The University of Texas Rio Grande Valley: Family Medicine Residency Program

The University of Texas Rio Grande Valley (UTRGV) Family Medicine Residency (FMR) program implemented a Primary Care Behavioral Health (PCBH) model where they integrated a Behavioral Health Consultant (BHC) as part of the primary care team. The program’s goal is to:

• improve population health,
• emphasize early identification and prevention,
• serve a high volume of patients,
• provide triage and clinical services in a stepped care fashion,
• use panels instead of a clinical case model, and
• provide measurement-based care.

Study Goals:

The goal of the study is to assess the effectiveness of PCBH services on patient physical health, behavioral health, and quality of life at 12-months. The study also assesses if FMR was implemented as intended.

Research Questions:

The research questions for the impact evaluation were:

1. When compared to patients that do not participate in the intervention, do patients who participate in the PCBH intervention experience improvements in:
   1. depressive symptoms after 12 months?
   2. quality of life after 12 months?
   3. anxiety symptoms after 12 months?
   4. blood pressure?
   5. body mass index (BMI) after 12 months?
2. Do patients with a history or diagnosis of diabetes who participate in the PCBH intervention experience improvements in HbA1c level after 12 months when compared to patients that do not participate in the intervention?

The study also included implementation research questions, which examined program implementation and patient and provider satisfaction.

Findings:

The study found the following:

• Impact results indicated a statistically significant decrease in depression for the intervention group compared to the comparison group.
• Impact findings for BMI and blood pressure were in the opposite direction than desired, with significant increases observed for these measures for the treatment group.
• Implementation results generally indicated the program was implemented as intended; however, program quality appeared to vary by location, with one of the two intervention clinics reporting greater adherence to Integrated Behavioral Health core principles than the second clinic.
• The delivery of care using the PCBH model continues to be strong after the research period.

For more information, download the full report and report brief.