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Barriers to and Facilitators of Integrated Primary Care Engagement: Convergent and Divergent Perspectives of Care Team Members and Caregivers
Journal article   Open access   Peer reviewed

Barriers to and Facilitators of Integrated Primary Care Engagement: Convergent and Divergent Perspectives of Care Team Members and Caregivers

Chimereodo Okoroji, Lindsay Poole, Jesslyn Jamison, Donna Armentrout, Angela Pereyra Monero, Jennifer A. Mautone and Ariel A. Williamson
Families systems & health, v 44(2), pp 140-156
01 Jun 2026
DOI: https://doi.org/10.1037/fsh0001003
PMID: 40608445
url
https://doi.org/10.1037/fsh0001003View
Published, Version of Record (VoR) Open

Abstract

Family Studies Health Care Sciences & Services Life Sciences & Biomedicine Public, Environmental & Occupational Health Science & Technology Social Sciences
Background: Integrated primary care (IPC) can improve access to behavioral health (BH) care, reduce stigma, and facilitate early intervention. However, few studies have examined key informants' perceptions of IPC engagement. Objective: We qualitatively identified convergent and divergent perspectives of care team members and caregivers on pediatric IPC-related engagement barriers, facilitators, and suggestions for improvements. Method: Care team members (N = 48, 98.3% female, 72.9% non-Hispanic/Latine White) and caregivers (N = 10, 100% female, 10.0%. Asian, 30.0% Black/African American, 60.0% non-Hispanic/Latine White) completed semistructured interviews on IPC engagement in a large pediatric primary care network. Thematic analysis was used to iteratively identify patterns of meaning, as well as convergent and divergent themes across informant groups. Results: Convergent barriers included stigma, prolonged wait times, limited BH knowledge, difficulty navigating services, and limited BH provider availability. Whereas care team members identified more family-related barriers (e.g., beliefs, experiences), caregivers identified divergent barriers such as limited childcare. Perceived engagement facilitators converged across groups and mostly pertained to systems-related factors such as the colocation of services. Converging recommendations included additional behavioral clinicians and support staff, provision of psychoeducational resources, and expanding IPC services. Conclusion: Although key informant groups similarly perceived many IPC benefits, including increased BH access, there are continued patient/family barriers to IPC engagement, with divergence in care team members' versus caregivers' views about the nature of these barriers. Findings suggest a need for systems-level changes to address these barriers and highlight the importance of including the unique perspectives of care team members and caregivers in future research examining IPC effectiveness.

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