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<p>Integrated behavioral health care is challenging to implement due to inherent complexities of the intervention and healthcare settings. Therefore, practitioner-friendly frameworks that systematically bridge implementation research with practice are critical to maximize the likelihood of intervention uptake, sustainability, and effectiveness. One such framework is the Readiness Building System (RBS). This two-study manuscript explores the application of RBS over four years within the Holistic Opportunity Program for Everyone—a novel integrated care program in public health clinics—using narrative and multilinear modeling. Study 1 illustrates how RBS was used cyclically to build readiness for integrated care, showing significant increases in readiness between 2020 and 2023 (<i>b</i> = 0.372, <i>q</i> &lt; 0.001). Study 2 examines how implementation outcomes varied alongside readiness-building efforts (2021–2023), revealing statistically significant increases in screening rates (<i>OR</i> = 1.54, <i>q</i> &lt; 0.001), follow-up screenings (<i>OR</i>: 2.05, <i>q</i> &lt; 0.001), and total referrals (<i>OR</i> = 1.65, <i>q</i> &lt; 0.001). While program indicators trended positively, opportunities for implementation improvement remained despite high organizational readiness. Findings suggest that longitudinal use of RBS enhances integrated care implementation and that multi-year readiness building is critical to maximize positive health outcomes and minimize unintended consequences. In addition, to close gaps between global readiness and implementation outcomes (evident in this study), we propose a new stage of RBS: activity-level readiness assessment. Finally, we emphasize that high-quality RBS should be data-<i>informed</i> rather than data-<i>driven</i>.</p>

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Building Readiness for Integrated Care: A Two-Part Study on Improving Implementation Outcomes Over Time

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年8月6日

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  • Annalise J. Tolley,
  • James B. Green,
  • Kirsten Gade,
  • Jennifer Langhinrichsen-Rohling,
  • Victoria C. Scott

摘要

Integrated behavioral health care is challenging to implement due to inherent complexities of the intervention and healthcare settings. Therefore, practitioner-friendly frameworks that systematically bridge implementation research with practice are critical to maximize the likelihood of intervention uptake, sustainability, and effectiveness. One such framework is the Readiness Building System (RBS). This two-study manuscript explores the application of RBS over four years within the Holistic Opportunity Program for Everyone—a novel integrated care program in public health clinics—using narrative and multilinear modeling. Study 1 illustrates how RBS was used cyclically to build readiness for integrated care, showing significant increases in readiness between 2020 and 2023 (b = 0.372, q < 0.001). Study 2 examines how implementation outcomes varied alongside readiness-building efforts (2021–2023), revealing statistically significant increases in screening rates (OR = 1.54, q < 0.001), follow-up screenings (OR: 2.05, q < 0.001), and total referrals (OR = 1.65, q < 0.001). While program indicators trended positively, opportunities for implementation improvement remained despite high organizational readiness. Findings suggest that longitudinal use of RBS enhances integrated care implementation and that multi-year readiness building is critical to maximize positive health outcomes and minimize unintended consequences. In addition, to close gaps between global readiness and implementation outcomes (evident in this study), we propose a new stage of RBS: activity-level readiness assessment. Finally, we emphasize that high-quality RBS should be data-informed rather than data-driven.