Development and evaluation of a PDA-based decision support system for pediatric depression screening

Area of Science:

• Pediatric mental health
• Clinical decision support systems
• Digital health interventions

Background:

• Depression is frequently underdiagnosed in pediatric care settings.
• Effective screening tools are needed to identify at-risk youth.
• Advanced Practice Nurses (APNs) play a crucial role in pediatric healthcare.

Purpose of the Study:

• To develop and evaluate a personal digital assistant (PDA)-based decision support system (DSS) for pediatric depression screening.
• To assess the feasibility and identify barriers to implementing this DSS in clinical practice.
• To gather insights from pediatric APN students on system usability and integration.

Main Methods:

• Selection and integration of a validated depression screening instrument into a PDA.
• Quantitative evaluation of system usage (screening rates).
• Qualitative evaluation using focus groups with APN students to identify barriers and facilitators.

Main Results:

• Only one-third of eligible pediatric patients were screened using the PDA-based DSS.
• Twenty percent of screened patients were identified as at risk for a mood disorder.
• Key barriers included time constraints, lack of knowledge, usability issues, and limited referral resources.

Conclusions:

• The PDA-based DSS shows potential for pediatric depression screening but faces significant implementation challenges.
• Addressing identified barriers is crucial for successful integration into clinical workflows.
• Further research and educational strategies are needed to optimize the use of digital tools for pediatric mental health screening.