Date of Award


Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Elise M. Alverson


Depression is a mental health issue that requires prompt identification and treatment. According to the CDC, it is estimated that in the U.S .one in 10 adults suffer from depression (CDC, 2011) with 4.7% of young adults, 18-39 years, suffer from depression (CDC, 2006). Many young adults report that college life is often more stressful than anticipated and the demands placed not only academically, but also socially, adversely affect their psychological and physical health (Dyson & Renk, 2006). The purpose of this EBP project was to answer the PICOT question: How does a depression screening tool in combination with a treatment and referral protocol, implemented at a university student health center (SHC), influence health care provider behavior? The Stetler Model (Stetler, 2001) guided the EBP project and the Kotter and Cohen’s (2002) eight steps for successful change provided the behavioral change theory. The project population consisted of fulltime freshmen college students enrolled at a Midwestern university during the 2012 fall semester. The intervention consisted of the administration of the Patient Health Questionnaire Two (PHQ-2) depression screening tool and implementation of a referral and depression treatment protocol. During the 12-week project, there were 225 freshmen clients seen in the SHC. A total of 213 (95%) were administered the PHQ-2 and 144 were given mental health pamphlets. This indicates a 64% adherence rate to the EBP protocol. A paired samples t-test was calculated to compare the initial PHQ-2 (m=4.5, SD=1.62) score to the follow-up PHQ-score (m=1.5, SD=1.38) for those clients (n=12) who returned for their follow-up at the SHC. A significant decrease from initial PHQ-2 to follow-up was found (t (11) =8.617, p<.001). The implementation of a routine depression screening tool and treatment protocol demonstrated to be more effective than having no protocol. Recommendations for the future include continued implementation and further research with regards to depression treatment/referral for the college population.