Table 2.

Strategy Fielding Experience for a Preventive Mental Health Intervention for Adolescents

Practice Site	Organizational Description	Office Staffing	Specialty	Barriers/Local Situation	Approach	Outcome/Practice Comments	Referred/Enrolled, %	Total Marketing Costs/Enrollment
A	Small primary care practice (< 4 physicians)	RN	Pediatrics	Minimal, strong nurse leader present	Offer educational programs Frequent visits with small incentive gifts (food) Phone consultation when needed for physicians	Very satisfied with the study and their patients’ experiences	39.7	$15
B	Small primary care practice (< 4 physicians)	RN/MA	Pediatrics	Did not recognize critical role of screening initially Strong nurse leader present	Follow-up visits and training Appreciation gifts	Very satisfied with the study and continued marketing and screening until end of study	50.0	$85
C	Small primary care practice (< 4 physicians)	RN/MA	Internal medicine/ pediatrics	Low number of adolescents 1 practice moved	Follow-up visits and training Appreciation gifts	Very satisfied with the study but marketing/screening eventually stopped	50.0	$36
D	Intermediate primary care practice (4–9 physicians)	RN/MA	Pediatrics	Strong nurse leader present Practice management challenges during study	Increased convenience by frequent visits to pick up screens via faxing to office	Very satisfied with the study and continued marketing/screening until end of study	20.0	$60
E	Intermediate primary care practice (4–9 physicians)	RN/MA	Internal medicine/ pediatrics	Practice management challenges during study Low interest/trust by nursing staff	Follow-up visits and training Appreciation gifts Focus on building trust of African American nursing staff	Marketing/screening never firmly established as part of routine but high enrollment rates among African American adolescents	15.8	$134
F	Large primary care practice (> 10 physicians)	MA	Pediatrics	Management transition during study Low interest by staff	Several educational meal/programs Appreciation gifts	Screening never firmly established Families that were screened were responsive	63.6	$43
G	Municipal hospital clinic	NA	Mental health	Low-income primary care mental health clinic Low interest in study that required travel off site	Committed paid staff person to approach patients introduced by provider	Very few adolescents willing to enroll in study that required travel off site	50.0	$848
H	Large primary care practice (> 10 physicians)	RN/MA	Family medicine	Large complex clinic Did not have procedure to screen Low physician knowledge	Wrote screening policy procedure Two educational programs for physicians	Successfully marketed/screened once policy established No enrollment attributed to low levels of physician endorsement	0.0	NA
I	Large primary care practice (> 10 physicians)	MA	Pediatrics	Started in study late Few adolescent visits Were not screening at all	Education and appreciation visits	Study ended before full opportunity to evaluate clinic	0.0	NA
J	Intermediate primary care practice (4–9 physicians)	RN/MA	Family medicine	Strong nurse leaders present Coordination Long distance from study office with local principal investigator Large organization at 2 sites	Frequent phone calls Weekly reports to improve coordination Availability by cell phone for questions	Highest number of referrals from any clinic	22.9	$15
K	Large primary care practice (> 10 physicians)	RN/MA	Family medicine	Strong nurse leaders present Coordination Long distance from study office with local principal investigator Large organization at 2 sites	Frequent phone calls Weekly reports to improve coordination Availability by cell phone for question	Marketing/screening established and improved once procedures put into place	16.7	$58
L	Intermediate primary care practice (4–9 physicians or nurse practitioners)	RN	Internal medicine, nurse practitioners, and family medicine	Practice management challenges during study No nurse champions Reluctance to screen	Follow-up visits and education program Information table and direct advertising	Passive advertising was more successful	45.9	$28

Abbreviations: MA = medical assistant, NA = not applicable, RN = registered nurse.