ-9) and/or Generalized Anxiety Disorder Scale-7 (GAD-7) scores > 5 were eligible for the group. The group was held biweekly in the family medicine practice with rolling enrollment. The PHQ-9 and GAD-7 were administered at every visit, and changes in depression and anxiety symptoms were analyzed using multilevel modeling. We evaluated feasibility, acceptability/satisfaction, penetration, and sustainability.
  
  
  RESULTS
  Over the course of 19 months, 50 patients were referred to the group, and 29 enrolled. The median number of visits attended was four among those who attended more than one group visit. Results revealed that depression and anxiety symptoms decreased significantly over the first four visits attended (d = -.26 and -.19, respectively). Patients who attended more than one group reported high satisfaction. The group was sustainable after the research funding ended; however, penetration was low.
  
  
  CONCLUSIONS
  A rolling enrollment group for patients with depression and anxiety that utilized mindfulness- and acceptance-based treatment principles is feasible to implement in a primary care setting but is not without challenges. Recommendations for ways to enhance implementation and future research are provided. (PsycINFO Database Record
authors.affiliation: Warren Alpert Medical School of Brown University.
authors.forename: Cara H
authors.identifier: 0000-0001-9741-5031
authors.initials: CH
authors.lastname: Fuchs
authors.affiliation: Department of Psychological and Brain Sciences, Washington University.
authors.forename: Natasha
authors.initials: N
authors.lastname: Haradhvala
authors.affiliation: Warren Alpert Medical School of Brown University.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Evans
authors.affiliation: Warren Alpert Medical School of Brown University.
authors.forename: Justin M
authors.initials: JM
authors.lastname: Nash
authors.affiliation: Warren Alpert Medical School of Brown University.
authors.forename: Risa B
authors.initials: RB
authors.lastname: Weisberg
authors.affiliation: Warren Alpert Medical School of Brown University.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Uebelacker
mesh_terms: D000328:Adult; D001007:Anxiety / Q000628:therapy*; D019033:Delivery of Health Care, Integrated / Q000379:methods / Q000639:trends; D003863:Depression / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064866:Mindfulness / Q000379:methods / Q000592:standards*; D017063:Outcome Assessment, Health Care; D011320:Primary Health Care / Q000379:methods / Q000592:standards; D011594:Psychometrics / Q000295:instrumentation / Q000379:methods; D011615:Psychotherapy, Group / Q000379:methods / Q000592:standards; D011795:Surveys and Questionnaires