• Ariel B Neikrug, Shreya S Cho, Ethan S Nguyen, Annamarie Stehli, Shutong Huo, Careesa Garcia, Stephanie Au, Mandana Masoumirad, Wendy Cant, Khanh-Van Le-Bucklin, Jane P Gagliardi, Glen L Xiong, and Robert M McCarron.
• Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, CA, USA. aneikrug@hs.uci.edu.
• J Gen Intern Med. 2024 Oct 31.

BackgroundInadequate access to behavioral health services disproportionately impacts marginalized populations who live in disadvantaged areas. To reduce this gap, programs dedicated to optimizing behavioral health education and training must focus their efforts to enroll providers who practice in these disadvantaged areas.ObjectiveThe Train New Trainers (TNT) fellowship program aims to enhance behavioral health knowledge, skills, and attitudes of primary care providers (PCPs) who deliver care in disadvantaged communities. We evaluate the effectiveness of the TNT recruitment strategy and the use of scholarships for targeting and recruiting PCPs who practice in disadvantaged communities.DesignObservational study.ParticipantsTNT fellows from 2016 to 2023.Main MeasuresState/federal classifications of medically underserved counties were used to establish scholarship criteria. Area Deprivation Index (ADI) was utilized to provide criterion validity for the use of state/federal criteria in the recruitment strategy, and to evaluate the effectiveness of the program in successfully recruiting PCPs practicing in disadvantaged communities.Key ResultsPractice location data were available for 347 fellows, 88.8% of whom received scholarships. Of the 347 practices, 300 (86.5%) primarily served communities meeting at least one state or federal criterion for medical shortage areas and/or underserved areas. According to ADI scores, 32.3% of practices served areas classified in the highest ADI (ADI decile 9 or 10), with a progressive increase in the proportion of fellows practicing in underserved areas each year; in 2023, 89.9% of practices met federal shortage criteria and 40.5% served areas with the highest deciles of ADI.ConclusionsThe TNT program strategy for recruiting PCPs from high medical need geographical areas is associated with bringing primary care psychiatry education to areas considered underserved and disadvantaged. Equipping PCPs practicing in underserved areas with enhanced knowledge and skills in behavioral medicine has the potential to significantly improve the existing access gap in disadvantaged communities.© 2024. The Author(s).

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