Date of Award


Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Christine P. Kurtz


Generalized anxiety disorder (GAD) is very prevalent in the United States with 5.7% of citizens affected (National Institute of Mental Health [NIMH], 2017). This number is expected to be even higher because individuals avoid care due to stigma of mental illness (Andrews et al., 2018). GAD can have significant implications such as decreased ability to function, decreased quality of life and increased risk of suicide (Fong, 2018; Lizarondo, 2018). The purpose of this project was to improve outcomes for adult patients with GAD in the primary care setting by improving treatment to follow best practice recommendations. The Johns Hopkins Evidence Based Practice Model was utilized as a guide throughout this project. After a thorough literature search, it was concluded that best practice for treatment of GAD is with a protocol of a combination with education provided through written and verbal transmission, cognitive behavioral therapy (CBT) via smartphone application (app) and pharmacologic therapy via aselective serotonin reuptake inhibitor (SSRI). This protocol was initiated among patients at a rural family practice office in Northeast Indiana. The patients’ anxiety and depression symptoms were measured via the Generalized Anxiety Disorder 7-item (GAD-7) scale and Patient Health Questionnaire (PHQ-9) at baseline, and at weeks 4, 6 and 12. A one-way repeated measures analysis of variance (ANOVA) was conducted to analyze scores and found statistically significant differences in anxiety (F (3,39) = 6.992, p < .001) and depression (F (3, 39) = 8.867, p < .000) symptoms from baseline (M = 12.5714, SD = 6.51288; M = 12.4286, SD = 7.70329) to eight weeks (M = 5.2857, SD = 4.26846; M = 4.7143, SD = 4.51372) and from baseline to 12 weeks (M = 6.1429, SD = 5.88162; M = 4.6429, SD = 5.25660). Primary care providers are encouraged to treat patients with GAD utilizing education, CBT via smartphone app, and SSRIs due to the protocol’s cost-effectiveness, accessibility, and efficacy.

Creative Commons License

Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.

B. Hinman DNP poster.pdf (534 kB)