Table 3.

Representative quotes for PCP motivation to participate in Project TEACH and their experience with training and Project TEACH components.

Theme	Representative quotes
Motivation for training and barriers to participation	I do primary care pediatrics and we have had disappointing mental health resources in our community. So, I and all my colleagues have felt a lot of pressure, you know, to improve the quality of the care that we give related to behavioral health. The main motivation was discomfort with dealing with problems that were among the most common I had to face in an aging pediatric population, meaning lots of teens. And so that was primarily the reason, just that I didn’t feel competent to deal with the things I had to deal with, and I didn’t have adequate options for working with these kids. The main [motivation] was [that] my patients wanted me to do it. Basically, they wanted me to be the one that they talk to, that they confide in. They did not want to go to an outside person. I still feel that that’s kind of outside of the realm of pediatric practice. I don’t think the patient [in this urban area] really wants their pediatrician to deal with anything other than adjustment type issues. I think that if somebody is really feeling threatened they want a therapist… I don’t think they would necessarily want to get drugs from a pediatrician.
Training Content and Structure	…the teaching setting and the teacher were excellent. I’m not sure if it would be as effective if it was not Dr. X. … And, pretty much every session he’s given, 90–95% of the pediatricians in the community are there, and there’s almost nothing that can get that many pediatricians in the same room at the same time. They’re {training materials} sitting right by my desk and I refer back to them. I’ve used them for coming up with the proper medication to use in a situation, but usually before I’ve used it I’ve called CAP PC. I haven’t felt comfortable just going and prescribing for somebody. I wanna bounce it off a psychiatrist first. I rely on them {the questionnaires} to provide direction and clues and open up ideas or conversations, but using them, which I didn’t do before has allowed me to be more efficient in getting a hook on some of the problems. The more we do the more comfortable we feel. I would say coming back to not just training but more extensive training. Not just attending one or two lectures here, it’s not that active. But doing, dealing with patients or discussing the cases when we go and attend these sessions. You know it’s a three hour session, it’s not just like one hour. They’re in-depth sessions. I think the monthly conference calls really helped. I would definitely take another half day or a day a year after to really even just go through exactly the same information that we went through. I’m a group learner. I’m an auditory learner and that format works better for me. There is synergy of training, conference calls, and then using the consult line: Then what also changed is my level of confidence that at least my consultation program is there for me to pick up the phone and talk to these people that trained us and did the program and their hotline if I’m in a situation where I cannot find who I need to talk to.

Theme

Representative quotes

Motivation for training and barriers to participation

I do primary care pediatrics and we have had disappointing mental health resources in our community. So, I and all my colleagues have felt a lot of pressure, you know, to improve the quality of the care that we give related to behavioral health.
The main motivation was discomfort with dealing with problems that were among the most common I had to face in an aging pediatric population, meaning lots of teens. And so that was primarily the reason, just that I didn’t feel competent to deal with the things I had to deal with, and I didn’t have adequate options for working with these kids.
The main [motivation] was [that] my patients wanted me to do it. Basically, they wanted me to be the one that they talk to, that they confide in. They did not want to go to an outside person.
I still feel that that’s kind of outside of the realm of pediatric practice. I don’t think the patient [in this urban area] really wants their pediatrician to deal with anything other than adjustment type issues. I think that if somebody is really feeling threatened they want a therapist… I don’t think they would necessarily want to get drugs from a pediatrician.

Training Content and Structure

…the teaching setting and the teacher were excellent. I’m not sure if it would be as effective if it was not Dr. X. … And, pretty much every session he’s given, 90–95% of the pediatricians in the community are there, and there’s almost nothing that can get that many pediatricians in the same room at the same time.
They’re {training materials} sitting right by my desk and I refer back to them. I’ve used them for coming up with the proper medication to use in a situation, but usually before I’ve used it I’ve called CAP PC. I haven’t felt comfortable just going and prescribing for somebody. I wanna bounce it off a psychiatrist first.
I rely on them {the questionnaires} to provide direction and clues and open up ideas or conversations, but using them, which I didn’t do before has allowed me to be more efficient in getting a hook on some of the problems.
The more we do the more comfortable we feel. I would say coming back to not just training but more extensive training. Not just attending one or two lectures here, it’s not that active. But doing, dealing with patients or discussing the cases when we go and attend these sessions. You know it’s a three hour session, it’s not just like one hour. They’re in-depth sessions.
I think the monthly conference calls really helped. I would definitely take another half day or a day a year after to really even just go through exactly the same information that we went through. I’m a group learner. I’m an auditory learner and that format works better for me.
There is synergy of training, conference calls, and then using the consult line: Then what also changed is my level of confidence that at least my consultation program is there for me to pick up the phone and talk to these people that trained us and did the program and their hotline if I’m in a situation where I cannot find who I need to talk to.