Improving Early Identification and Management of Depression Symptomology Through Implementation of Universal Depression Screening in a University Student Health Center

Author

Jessica M. Monjaras, Valparaiso University

Date of Award

5-7-2024

Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Jamie Bump

Abstract

Depression is the leading cause of disability in the United States for individuals aged 15 to 44 (Anxiety and Depression Association of America, 2023). The purpose of this evidence-based practice (EBP) project was to increase early identification of depression through implementation of universal depression screening, and to implement management strategies to decrease symptoms of depression. A two-tiered approach to universal depression screening was utilized through use of the PHQ-2 and PHQ-9 screening tools. Ten young adult patients, between the ages of 18 to 25, from a university student health center clinic in Northwest Indiana participated in this project. Participants underwent an 8-week intervention consisting of management strategies that included some or all the following based on a provider and patient shared decision-making process: lifestyle modification education and associated referrals, use of digital cognitive behavioral therapy (dCBT), referral to counseling services, and/or pharmacotherapy if indicated. Participants were contacted at 2, 4, and 8 weeks from baseline to obtain PHQ-9 scores and assess adherence to interventions. A paired t test was utilized to compare the mean baseline PHQ-9 scores to mean 8-week PHQ-9 scores. A significant decrease from baseline to eight weeks was found (t(9)=8.10, p <0.001). These findings suggest that use of intervention strategies outlined as best practice in this EBP project contributed to a statistically significant reduction in depression symptoms. Fisher’s exact test was also used to analyze the proportion of newly identified patients with depression symptomology before and after implementation of universal depression screening. There was statistical evidence of a difference between the two periods of time (x2 (1)=16.53, p<0.001). The relative risk was found to be 2.5, meaning that patients within the implementation period ran 2.5 times the risk of depression symptoms being detected as patients before implementation. Future research should be conducted to identify barriers to implementing psychological interventions in young adult populations, and evaluation of their effectiveness in comparison to pharmacological interventions alone. Future development of depression screening tools that are specific to a young adult patient population should also be investigated.

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Recommended Citation

Monjaras, Jessica M., "Improving Early Identification and Management of Depression Symptomology Through Implementation of Universal Depression Screening in a University Student Health Center" (2024). Evidence-Based Practice Project Reports. 203.
https://scholar.valpo.edu/ebpr/203