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Several major policy reports describe the central role of primary care in improving the delivery of behavioral health care services to children and adolescents. Although primary care providers are uniquely positioned to provide these services, numerous obstacles hinder the integration of these services, including time, clinic management and organization issues, training, and resources. Although many of these obstacles have been described in the literature, few studies have investigated these issues from the first-person perspective of front-line providers. The purpose of this study, therefore, is to provide an in-depth description of primary care providers' attitudes and perceptions of adolescent behavioral health care across a diversity of primary care settings (i.e., Federally Qualified Health Center [FQHC], FQHC-Look Alike, school-based, military). Sixteen focus groups were conducted at 5 primary care clinics. Thematic analysis was used to analyze the focus group data. Obstacles to integration are presented as well as strategies to overcome these challenges, using training and education, working groups, and community collaboratives.

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A growing body of literature indicates that evidence-based behavioral health practices and programs are not being implemented into clinical settings effectively. As a result, many adolescents living with a behavioral health problem are not receiving the quality of services they need. This feasibility study addressed this science-to-service gap through the implementation of an evidence-based adolescent behavioral health screening, assessment, and brief intervention protocol in five distinct primary care settings. This case study documents the authors' experiences in utilizing Fixsen, Naoom, Blase, Friedman, and Wallace's (2005) implementation framework to guide their purveyor efforts, and outlines solutions to overcoming the challenges purveyors may face when implementing evidence-based programs into primary care.