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VISN 2 Center for Integrated Healthcare (CIH)

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The Primary Care Behavioral Health Provider Adherence Questionnaire (PPAQ)

PPAQ

PPAQ-2

Publications

Contact Information

Purpose and Function

The PPAQ uses a 5-point, Likert-type response scale ranging from “never” to “always.” The PPAQ includes essential items, which measure behaviors that are highly consistent with the PCBH/CCC model, and prohibited items, which measure behaviors that are inconsistent with the PCBH/CCC model. When used as a self-assessment, PC-MHI providers can evaluate their usual clinical practices across four domains of practice: Clinical Scope and Interventions; Practice and Session Management; Referral Management and Care Continuity; Consultation, Collaboration, and Interprofessional Communication.


The PPAQ has also been converted into a user-friendly self-assessment toolkit. The Excel-based PPAQ toolkit automatically scores the PPAQ items and includes interpretation guides as well as suggestions for how to apply the results of the self-assessment to improve integrated care practice. There are three versions of the toolkit available: one for VA-based integrated care providers; one for integrated care providers practicing in non-VA settings; and the latest version applicable to both VA and non-VA providers which will compare PPAQ scores at two time points (e.g., baseline and follow-up).


All PPAQ products are free to use for personal reference, training, or quality improvement activities. Please contact us at (gregory.beehler@va.gov) to discuss options if you would like to use the PPAQ in research.

PPAQ-2

The original PPAQ has been updated to the PPAQ-2 but remains a self-report instrument completed by integrated behavioral health providers to assess adherence to key features of integrated care health services delivery. However, the instrument can now be used to assess features of the Primary Care Behavioral Health (PCBH) and/or Collaborative Care Management (CCM) models. The PPAQ-2 uses a 5-point, Likert-type response scale ranging from “never” to “always.” When used as a self-assessment, integrated care providers can evaluate their usual clinical practices across multiple domains of practice described in detail in the User Guide.

Special note: In addition to adding items representing the CCM model, several items were removed from the original PCBH components of the PPAQ. Please see the User Guide for complete information regarding changes to the PCBH items in the PPAQ-2.

VA users can access the enhanced PPAQ-2 toolkit here: Primary Care Behavioral Health Provider Adherence Questionnaire-2 (PPAQ-2) Toolkit - Home (sharepoint.com)

All PPAQ products are free to use for personal reference, training, or quality improvement activities. Please contact us at (gregory.beehler@va.gov) to discuss options if you would like to use the PPAQ in research.

Publications

The PPAQ has been developed and validated through a series of studies described in the following publications:

Beehler, G. P., Funderburk, J. S., Possemato, K., & Vair, C. (2013). Developing a measure of provider adherence to improve the implementation of behavioral health services in primary care: A Delphi study. Implementation Science, 8, 19. (Link to PubMed Abstract)

Beehler, G. P., Funderburk, J. S., Possemato, K., & Dollar, K. (2013). Psychometric assessment of the Primary Care Behavioral Health Provider Adherence Questionnaire (PPAQ). Translational Behavioral Medicine, 3, 379-391. (Link to PubMed Abstract)

Beehler, G. P., Funderburk, J. S., King, P., Wade, M., & Possemato, K. (2015). Using the Primary Care Behavioral Health Provider Adherence Questionnaire (PPAQ) to identify practice patterns. Translational Behavioral Medicine, 5, 384-392. (Link to PubMed Abstract)

Beehler, G. P., & Lilienthal, K. R. (2017). Provider perceptions of an integrated primary care quality improvement strategy: The PPAQ Toolkit. Psychological Services, 14, 50-56. (Link to PubMed Abstract)

Beehler, G. P., Funderburk, J. S., King, P. R., Possemato, K., Maddoux, J. A., Goldstein, W. R., & Wade, M. (2020). Validation of an expanded measure of integrated care provider fidelity: PPAQ-2. Journal of Clinical Psychology in Medical Settings, 27, 158-172. (Link to PubMed Abstract)

Contact Information

For additional information about the PPAQ, contact:

Dr. Gregory P. Beehler
Associate Director for Research & Clinical Research Psychologist
VA Center for Integrated Healthcare
Phone: 716-862-7934
Email: gregory.beehler@va.gov