Increasing Providers Compliance with PHQ-9 Screening for Adolescents in Primary Care Setting

Purpose: The purpose of this quality improvement initiative was to expand the provider’s knowledge and intent in promoting the use of patient health questionnaire-9 (PHQ-9) screening. Background: Depression is one of the most common and devastating mental health illnesses that negatively affects adolescents worldwide. The consistent rise has made depression a leading cause of disability and a significant burden globally. One reason for this is the lack of screening in primary care (PC) settings, causing depressive symptoms to remain undetected. The American Academy of Pediatrics now recommends routine depression screening for adolescents 12 to 18 years of age in PC settings. Though no universal tool is currently accepted, the PHQ-9 screening has proved to be one of the most reliable tools to help identify depression in the adolescent population.Method: This quality improvement project consisted of a pretest-posttest quantitative design. An evidence-based educational intervention was conducted via an asynchronous learning format, discussing current recommendations for adolescent depression screening and the importance of conducting PHQ-9 screening in the PC setting. Pretest-posttest questionnaires were delivered using Qualtrics to generate, collect, and analyze data effectively. The participants were given seven days to complete the pretest-posttest questionnaire. Results were shared with the implementation site. Results: Data collection took place over one week. Three providers completed the pretest- posttest questionnaires. Upon completion, providers’ knowledge increased by 13.4% after participating in the educational intervention. A six-point increase in the Likert scale was noted whereby providers were in stronger agreement to become compliant with utilizing PHQ-9 screening, better understood the Guidelines for Adolescent Depression in Primary Care (GLAD- PC), agreed with GLAD-PC, and better understood the common risk factors that are associated with adolescent depression post-intervention. Additionally, the posttest survey results of the Likert scale question on providers intent to use the PHQ-9 screening indicated 100% of providers were agreeable to using the PHQ-9 after the educational intervention. Conclusion: This project has established that evidence-based training can transform participants’ beliefs, attitudes, and intent toward a target behavior. Future studies will be completed at the implementation site to promptly identify, diagnose, and treat adolescents affected or at risk for depression