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Introduction: Integrated primary care teams are increasingly relying upon virtual care, including both telehealth and team members who are teleworking, due to the COVID-19 pandemic. This shift to virtual care can present challenges for the coordination and provision of team-based care in primary care. The current report uses extant literature on teams to provide recommendations to support integrated primary care teams, including behavioral health providers, in adapting to and sustaining virtual team-based care. Method: We used the Seven C's framework by Salas and colleagues (2015) to organize our findings and recommendations, focusing on coordination, cooperation, cognition, and communication. Results: Integrated primary care teams may benefit from tending to both implicit and explicit forms of coordination and the use of debriefs to improve team coordination. Given the potential challenge of trust in a virtual team, documentation of care coordination and reexamination of how feedback is provided to primary care providers may benefit team cooperation. Sharing team goals and crosstraining on specific aspects of team processes, such as communicating essential information to behavioral health providers for a warm handoff, may improve the cognition of the team. Teams may also benefit by findings ways to incorporate informal communication into the workflow and using closed-loop communication to decrease missed communications. Discussion: This report provides initial recommendations based on extant team literature to support integrated primary care teams in adapting to virtual care. Future work should build off this report by examining virtual integrated primary care teams and providing evidence-based recommendations to optimize virtual care. Public Significance Statement This brief report uses evidence from extant literature on teams to provide recommendations for integrated primary care teams that are increasingly relying upon virtual care during the COVID-19 pandemic. These recommendations may help integrated primary teams successfully transition to virtual team-based care during the pandemic and beyond. Keywords: integrated primary care, team-based care, behavioral health provider, virtual, The shift of primary care toward team-based care (Jackson et al., 2013) and integration of behavioral health providers (BHPs) to improve mental and behavioral health access (Possemato et al., 2018) [...]

According to the Necessity-Concerns Framework, beliefs about medication necessity and concerns are two core themes from diverse patient medication beliefs across chronic illnesses that may directly influence adherence. Past work has supported associations of necessity and concerns to adherence in the chronic disease literature and in HIV research. However, there has not been a focused review of the literature on associations of necessity and concerns to HIV medication adherence, nor on what variables may influence these associations. This systematic review synthesized findings from 26 studies regarding associations of necessity and concerns to HIV medication adherence. Both beliefs showed small, clinically significant effects on adherence. A subset of studies identified perceptions of healthcare providers as determinants of necessity and concerns beliefs with indirect effects on adherence. Overall, necessity and concerns demonstrated clinically significant associations to adherence among people with HIV., Author(s): Luke D. Mitzel [sup.1] , Peter A. Vanable [sup.1] Author Affiliations: (1) grid.264484.8, 0000 0001 2189 1568, Department of Psychology, Syracuse University, , 430 Huntington Hall, 13244, Syracuse, NY, [...]

HIV-related stigma and beliefs about medication necessity and concerns have separately demonstrated significant associations with antiretroviral adherence in people with HIV. However, no work has examined both of these associations in the same model. Based on the necessity-concerns framework, this study examined four alternative models of relationships among HIV-related stigma, medication beliefs, and adherence. Cross-sectional analyses were used to test the four alternative models to best depict associations among HIV-related stigma, medication beliefs, and medication adherence. Models tested included two indirect effects models, an interaction model, and a simple predictors model with no interaction or indirect effects. The outcome variable was HIV medication adherence, and model fit was determined by variance accounted for, Akaike information criterion (AIC), and Bayesian information criterion (BIC) values. An interaction model between internalized stigma and medication concerns accounted for the most variance in adherence. There was also a significant indirect effect of internalized stigma on adherence via medication concerns. Medication concerns are a promising target for interventions focusing on increasing adherence among people with HIV. [ABSTRACT FROM AUTHOR]

Background: Cannabis use is more common among individuals with chronic pain, and is often used to relieve physical discomfort. However, little is known about factors that are associated with cannabis use among individuals with chronic pain, and there is reason to suspect that perceptions of discomfort intolerance (DI) play an important role in pain-cannabis relations. Method: The goal of this study was to conduct an initial examination of perceived DI, pain severity, and pain-related interference in relation to frequency of cannabis use among individuals with chronic pain. Specifically, we hypothesized that pain severity/interference and factors of DI (avoidance and intolerance), would each be positively associated with cannabis use frequency. Results: Participants (N = 109; 44% male; Mage = 27) endorsed chronic pain and at least one instance of lifetime cannabis use. Most participants characterized their chronic pain as high intensity and low disability, and the two most commonly reported frequencies of cannabis use were "less than monthly" (n = 38), and "daily/almost daily" (n = 32). Results indicated that discomfort avoidance (but not discomfort intolerance), pain severity, and pain-related interference were each independently and positively associated with frequency of cannabis use. Conclusions: These preliminary findings suggest that continued examination of perceived discomfort avoidance in relation to co-occurring pain and cannabis use is warranted. Future research should replicate these results among treatment-seeking pain patients who are prescribed medical cannabis. [ABSTRACT FROM AUTHOR]