Clinicians' provision of a self-guided digital mental health intervention to adolescents with depressive symptoms at preventive health visits in California.
We explored the feasibility of integrating a digital mental health intervention (DMHI) for adolescents identified with mild or moderate depressive symptoms during preventive health encounters.
We conducted a quality improvement study at a large integrated health care system in California from August to December 2023. Collaborators included 47 physicians and a nurse practitioner.
Of 1200 health encounters with adolescents, 1143 (95%) documented depression screening. Screening identified depressive symptoms at 106 (9%) encounters, including 41 (3%) with mild to moderate symptoms, 14 (1%) with moderately severe or severe symptoms, and 51 (5%) who screened positive with no information on depression severity. Clinicians documented a DMHI referral offer at 17 encounters with mild to moderate symptoms (41%) and 7 encounters with moderately severe or severe symptoms (50%). Over half of youths with depressive symptoms who were offered the DMHI accepted it (52%), but only one-fifth obtained the download instructions. Clinicians appreciated having a DMHI available, but challenges included difficulty identifying adolescents with depressive symptoms and low adolescent interest. Clinicians recommend facilitating adolescent download of the DMHI at the visit and involving parents/guardians.
A clinician-focused implementation strategy demonstrated limited success in integrating DMHI into adolescent preventive health visits.
We conducted a quality improvement study at a large integrated health care system in California from August to December 2023. Collaborators included 47 physicians and a nurse practitioner.
Of 1200 health encounters with adolescents, 1143 (95%) documented depression screening. Screening identified depressive symptoms at 106 (9%) encounters, including 41 (3%) with mild to moderate symptoms, 14 (1%) with moderately severe or severe symptoms, and 51 (5%) who screened positive with no information on depression severity. Clinicians documented a DMHI referral offer at 17 encounters with mild to moderate symptoms (41%) and 7 encounters with moderately severe or severe symptoms (50%). Over half of youths with depressive symptoms who were offered the DMHI accepted it (52%), but only one-fifth obtained the download instructions. Clinicians appreciated having a DMHI available, but challenges included difficulty identifying adolescents with depressive symptoms and low adolescent interest. Clinicians recommend facilitating adolescent download of the DMHI at the visit and involving parents/guardians.
A clinician-focused implementation strategy demonstrated limited success in integrating DMHI into adolescent preventive health visits.
Authors
Becker Becker, Lyons Lyons, Zeledon Zeledon, Ganju Ganju, Koebnick Koebnick, Xiang Xiang, Franchino Franchino, Cheng Cheng
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