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Flexible Assertive Community Treatment (FACT) aims to reduce fragmentation through multidisciplinary, community-based care. However, evidence remains limited regarding the services rural FACT teams deliver and how integrated care is enacted in everyday practice. This study examined service distribution and the coordination practices that enable integration in a rural Norwegian FACT team.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used an explanatory sequential mixed-methods design. A prospective service mapping captured 2,319 patient-related contacts among 70 patients over 12 weeks and was analysed with time-weighted descriptive statistics. A subsequent focus group with team members was analysed using reflexive thematic analysis. Integration occurred by building (quantitative results informed the interview guide) and merging (interpretive integration of quantitative patterns and qualitative themes).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Approximately 80% of services were delivered directly by the team and 20% in collaboration with external partners. Service delivery was broadly divided between clinical contacts (one-third) and interprofessional coordination\/collaboration (one-third); the remaining third comprised daily life mastery, therapeutic alliance, and social support. 28% of contacts were conducted via phone, text, or videoconference, mainly for rapid coordination. Qualitative findings identified three interrelated practices underpinning integration under rural constraints: collaborative alliance, involving trust-based partnerships with patients, families, and services; information alignment, encompassing the gathering, refinement, and communication of fragmented information to establish a shared and actionable understanding; and safety valve thinking, referring to anticipating uncertainty and maintaining contingency plans to flexibly organise care within the rural network of care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Integrated care in rural FACT practice is enabled through extensive coordination and collaborative work, supported by relational and adaptive practices. These findings underscore the importance of context-sensitive adaptations alongside model fidelity to sustain patient safety and continuity of care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12913-026-15094-w","type":"journal-article","created":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T01:32:57Z","timestamp":1784338377000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Integrated care delivery in a rural Norwegian FACT team: an explanatory sequential mixed-methods study"],"prefix":"10.1186","volume":"26","author":[{"given":"Bj\u00f8rn Steinar","family":"Storvik","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aud Uhlen","family":"Obstfelder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Signe","family":"Landheim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gry Cecilie Lunder","family":"H\u00f8iland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,18]]},"reference":[{"issue":"4 Suppl","key":"15094_CR1","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1177\/1359786810382058","volume":"24","author":"D Lawrence","year":"2010","unstructured":"Lawrence D, Kisely S. 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According to national legislation, the project did not require approval from the Regional Committee for Medical and Health Research Ethics (REK), as it did not involve medical or health research on patients, biological material, or identifiable health data as defined by the Norwegian Health Research Act. The project was assessed and approved by the Data Protection Officer at Innlandet Hospital Trust (reference number: 104187). All participants in the qualitative focus group provided informed consent prior to participation. The quantitative component consisted of anonymized routine service data. In line with national guidelines, individual consent was not required for the use of these data.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable. 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