DIET & NUTRITION 
PATIENT EDUCATION 
OBESITY/WEIGHT MANAGEMENT 
EXERCISE/TRAINING 
LEGAL MATTERS 
GUIDELINES/RECOMMENDATIONS 
This prospective cohort study (N=61) evaluated a nurse practitioner-led integrated care program combining behavioral health services with primary care in a rural university setting over 9 months. The study demonstrates strong methodological rigor with validated screening tools (PHQ-9, GAD-7) and comprehensive outcome tracking, though limited by single-site design and grant-dependent sustainability.
⚕️ Key Clinical Considerations ⚕️
- Significant symptom reduction: Mean PHQ-9 scores decreased 4.4 points and GAD-7 scores decreased 4.7 points (both p<0.001).
- Strong correlation coefficients: PHQ-9 showed 0.7032 correlation and GAD-7 showed 0.6490 correlation between baseline and outcomes.
- High patient satisfaction: 97% of students reported satisfied or very satisfied with integrated care services.
- Accessibility improvement: Program eliminated 7-10 day wait times through same-day warm handoffs to behavioral health providers.
- Provider collaboration effectiveness: Weekly case reviews with psychiatric consultant support enhanced medication management confidence.
🎯 Clinical Practice Impact 🎯
- Patient Communication: Enhanced rapport building led to more accurate symptom reporting on follow-up screenings, with some students initially underreporting due to stigma concerns.
- Practice Integration: Warm handoff protocols between FNPs and behavioral health providers created seamless care transitions within existing primary care workflows.
- Risk Management: Weekly psychiatric consultation provided medication management support and appropriate triage to higher levels of care when indicated.
- Action Items: Implement standardized screening with validated tools, establish clear role definitions for behavioral health providers, and ensure adequate supervision for brief intervention training.
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