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Associations Between Patient Comfort with a Primary Care Provider and Three Measures of Behavioral Health Services Utilization

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Abstract

Background

Behavioral health services (BHS) can help improve and treat mental and emotional health problems. Yet, attitudinal and/or structural barriers often prevent individuals from accessing and benefiting from these services. Positive provider-patient interactions in healthcare, encompassing patient comfort with a primary care provider (PCP), which is often enhanced by shared decision-making, may mitigate the stigma associated with seeing a mental health professional; this may improve BHS utilization among patients who need these services. However, few studies have examined how patient comfort with a PCP, often through shared decision-making, may influence patients’ BHS utilization in the real world. This study sought to address this gap in practice.

Method

Multivariable regression analyses, using weighted data from an internet panel survey of Los Angeles County adults (n = 749), were carried out to examine the associations between patient comfort with a PCP and three measures of BHS utilization. Subsequent analyses were conducted to explore the extent to which shared decision-making moderated these associations.

Results

Participants who reported an intermediate or high comfort level with a provider had higher odds of reporting that they were likely to see (aOR = 2.10 and 3.84, respectively) and get advice (aOR = 2.75 and 4.76, respectively) from a mental health professional compared to participants who reported a low comfort level. Although shared decision-making influenced participants’ likelihood of seeing and getting advice from a mental health professional, it was not a statistically significant moderator in these associations.

Conclusion

Building stronger relationships with patients may improve BHS utilization, a provider practice that is likely underutilized.

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Data Availability

All data is available upon request.

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Funding

This study is an analysis of existing data from an internet panel survey conducted by a survey firm in 2015. At the time, the firm was working with the Division of Chronic Disease and Injury Prevention in the Los Angeles County Department of Public Health to advance chronic disease prevention programming. Data analysis for the study was completed without funding support from any commercial or government entity.

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Authors and Affiliations

  1. Research Group On Statistics, Econometrics, and Health (GRECS), University of Girona, Carrer de la Universitat de Girona 10, Campus de Montilivi, Girona, 17003, Spain

    Brenda Robles

  2. Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain

    Brenda Robles

  3. Department of Internal Medicine, David Geffen School of Medicine at University of California, Los Angeles (UCLA), 911 Broxton Ave., Los Angeles, CA, 90024, USA

    Hannah Kwak

  4. Department of Epidemiology, UCLA Fielding School of Public Health, Box 951722, Los Angeles, CA, 90095, USA

    Tony Kuo

  5. Department of Family Medicine, David Geffen School of Medicine at UCLA, 10880 Wilshire Blvd., Suite 1800, Los Angeles, CA, 90024, USA

    Tony Kuo

  6. Population Health Program, UCLA Clinical and Translational Science Institute, 10833 Le Conte Ave., BE-144 CHS, Los Angeles, CA, 90095, USA

    Tony Kuo

Authors
  1. Brenda Robles
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Contributions

B.R. and T.K. conceptualized the initial survey design. B.R. was responsible for data collection. H.K. helped conceptualize the analysis plan and drafted the original version of the article. B.R. carried out the project’s analysis and drafted the final version of the article. T.K. provided iterative feedback and helped review and edit all versions of the main text for intellectual content. All authors contributed to the interpretation and presentation of the data and assisted with the preparation of the final version of the article. All authors have read and approved the article for publication.

Corresponding author

Correspondence to Brenda Robles.

Ethics declarations

Ethical Approval

The original internet panel survey, for which the present study is based on, was conducted according to the guidelines envisaged by the Declaration of Helsinki. All procedures involving study participants were approved by the Institutional Review Board at the Los Angeles County Department of Public Health.

Consent to Participate

Informed consent was obtained from all participants in the original internet panel survey.

Welfare of Animals

This article does not contain any studies with animals performed by any of the authors.

Conflict of Interest

The authors declare no competing interests.

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Robles, B., Kwak, H. & Kuo, T. Associations Between Patient Comfort with a Primary Care Provider and Three Measures of Behavioral Health Services Utilization. Int.J. Behav. Med. (2024). https://doi.org/10.1007/s12529-024-10259-5

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