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Table 2 Major Themes

From: Implementation of the CALM intervention for anxiety disorders: a qualitative study

Major Theme Subtheme
Barriers to Implementation
Provider attitudes/behaviors
Uneven physician "buy in"
  Enthusiasm could wane without continued intervention
  Feeling that prevalence of anxiety was low in their clinic
Clinic structure Part-time primary care providers harder to reach
  Space concerns for ACS
Intervention characteristics Part-time ACS
  Communication with ACSs sometime unsatisfactory
  Some nurses felt "out of the loop" and not consistent targets for education and marketing
Patient characteristics Challenges of Low SES patients
  Hispanic patients resistant to CALM
  Drop-outs weaken enthusiasm among providers and staff
Facilitators to Implementation  
Provider attitudes/behaviors Interest in mental health increases uptake
  Buy-in/support from nurses/staff
Clinic structure Presence of MH professional
  Reliable and appropriate space for ACS
Intervention characteristics ACS in clinic full time (or close)
  "Face-time" with providers/relationships
  CALM not overly burdensome
  Providers appreciated referral source and additional care
  Positive feedback from/about patients
  Providers very positive about ACS
Patient Characteristics Prefer coming to primary care
Barriers to Sustaining CALM  
Clinic structure Paying for ACS service
  Space for ACS and doing therapy
Facilitators to Sustaining CALM  
   -Provider attitudes Providers high value of CALM
   -Clinic structure Already doing CC for other disorders
  Presence of MH person who could adopt
  1. MH = mental health; ACS = anxiety clinical specialist; PCP = primary care physician; CALM = Coordinated Anxiety Learning and Management; SES = socioeconomic status; CBT = cognitive behavioral therapy; CC = collaborative care.