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Improving Adolescent Depression Screening in Pediatric Primary Care.

Valerie S Harder1, Sara E Barry2, Sarah French2

  • 1Departments of Pediatrics (VS Harder, SE Barry, S French, AB Consigli, and BL Frankowski); Psychiatry (VS Harder), Vermont Child Health Improvement Program, University of Vermont, Burlington.

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Summary

Quality improvement initiatives significantly boosted adolescent depression screening rates in primary care settings. A learning collaborative increased screening from 34% to 97% over seven months, improving patient care.

Keywords:
adolescent mental healthprimary carequality improvement

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Area of Science:

  • Public Health
  • Adolescent Medicine
  • Quality Improvement Science

Background:

  • Adolescent depression is a major public health concern.
  • Low screening rates in primary care hinder early intervention.
  • Quality improvement (QI) initiatives offer a pathway to enhance screening practices.

Purpose of the Study:

  • To evaluate the effectiveness of a QI learning collaborative on adolescent depression screening.
  • To assess the impact on initial plans of care for screened adolescents.
  • To determine if QI interventions improve screening rates in pediatric practices.

Main Methods:

  • Seventeen pediatric practices joined a QI learning collaborative.
  • Monthly medical record reviews tracked screening and care plans over seven months.
  • Comparison with 21 control practices using randomly sampled annual data.

Main Results:

  • Screening rates at participating practices increased from 34% to 97% within seven months.
  • Adolescents in QI practices had significantly higher odds of being screened (3.5x) and with validated tools (37.5x).
  • Improvements were sustained and statistically significant compared to control practices.

Conclusions:

  • QI learning collaboratives effectively increase adolescent depression screening in primary care.
  • These initiatives improve the likelihood of using validated screening tools.
  • QI interventions demonstrate a significant positive impact on adolescent mental health screening practices.