Original Article

Patient Acceptance of Primary Care Behavioral Health in a Resident Obstetrics and Gynecology Clinic

Authors: Dung Dang, MD, Jennifer Salcedo, MD, MPH

Abstract

Objectives: Primary care behavioral health (PCBH) is a patient care model in which a behavioral health consultant (BHC) works alongside the primary care provider to address behavioral components of health conditions. PCBH is well received in the primary care setting; however, little is known about acceptability of the service among prenatal patients. The study was designed to explore the acceptability of PCBH among pregnant patients in a resident obstetrics and gynecology clinic.

Methods: A survey designed to assess different components of acceptability was administered to eligible pregnant patients who received prenatal care at the resident obstetrics and gynecology clinic.

Results: The majority of patients wanted to receive education on pregnancy-relevant topics from the BHC: healthy weight gain (68.4%), healthy eating (70.4%), healthy exercise (73.5%), and mood disorders (63.3%). The majority of participants wanted help from the BHC in managing coexisting conditions affecting pregnancy: stress (63.3%), depression (75.5%), or anxiety (73%). The majority of patients (55.6%) preferred to work with a BHC for mental health concerns rather than an outside psychiatrist or counselor. PCBH service was perceived to be easy to understand (78%). Barriers to engaging in the PCBH service included time (41.4%), lack of perceived need (13.8%), unavailability (6.9%), and others (13.8%). Despite the perceived benefit, there was an implication of stigma among prenatal patients seeking PCBH or mental health care.

Conclusions: Overall, the PCBH model had high acceptability among a prenatal care population in a resident obstetrics and gynecology clinic and offers potential to improve prenatal outcomes.
Posted in: Obstetrics and Gynecology77

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References

1. Hunter CL, Funderburk JS, Polaha J, et al. Primary care behavioral health (PCBH) model research: current state of the science and a call to action. J Clin Psychol Med Settings 2017;25:127–156.
 
2. Ede V, Okafor M, Kinuthia R, et al. An examination of perceptions in integrated care practice. Community Ment Health J 2015;51:949–961.
 
3. Miller-Matero LR, Khan S, Thiem R, et al. Integrated primary care: patient perceptions and the role of mental health stigma. Prim Health Care Res Dev 2018;20:e48.
 
4. Melville JL, Reed SD, Russo J, et al. Improving care for depression in obstetrics and gynecology. Obstet Gynecol 2014;123:1237–1246.
 
5. Grote NK, Katon WJ, Russo JE, et al. Collaborative care for perinatal depression in socioeconomically disadvantaged women: a randomized trial. Depress Anxiety 2015;32:821–834.
 
6. Goler NC, Armstrong MA, Taillac CJ, et al. Substance abuse treatment linked with prenatal visits improves perinatal outcomes: a new standard. J Perinatol 2008;28:597–603.
 
7. St. John-Larkin C. The Heart Program: integrated mental health care in an adolescent obstetric and teen-tot medical home. J Am Acad Child Adolesc Psychiatry 2016;55:S7–S7.
 
8. Bhat A, Reed S, Mao J, et al. Delivering perinatal depression care in a rural obstetric setting: a mixed methods study of feasibility, acceptability and effectiveness. J Psychosom Obstet Gynaecol 2017;34:273–280.
 
9. Siega-Riz A, Viswanathan M, Moos M, et al. A systematic review of outcomes of maternal weight gain according to the Institute of Medicine recommendations: birthweight, fetal growth, and postpartum weight retention. Am J Obstet Gynecol 2009;201:339.e1–339.e14.
 
10. American College of Obstetricians and Gynecologists. Screening for perinatal depression. ACOG Committee Opinion No. 757. Obstet Gynecol 2018;132: e208–e212.
 
11. Sekhon M, Cartwright M, Francis JJ. Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework. BMC Health Serv Res 2017;17:88.
 
12. Kenton NR, Broffman L, Mcmenamin KA, et al. Patient experiences in behavioral health integrated primary care settings: the role of stigma in shaping patient outcome over time. Psychol Health Med 2019;24:1182–1197.