%0 Journal Article
%@ 1438-8871
%I JMIR Publications
%V 26
%N 
%P e54528
%T Evaluating the Implementation and Clinical Effectiveness of an Innovative Digital First Care Model for Behavioral Health Using the RE-AIM Framework: Quantitative Evaluation
%A Nordberg,Samuel S
%A Jaso-Yim,Brittany A
%A Sah,Pratha
%A Schuler,Keke
%A Eyllon,Mara
%A Pennine,Mariesa
%A Hoyler,Georgia H
%A Barnes,J Ben
%A Murillo,Lily Hong
%A O'Dea,Heather
%A Orth,Laura
%A Rogers,Elizabeth
%A Welch,George
%A Peloquin,Gabrielle
%A Youn,Soo Jeong
%+ Reliant Medical Group, OptumCare, 5 Neponset St., Worcester, MA, 01606, United States, 1 5088560732, Samuel.Nordberg@reliantmedicalgroup.org
%K digital mental health interventions
%K implementation
%K clinical effectiveness
%K practice-oriented research
%K access to care
%D 2024
%7 30.10.2024
%9 Original Paper
%J J Med Internet Res
%G English
%X Background: In the United States, innovation is needed to address the increasing need for mental health care services and widen the patient-to-provider ratio. Despite the benefits of digital mental health interventions (DMHIs), they have not been effective in addressing patients’ behavioral health challenges as stand-alone treatments. Objective: This study evaluates the implementation and effectiveness of precision behavioral health (PBH), a digital-first behavioral health care model embedded within routine primary care that refers patients to an ecosystem of evidence-based DMHIs with strategically placed human support. Methods: Patient demographic information, triage visit outcomes, multidimensional patient-reported outcome measure, enrollment, and engagement with the DMHIs were analyzed using data from the electronic health record and vendor-reported data files. The RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework was used to evaluate the implementation and clinical effectiveness outcomes of PBH. Results: PBH had a 47.58% reach rate, defined as patients accepting the PBH referral from their behavioral health integrated clinician. PBH patients had high DMHI registration rates (79.62%), high activation rates (76.54%), and high retention rates at 15 days (57.69%) and 30 days (44.58%) compared to literature benchmarks. In total, 74.01% (n=168) of patients showed clinical improvement, 22.47% (n=51) showed no clinical change, and 3.52% (n=8) showed clinical deterioration in symptoms. PBH had high adoption rates, with behavioral health integrated clinicians referring on average 4.35 (SD 0.46) patients to PBH per month and 90%-100% of clinicians (n=12) consistently referring at least 1 patient to PBH each month. A third (32%, n=1114) of patients were offered PBH as a treatment option during their triage visit. Conclusions: PBH as a care model with evidence-based DMHIs, human support for patients, and integration within routine settings offers a credible service to support patients with mild to moderate mental health challenges. This type of model has the potential to address real-life access to care problems faced by health care settings. 
%R 10.2196/54528
%U https://www.jmir.org/2024/1/e54528
%U https://doi.org/10.2196/54528