Media is loading

Document Type


Session Format

Oral presentation only (pre-record | virtual)

Publication Date


Faculty Advisor

Sheryl Winn

Start Date

27-3-2024 10:00 AM

End Date

3-3-2024 10:50 AM


Increasing Annual Depression Screening for Adults in a Primary Care Setting


Depression is a mental illness that's common worldwide, which can cause an individual to function poorly in society and can progress to suicide. Because of several barriers, patients in a primary care environment are not being seen or treated for depression. Even though the U.S. Preventive Services Task Force (USPSTF) recommends that all adults in primary care receive annual depression screening that delivers effective treatment with the correct diagnosis and accurate follow-up, patients are still not being screened for depression.


This project aims to improve the annual screening in primary care by addressing the need regarding staff knowledge, beliefs, and education. The ultimate goal is also to develop clinical guideline that encourage staff to use reliable tools such as PHQ-2 and PHQ-9 to diagnose and identify depression. Both tools have demonstrated good accuracy, validity, and reliability to be used in primary care. The Cronbach's alpha scores for PHQ-2 and PHQ-9 were 0.904, confirming these tools' validity and reliability. They have been widely used in clinical practice to screen, diagnose and determine depression severity.

Pico Question:

In a primary care clinic in Georgia, does educating staff about depression and the use of the Patient Health Questionnaire (PHQ-2 and PHQ-9) mental health depression screening tools increase the rate of annual depression screenings by >20% in all adults and increase the clinical staff’s competency and knowledge in implementing the tool by >20% compared to current practice within eight weeks?


This is a quasi-experimental, correlational clinical project to increase adult depression screening in primary care. This research was framed by implementing the evidence-based Plan, Do, Study, Act (PDSA) Cycle change theory, where educational training was provided through PowerPoint sessions to increase staff knowledge of mental health and the importance of annual depression screening using screening tools. A pretest, posttest, and Likert scale were administered to monitor any changes in staff knowledge levels before and after education. A protocol and clinical guideline were provided to increase the screening rates. The research used patient health questionnaires (PHQ-2 and PHQ-9) measuring tools to help diagnose depression early that may have been undiagnosed or untreated without evidence-based instruments. A chart audit was implemented to get a baseline and to observe any changes in the rates of the PHQ tools after utilizing the depression screening. Descriptive analyses verified each variable. The lead researcher manually reviewed data collected by the patient's electronic health record (EHR). Each recognized chart was checked to validate if screening was done, if the health depression assessment questionnaire was performed using the PHQ2 questionnaire, and, if it were, whether the PHQ-9 was indicated and conducted.


The sample consisted of N=6 females. The participants were recruited from a small outpatient primary care clinic on the Southside of Atlanta. All participants completed the pre- and post-quiz. With a score of less than 80% on the post-test, remediation was required before continuing with the remaining intervention phase of the study. However, all participants scored 100% after the educational session. To determine the rate of annual depression screening pre-intervention compared to post-intervention. A nonparametric paired sample was performed on all variables. The chart audit finding consists of N=300 reviewed charts: 100 in pre-invention, 100 post-invention Phase I, and 100 in Phase II. The findings indicated an increase from 5 % pre-intervention to 98 and 100% post-intervention after educational training and the establishment of a developed protocol and guideline. In order to determine the staff’s knowledge level pre- and post-invention based on the developed quiz on depression, a pair sample t-test was performed. It was found that the overall knowledge level pre-intervention to post-intervention test scores rose from 85.3 % before attending the educational training to 100% after. It increased by 14.7, which was statistically significant.

Keywords: depression, depressive, PHQ2 and PHQ-9, patient healthcare questionnaire, primary care, depression screening, suicide, policy, protocol,



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.