Depression Screening in Asian Americans: A Quality Improvement Project

Abstract

Introduction: Depression, a common mental health disorder in adults, that may result in severe impairment throughout adulthood when it is concealed or ignored. Depression often coincides with substantial current and future morbidity, impairments, smoking, substance abuse, and obesity. Asian Americans, one of the fastest growing minority population in the United States, are known to have lower access to mental health care and receive lower quality of care. The purpose of this project is to promote practice change in professional caregivers on the use and benefits of the 9-item Patient Health Questionnaire (PHQ-9) for depression screening in Asian Americans with the outcome of this project the consistent use of the PHQ-9. This project specifically involves education about and the implementation of PHQ-9 depression screening tool in a primary clinic. Methods: The participants, physician and licensed vocational nurse (LVN), were given a pre-test to assess their knowledge of depression, depression in Asian Americans, and the PHQ-9. The student then provided an education training using PowerPoint to both participants and two scripted role-play training sessions with only the physician. After the training sessions, the participants then were given a post-test to assess their knowledge and post-intervention survey to identity whether the educational and training sessions were beneficial and inquire about additional barriers that prevent the use of the depression screening tool. Lastly, the number of completed depression screening tools and the number of patients seen in a week were tallied. Results: Pre-test results for the provider included three out of six correct answers (50%) and post-test results included six out of six correct answers (100%). Pre-test results for the LVN included two out of six correct answers (33.3%) and post-test results included five out of six correct answers (83.3%). Also, both participants reported project as educational and beneficial. A total of 91 patients was seen and a total of 66 (72.53%) PHQ-9 depression screening tools were completed during March 5th to 9th. Conclusion: The two-tier educational interventions successfully educated the physician and LVN and effectually resulted in the implementation of the PHQ-9. The PHQ-9 depression screening tool is a valuable when screening amongst AA primary care patients. In addition to facilitating diagnosis, the PHQ-9 may also be used to reassess, monitor treatment improvement, and advise treatment decisions.