Primary Care Behavioral Health Patients' Stage of Change: Correlates and Relation to Follow-Up Session Attendance

Introduction: In this study, we examined patients' readiness to change behavior (their stage of change) in a primary care behavioral health (PCBH) setting. We examined sociodemographic and health correlates of patients' stage of change and whether stage of change related to follow-up visit attendance. Method: One-hundred eleven adult primary care patients completed self-report measures of psychiatric symptoms, hope, and stage of change at their initial behavioral health session. Demographic, health information, and follow-up visit attendance were gathered from patient electronic health records. Results: Results suggest most patients referred to PCBH providers were in preparation and action stages of change. At the bivariate level, older age and non-Latinx ethnicity were associated with greater readiness to change. At the multivariate level, older age and higher levels of hope were associated with later stages of change. Patients in preparation, but not action, stages of change were significantly more likely to attend a follow-up behavioral health appointment than were patients in precontemplation/contemplation. Discussion: Findings suggest most PCBH patients are prepared to take action or have already taken action to improve their behavioral health. Further, a single item assessing patients' stage of change is associated with continued retention in behavioral health treatment. Public Significance Statement The present study suggests patients receiving a warm hand-off to behavioral health providers at integrated primary care clinics serving a low-income and ethnically diverse community are most likely to be in preparation and action stages of change, compared to precontemplation and contemplation. Findings suggest a single item measure of readiness to change may predict attendance at behavioral health sessions, with patients in the preparation stage of change being most likely to return for additional sessions, and that action-oriented intervention strategies are appropriate for most behavioral health patients.