Families, systems & health : the journal of collaborative family healthcare · 2026
Design and implementation of a stratified care model for refugee women's behavioral health in an obstetrical care setting.
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Taknint Joelle T, Gellatly Resham, Ameresekere Maithri, Montgomery Audrey, Louis Kettie, Sokoto Kalo C, Milord Johanna
Аннотация
INTRODUCTION: In December 2022, hospital-based obstetrical providers identified significant behavioral health (BH) needs among recently arrived Haitian refugee patients. Demand for BH services exceeded capacity, and services were not culturally tailored for perinatal Haitian women. This necessitated a reimagining of the BH care model. This quality improvement article describes the process of designing and implementing an embedded BH care model into a refugee-serving obstetrical clinic.
METHOD: An intervention mapping (IM) approach guided this study. A needs assessment (IM Phase 1; January 2023) was conducted with interest holders (n = 8), and the Integrated Women's Behavioral Health Framework (Crawford et al., 2022) was selected for adaptation and implementation (IM Phase 2). Following logic model development (IM Phase 3), a stratified care model, the Refugee Women's Health Clinic behavioral health care model, was developed (IM Phase 4) and implemented (IM Phase 5). A process evaluation was conducted to assess fidelity, dose exposure and completeness, dose satisfaction, reach, recruitment, and context (IM Phase 6).
RESULTS: Results (IM Phase 6) indicated good fidelity in implementing BH screening (78%), significant group psychotherapy uptake (accounting for 49% of all BH visits during the study period), and the need for iterative care model adaptation to changing needs in the local context.
DISCUSSION: The Refugee Women's Health Clinic behavioral health care model was feasible to implement in a low-resource setting. Process evaluation findings support model uptake and offer a potential blueprint for BH care model design in similar integrated care settings, in line with the goals of IM. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
METHOD: An intervention mapping (IM) approach guided this study. A needs assessment (IM Phase 1; January 2023) was conducted with interest holders (n = 8), and the Integrated Women's Behavioral Health Framework (Crawford et al., 2022) was selected for adaptation and implementation (IM Phase 2). Following logic model development (IM Phase 3), a stratified care model, the Refugee Women's Health Clinic behavioral health care model, was developed (IM Phase 4) and implemented (IM Phase 5). A process evaluation was conducted to assess fidelity, dose exposure and completeness, dose satisfaction, reach, recruitment, and context (IM Phase 6).
RESULTS: Results (IM Phase 6) indicated good fidelity in implementing BH screening (78%), significant group psychotherapy uptake (accounting for 49% of all BH visits during the study period), and the need for iterative care model adaptation to changing needs in the local context.
DISCUSSION: The Refugee Women's Health Clinic behavioral health care model was feasible to implement in a low-resource setting. Process evaluation findings support model uptake and offer a potential blueprint for BH care model design in similar integrated care settings, in line with the goals of IM. (PsycInfo Database Record (c) 2026 APA, all rights reserved).