• Danielle F Loeb, Danielle M Kline, Kurt Kroenke, Cynthia Boyd, Elizabeth A Bayliss, Evette Ludman, L Miriam Dickinson, Ingrid A Binswanger, and Samantha P Monson.
• Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Academic Office 1; Mailstop B180; 12631 East 17th Ave, Aurora, CO, 80045, USA. danielle.loeb@cuanschutz.edu.
• Bmc Fam Pract. 2019 Sep 6; 20 (1): 124124.

BackgroundTeam-based models of care are efficacious in improving outcomes for patients with mental and physical illnesses. However, primary care clinics have been slow to adopt these models. We used iterative stakeholder engagement to develop an intervention to improve the implementation of team-based care for this complex population.MethodsWe developed the initial framework for Relational Team Development (RELATED) from a qualitative study of Primary Care Providers' (PCPs') experiences treating mental illness and a literature review of practice facilitation and psychology clinical supervision. Subsequently, we surveyed 900 Colorado PCPs to identify factors associated with PCP self-efficacy in management of mental illness and team-based care. We then conducted two focus groups for feedback on RELATED. Lastly, we convened an expert panel to refine the intervention.ResultsWe developed RELATED, a two-part intervention delivered by a practice facilitator with a background in clinical psychology. The facilitator observes PCPs during patient visits and provides individualized coaching. Next, the facilitator guides the primary care team through a practice change activity with a focus on relational team dynamics.ConclusionThe iterative development of RELATED using stakeholder engagement offers a model for the development of interventions tailored to the needs of these stakeholders.Trial RegistrationNot applicable.

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