Improving Adolescent Depression Screening in Pediatric Primary Care

Harder, Valerie S.; Barry, Sara E.; French, Sarah; Consigli, Alyssa; Frankowski, Barbara L.

doi:10.1016/j.acap.2019.02.014

Cited by 28 publications

(31 citation statements)

References 16 publications

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“…The additional requirements for practice staff may have a negative impact on those who are less confident and comfortable, do not have as vested an interest in mental health, or do not see the benefit for their GPs and patients. Given general practice organisation, staff commitment to the project, and workflows are barriers to implementation [35,36], careful consideration needs to be given to the role of the practice staff in the Youth StepCare service [37]. Future trials may benefit from providing practice staff with additional training in mental health and nominating champions to lead the implementation of the service on a day-to-day basis.…”

Section: Operational Feasibilitymentioning

confidence: 99%

Youth StepCare: a pilot study of an online screening and recommendations service for depression and anxiety among youth patients in general practice

et al. 2020

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Background: General Practitioners (GPs) are ideally placed to identify and manage emerging mental illness in young people, however, many report low levels of confidence in doing so. A web-based universal screening service delivered via a mobile tablet, Youth StepCare, was developed to assist GPs in identifying depression and anxiety symptoms in youth patients. This service also provided evidence-based treatment recommendations and fortnightly monitoring of symptoms. The current study assessed the feasibility and acceptability of delivering the Youth StepCare service in Australian general practices. Methods: A 12-week uncontrolled trial was undertaken between August 2018 and January 2019 in two general practices in NSW, Australia. The service was offered to all youth patients aged 14 to 17 years who visited a participating GP during the screening period with their parent or guardian. Youth patients reported the presence of depressive and anxiety symptoms using the self-report Patient Health Questionnaire-9 and the Generalised Anxiety Disorder Questionnaire-7. New cases were defined as those who reported symptoms but were not currently seeking help from their GP, nor had sought help in the past. Feasibility and acceptability among GPs and practice staff were assessed using a battery of questionnaires. Results: Five GPs and 6 practice staff took part. A total of 46 youth patients were approached, 28 consented, and 19 completed the screener (67.9%). Nine reported symptoms of anxiety or depression, two of which were new cases (22.2%). GPs and practice staff were satisfied with the service, reporting that there was a need for the service and that they would use it again. Conclusions: The Youth StepCare service appears to be a useful tool for identifying youth with unidentified symptoms of mental illness that can be easily embedded into general practice. Further research would benefit from exploring the factors affecting initial GP uptake and a larger trial is required to determine the efficacy of the service on young people's symptom reduction.

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Section: Operational Feasibilitymentioning

confidence: 99%

Youth StepCare: a pilot study of an online screening and recommendations service for depression and anxiety among youth patients in general practice

et al. 2020

View full text Add to dashboard Cite

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“…Given factors such as practice organisation, staff commitment to the project, and existing challenges to patient and office workflows are identified barriers to sustained success of newly implemented initiatives (28,36), the role of the practice staff, whether they are the most appropriate person to approach potential participants (53), and the manner in which the service fits into the front-of-house practice structure requires further investigation to determine its practicality on a larger scale and its sustainability.…”

Section: Operational Feasibilitymentioning

confidence: 99%

“…As opposed to IMPARTS, which is embedded directly into the hospital software and patients' medical files, both Check Up GP and mobiletype sends the screener results to an external website which GPs are required to access and review. This complexity creates a potential barrier to use by disrupting their usual workflow (28,(34)(35)(36). Ultimately, screening solutions for youth mental health should enable detection of all symptom levels to provide prevention, early intervention, and treatment alongside decision-making support that is delivered within a setting that can offer immediate care.…”

Section: Introductionmentioning

confidence: 99%

Youth StepCare: A pilot study of an online screening and recommendations service for depression and anxiety among youth patients in general practice.

Parker

Achilles

Subotic-Kerry

et al. 2019

Preprint

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Background: General Practitioners (GPs) are ideally placed to identify and manage emerging mental illness in young people, however, many report low levels of confidence in doing so. A web-based universal screening service delivered via a mobile tablet, Youth StepCare, was developed to assist GPs in identifying depression and anxiety symptoms in youth patients providing evidence-based treatment recommendations and fortnightly monitoring of symptom progress. The current study assessed the feasibility and acceptability of delivering the Youth StepCare service in Australian general practices among GPs, practice staff, and youth patients. Methods: A 12-week uncontrolled trial was undertaken between August 2018 and January 2019 in two general practices in NSW, Australia. The service was offered to all youth patients aged 14-17 years who visited their participating GP during the screening period alongside their parent or guardian. Youth patients reported the presence of depressive and anxiety symptoms using the self-report Patient Health Questionnaire-9 and the Generalised Anxiety Disorder Questionnaire-7. New cases were defined as those who were experiencing symptoms and were not currently visiting their GP, nor had previously sought help for mental health issues. Feasibility and acceptability of the service among GPs, practice staff, and youth patients was assessed using a battery of questionnaires. Results: Five GPs and 6 practice staff participated in the trial. A total of 46 youth patients were approached and 28 consented to participate. Of these, 19 completed the screener (67.9%). Nine reported symptoms of anxiety or depression, two of which were new cases (22.2%). GPs and practice staff were satisfied with the service, reporting that there was a need for the service, and that they would use it again. Youth patients also reported the service was easy to understand and didn’t cause distress. Conclusions: Although young people account for a small proportion of patients visiting their GP, the Youth StepCare service appears to be a useful tool for identifying youth with undeclared symptoms which can be easily embedded into general practice. Further research would benefit from exploring reasons for lower GP uptake and a larger trial is required to determine the efficacy of the service on symptom reduction.

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“…Both screening services currently available for youth, Check Up GP and mobiletype, use an external website which require GPs to access and then review. This disruption to usual workflow can create barriers to the uptake and use (27)(28)(29)(30)(31). In addition, because GPs report lower levels of confidence treating youth patients and their complex presentations, the usefulness of screening services is likely to be enhanced when decisionmaking support is provided, as demonstrated in the mobiletype trial.…”

Section: Integrating Mental and Physical Healthcare: Research Traininmentioning

confidence: 99%

“…Using this familiar process reduces service complexity, assists with normalising routine review of patients' mental health as with any physical illness, and instils the sense that GPs "own" the service rather than researchers (23), which all help decrease the potential barriers to use and increase the likelihood of service engagement (28)(29)(30)(31)(36)(37)(38)(39)(40). On the other hand, practice staff reported a lower alignment with existing structures and processes rating, most likely reflecting that the tasks were added to their usual workflow and interactions with patients, namely, remembering to check youth eligibility, offer the mobile tablet, and explain the service to the patients and their parent.…”

Section: Operational Feasibilitymentioning

confidence: 99%

Youth StepCare: A pilot study of an online screening and recommendations service for depression and anxiety among youth patients in general practice.

Parker

Achilles

Subotic-Kerry

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: General Practitioners (GPs) are ideally placed to identify and manage emerging mental illness in young people, however, many report low levels of confidence in doing so. A web-based universal screening service delivered via a mobile tablet, Youth StepCare, was developed to assist GPs in identifying depression and anxiety symptoms in youth patients. The service also provided evidence-based treatment recommendations and fortnightly monitoring of symptoms. The current study assessed the feasibility and acceptability of delivering the Youth StepCare service in Australian general practices. Methods: A 12-week uncontrolled trial was undertaken between August 2018 and January 2019 in two general practices in NSW, Australia. The service was offered to all youth patients aged 14-17 years who visited their participating GP during the screening period alongside their parent or guardian. Youth patients reported the presence of depressive and anxiety symptoms using the self-report Patient Health Questionnaire-9 and the Generalised Anxiety Disorder Questionnaire-7. New cases were defined as those who were experiencing symptoms and were not currently visiting their GP, nor had previously sought help for mental health issues. Feasibility and acceptability of the service among GPs and practice staff was assessed using a battery of questionnaires. Results: Five GPs and 6 practice staff participated in the trial. A total of 46 youth patients were approached and 28 consented to participate. Of these, 19 completed the screener (67.9%). Nine reported symptoms of anxiety or depression, two of which were new cases (22.2%). GPs and practice staff were satisfied with the service, reporting that there was a need for the service, and that they would use it again. Conclusions: The Youth StepCare service appears to be a useful tool for identifying youth with unidentified symptoms of mental illness that can be easily embedded into general practice. Further research would benefit from exploring the factors affecting initial GP uptake and a larger trial is required to determine the efficacy of the service on young people’s symptom reduction.

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Improving Adolescent Depression Screening in Pediatric Primary Care

Cited by 28 publications

References 16 publications

Youth StepCare: a pilot study of an online screening and recommendations service for depression and anxiety among youth patients in general practice

Youth StepCare: a pilot study of an online screening and recommendations service for depression and anxiety among youth patients in general practice

Youth StepCare: A pilot study of an online screening and recommendations service for depression and anxiety among youth patients in general practice.

Youth StepCare: A pilot study of an online screening and recommendations service for depression and anxiety among youth patients in general practice.

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