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2013 CFHA Research Fellow
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Christina L. Vair, PhD

Undergraduate Institution & Degree:   
Bachelor of Arts (2005) in Psychology, Warren Wilson College, Swannanoa, North Carolina  

Graduate and Post-Graduate Education: 
Master of Arts (2009), Clinical Psychology, University of Colorado, Colorado Springs 

Doctor of Philosophy (2012), Clinical Psychology with emphasis in Geropsychology, University of Colorado, Colorado Springs

Pre-Doctoral Internship (2011-2012), VA Western New York Healthcare System, Buffalo, New York 

Post-Doctoral Fellowship, Advanced Fellowship Program in Mental Illness Research and Treatment (MIRECC; 2012-2014) with emphasis in Primary Care-Mental Health Integration, VA Center for Integrated Health Care, Buffalo, New York  

Born and raised in a tiny town in southwestern Michigan (Augusta, MI), just outside of Kalamazoo.   

Tell us about yourself:  
In my free time, I greatly enjoy being in the outdoors, particularly if I’m able to hike, bike, run or practice yoga. I’m a proud member of the growing urban farm movement in Buffalo, and spend most weekends in the Spring, Summer, and Fall out digging in the dirt to support local agriculture. I take great pride in being able to feed others with food I’ve grown and prepared myself!  

1. Describe your fellowship research project and why you are interested in studying more about this area.

My project, entitled “Training Experiences, Needs Assessment, and Model Adherent Behaviors of Psychology Integrated Care Trainees,” emerged directly from own experiences while training to be a behavioral health consultant within the Department of Veterans Affairs. One of the seminal experiences of my pre-doctoral internship was a rotation focused on learning about integrated care research at the VA Center for Integrated Healthcare. A core component of that rotation was assisting in developing a comprehensive didactic reading list of scholarly literature pertaining to the implementation of integrated care. Additionally, I had the opportunity to collaborate in the development of a self-report measure of behavioral health provider behaviors and fidelity to the primary care medical home model (The Primary Care Behavioral Health Provider Adherence Questionnaire [PPAQ]). It was at the intersection of these two tasks that I began to notice that a particular “voice” was missing from the literature, and it was that of many members of the future integrated care workforce: advanced psychology trainees.  

Though it has been well-established in the literature that behavioral and mental health needs are often identified and treated in primary care, there are few formal graduate or post-graduate training opportunities that exist to equip psychologists with the specific skills necessary for successful practice in such settings. A notable gap in the growing literature on primary care psychology is a description of the perspective of advanced psychology trainees. As such, my fellowship research project was designed to help address this absence by examining the trainee perspective, including self-evaluation of skills and perceptions of training needs with psychology pre-doctoral interns and postdoctoral fellows with training experience in integrated primary care settings. The purpose of this study was to address trainee perspectives as well as core competencies for primary care psychology practice and to provide linkage to these participants to resources to address possible training needs. 

Using an online survey, data were collected from 100 pre-doctoral and postdoctoral psychology trainees across the country. These self-report data included information pertaining to typical clinical behaviors, which provided the opportunity to assess trainee fidelity to the PCBH model, as well as compare reports of trainee fidelity to benchmarks with more seasoned providers from whom data had previously been collected. The data collected from this study provide new and unique insights not previously presented in the established integrated care literature. It is intended that this information can be used to determine potential areas for additional training for psychology trainees, to develop targeted training resources and materials, and in considering strategies for developing and disseminating useful training resources for behavioral health providers with roles in integrated primary care settings. 

2. Who was your project mentor?
Dr. Gregory P. Beehler, PhD (Associate Director for Research, VA Center for Integrated Healthcare, Buffalo, NY) 

3. What is the best & worst thing about working with your mentor?
Dr. Beehler is a phenomenal mentor in so many ways! He openly and generously shares his expertise in a way that is supportive as well as challenging, facilitating me to hold myself and my work to the highest standard. His approach to mentorship is truly collaborative, and he thoughtfully encourages me to think deeply on topics as varied as fidelity and implementation science, to the utilization of quantitative and qualitative methods. The biggest challenge I face in my mentorship with Dr. Beehler is that his encouragement of “big picture” thinking often leaves me wishing there were more hours in the day in order to accomplish all of the various research project ideas that we generate in our discussions. 

4. What attracted you to the field of collaborative care?
Though I didn’t yet known what a “behavioral health consultant” was while a graduate student, it was my earliest experiences within interdisciplinary health care teams in geriatrics where I first felt “at home” as a clinician. Training to be a geropsychologist meant learning about common and complex medical issues that face older adults, health care systems, barriers to accessing care, and psychopharmacology, all topics that drew me in and stimulated my intellectual curiosity. Further, these early clinical roles also provided a chance to think about the “whole person,” and helped me identify that as a clinician I wanted to work in settings that provided care that united mind and body, and that took into account and valued systems that effect patients, such as family and community. Identifying that my values as a clinician clearly linked to providing care that was “patient-centered” and “collaborative” in nature led me to seek out internship and post-doc opportunities that provided in-depth training in health psychology and integrated care. The Department of Veterans Affairs Primary Care-Mental Health Integration program was, and has been, a great fit for me to continue to pursue my passion for providing whole-person, population-based behavioral health care. 

5. What are your future plans?
Following my successful completion of my postdoctoral fellowship, I was provided with the opportunity to stay on staff as a clinical research psychologist with the VA Center for Integrated Healthcare. My current position has allowed me to continue to develop and hone skills as a researcher, and to focus on my dual interests of integrated care and aging. Through this role, I have also undertaken clinical work focused on group interventions to address health behavior. Moving forward, I intend to continue to pursue a career path in integrated care that will provide opportunities in program development and implementation, quality improvement/research, as well as behavioral health consulting. 

6. In all of the field, who is the person you look up to the most and why?

There is no single individual to whom I look up to in the field; rather, it is the community of researchers, educators, and clinicians committed to the provision of high quality, person-centered care that I owe a debt of gratitude for helping me define and pursue my passions as a scientist and practitioner in the field. In particular, my colleagues at the VA Center for Integrated Healthcare have been hugely influential in providing the support and resources to launch me, as well as the Collaborative Family Healthcare Association who has provided a professional “home” for me to call my own.  
7. What publications and presentations came out of your fellowship project?


Vair, C. L., Beehler, G. P., & Funderburk. J. S. (April 2016). Identifying clinical practice patterns of integrated primary care psychology interns and postdocs: Implications for training. Paper to be presented at the Society of Behavioral Medicine’s 37th Annual Meeting & Scientific Sessions, Washington, D.C. 

Vair, C. L., & Beehler, G. P. (October 2014). Where have they been and where are they going? Advanced psychology trainees’ reports on preparation for practice in integrated care. Paper presented at the Collaborative Family Healthcare Association Annual Conference, Washington, D.C. 

Relevant publication:

Beehler, G. P., Funderburk, J. S., Possemato, K., & Vair, C. L. (2013). Developing a measure of provider adherence to improve the implementation of behavioral health services in primary care: A Delphi study. Implementation Science, 8:19.   

NOTE: Two papers are currently in progress utilizing data collected from this fellowship project.  

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CFHA is a member-based, 501(c)(3) non-profit organization dedicated to making integrated behavioral and physical health the standard of care nationally. CFHA achieves this by organizing the integrated care community, providing expert technical assistance and producing educational content.