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Health care access issues present significant challenges for rural populations and health providers.Psychology can support improved access and quality of rural health services through the development ofintegrated behavior health programs within primary care settings. This article reviews a clinical trainingand service delivery program, the Rural Hawaii Behavioral Health Program, which has evolved inresponsetothepressinghealthneedsofNativeHawaiiansinruralcommunities.NativeHawaiianculturalfactors and components of the primary care model that have supported the development of this programwill be reviewed. Program expansion, sustainability, and treatment efficacy research will be discussed.Keywords: rural, Native Hawaiian, behavioral health, primary care psychologyJ
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