A pilot study of participatory and rapid implementation approaches to increase depression screening in primary care
Abstract Background Most individuals with depression go unidentified and untreated. In 2016 the US Preventive Services Task Force released guidelines recommending universal screening in primary care to identify patients with depression and to link them to treatment. Feasible, acceptable, and effecti...
Guardado en:
| Autores principales: | , , , , , , , , , , |
|---|---|
| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
BMC
2021
|
| Materias: | |
| Acceso en línea: | https://doaj.org/article/7762d6da11a94cba9710a40800b63c55 |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| id |
oai:doaj.org-article:7762d6da11a94cba9710a40800b63c55 |
|---|---|
| record_format |
dspace |
| spelling |
oai:doaj.org-article:7762d6da11a94cba9710a40800b63c552021-11-21T12:32:35ZA pilot study of participatory and rapid implementation approaches to increase depression screening in primary care10.1186/s12875-021-01550-51471-2296https://doaj.org/article/7762d6da11a94cba9710a40800b63c552021-11-01T00:00:00Zhttps://doi.org/10.1186/s12875-021-01550-5https://doaj.org/toc/1471-2296Abstract Background Most individuals with depression go unidentified and untreated. In 2016 the US Preventive Services Task Force released guidelines recommending universal screening in primary care to identify patients with depression and to link them to treatment. Feasible, acceptable, and effective strategies to implement these guidelines are needed. Methods This three-phased study employed rapid participatory methods to design and test strategies to increase depression screening at Penn Medicine, a large health system with 90 primary care practices. First, researchers solicited ideas and barriers from stakeholders to increase screening using an innovation tournament—a crowdsourcing method that invites stakeholders to submit ideas to address a workplace challenge. Second, a panel of stakeholders and scientists deliberated over and ranked the tournament ideas. An instant runoff election was held to select the winning idea. Third, the research team piloted the winning idea in a primary care practice using rapid prototyping, an approach that quickly refines and iterates strategy designs. Results The innovation tournament yielded 31 ideas and 32 barriers from diverse stakeholders (12 primary care physicians, 10 medical assistants, 4 nurse practitioners, 2 practice managers, and 4 patient support assistants). A panel of 6 stakeholders and scientists deliberated on the ideas and voted for patient self-report (i.e., through tablet computers, text message, or an online patient portal) as the winning idea. The research team rapid prototyped tablets in one primary care practice with one physician over 5 five-hour shifts to examine the feasibility, acceptability, and effectiveness of the strategy. Most patients, the physician, and medical assistants found the tablets acceptable and feasible. However, patient support assistants struggled to incorporate them in their workflow and expressed concerns about scaling up the process. Depression screening rates were higher using tablets compared to usual care; follow-up was comparable between tablets and usual care. Conclusions Rapid participatory methods engaged and amplified the voices of diverse stakeholders in primary care. These methods helped design an acceptable and feasible implementation strategy that showed promise for increasing depression screening in a primary care setting. The next step is to evaluate the strategy in a randomized controlled trial across primary care practices.Briana S. LastAlison M. ButtenheimAnne C. FuttererCecilia LiveseyJeffrey JaegerRebecca E. StewartMegan ReillyMatthew J. PressMaryanne PeiferCourtney Benjamin WolkRinad S. BeidasBMCarticleDepression screeningPrimary careParticipatory researchRapid implementationImplementation strategy designMedicine (General)R5-920ENBMC Family Practice, Vol 22, Iss 1, Pp 1-26 (2021) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
Depression screening Primary care Participatory research Rapid implementation Implementation strategy design Medicine (General) R5-920 |
| spellingShingle |
Depression screening Primary care Participatory research Rapid implementation Implementation strategy design Medicine (General) R5-920 Briana S. Last Alison M. Buttenheim Anne C. Futterer Cecilia Livesey Jeffrey Jaeger Rebecca E. Stewart Megan Reilly Matthew J. Press Maryanne Peifer Courtney Benjamin Wolk Rinad S. Beidas A pilot study of participatory and rapid implementation approaches to increase depression screening in primary care |
| description |
Abstract Background Most individuals with depression go unidentified and untreated. In 2016 the US Preventive Services Task Force released guidelines recommending universal screening in primary care to identify patients with depression and to link them to treatment. Feasible, acceptable, and effective strategies to implement these guidelines are needed. Methods This three-phased study employed rapid participatory methods to design and test strategies to increase depression screening at Penn Medicine, a large health system with 90 primary care practices. First, researchers solicited ideas and barriers from stakeholders to increase screening using an innovation tournament—a crowdsourcing method that invites stakeholders to submit ideas to address a workplace challenge. Second, a panel of stakeholders and scientists deliberated over and ranked the tournament ideas. An instant runoff election was held to select the winning idea. Third, the research team piloted the winning idea in a primary care practice using rapid prototyping, an approach that quickly refines and iterates strategy designs. Results The innovation tournament yielded 31 ideas and 32 barriers from diverse stakeholders (12 primary care physicians, 10 medical assistants, 4 nurse practitioners, 2 practice managers, and 4 patient support assistants). A panel of 6 stakeholders and scientists deliberated on the ideas and voted for patient self-report (i.e., through tablet computers, text message, or an online patient portal) as the winning idea. The research team rapid prototyped tablets in one primary care practice with one physician over 5 five-hour shifts to examine the feasibility, acceptability, and effectiveness of the strategy. Most patients, the physician, and medical assistants found the tablets acceptable and feasible. However, patient support assistants struggled to incorporate them in their workflow and expressed concerns about scaling up the process. Depression screening rates were higher using tablets compared to usual care; follow-up was comparable between tablets and usual care. Conclusions Rapid participatory methods engaged and amplified the voices of diverse stakeholders in primary care. These methods helped design an acceptable and feasible implementation strategy that showed promise for increasing depression screening in a primary care setting. The next step is to evaluate the strategy in a randomized controlled trial across primary care practices. |
| format |
article |
| author |
Briana S. Last Alison M. Buttenheim Anne C. Futterer Cecilia Livesey Jeffrey Jaeger Rebecca E. Stewart Megan Reilly Matthew J. Press Maryanne Peifer Courtney Benjamin Wolk Rinad S. Beidas |
| author_facet |
Briana S. Last Alison M. Buttenheim Anne C. Futterer Cecilia Livesey Jeffrey Jaeger Rebecca E. Stewart Megan Reilly Matthew J. Press Maryanne Peifer Courtney Benjamin Wolk Rinad S. Beidas |
| author_sort |
Briana S. Last |
| title |
A pilot study of participatory and rapid implementation approaches to increase depression screening in primary care |
| title_short |
A pilot study of participatory and rapid implementation approaches to increase depression screening in primary care |
| title_full |
A pilot study of participatory and rapid implementation approaches to increase depression screening in primary care |
| title_fullStr |
A pilot study of participatory and rapid implementation approaches to increase depression screening in primary care |
| title_full_unstemmed |
A pilot study of participatory and rapid implementation approaches to increase depression screening in primary care |
| title_sort |
pilot study of participatory and rapid implementation approaches to increase depression screening in primary care |
| publisher |
BMC |
| publishDate |
2021 |
| url |
https://doaj.org/article/7762d6da11a94cba9710a40800b63c55 |
| work_keys_str_mv |
AT brianaslast apilotstudyofparticipatoryandrapidimplementationapproachestoincreasedepressionscreeninginprimarycare AT alisonmbuttenheim apilotstudyofparticipatoryandrapidimplementationapproachestoincreasedepressionscreeninginprimarycare AT annecfutterer apilotstudyofparticipatoryandrapidimplementationapproachestoincreasedepressionscreeninginprimarycare AT cecilialivesey apilotstudyofparticipatoryandrapidimplementationapproachestoincreasedepressionscreeninginprimarycare AT jeffreyjaeger apilotstudyofparticipatoryandrapidimplementationapproachestoincreasedepressionscreeninginprimarycare AT rebeccaestewart apilotstudyofparticipatoryandrapidimplementationapproachestoincreasedepressionscreeninginprimarycare AT meganreilly apilotstudyofparticipatoryandrapidimplementationapproachestoincreasedepressionscreeninginprimarycare AT matthewjpress apilotstudyofparticipatoryandrapidimplementationapproachestoincreasedepressionscreeninginprimarycare AT maryannepeifer apilotstudyofparticipatoryandrapidimplementationapproachestoincreasedepressionscreeninginprimarycare AT courtneybenjaminwolk apilotstudyofparticipatoryandrapidimplementationapproachestoincreasedepressionscreeninginprimarycare AT rinadsbeidas apilotstudyofparticipatoryandrapidimplementationapproachestoincreasedepressionscreeninginprimarycare AT brianaslast pilotstudyofparticipatoryandrapidimplementationapproachestoincreasedepressionscreeninginprimarycare AT alisonmbuttenheim pilotstudyofparticipatoryandrapidimplementationapproachestoincreasedepressionscreeninginprimarycare AT annecfutterer pilotstudyofparticipatoryandrapidimplementationapproachestoincreasedepressionscreeninginprimarycare AT cecilialivesey pilotstudyofparticipatoryandrapidimplementationapproachestoincreasedepressionscreeninginprimarycare AT jeffreyjaeger pilotstudyofparticipatoryandrapidimplementationapproachestoincreasedepressionscreeninginprimarycare AT rebeccaestewart pilotstudyofparticipatoryandrapidimplementationapproachestoincreasedepressionscreeninginprimarycare AT meganreilly pilotstudyofparticipatoryandrapidimplementationapproachestoincreasedepressionscreeninginprimarycare AT matthewjpress pilotstudyofparticipatoryandrapidimplementationapproachestoincreasedepressionscreeninginprimarycare AT maryannepeifer pilotstudyofparticipatoryandrapidimplementationapproachestoincreasedepressionscreeninginprimarycare AT courtneybenjaminwolk pilotstudyofparticipatoryandrapidimplementationapproachestoincreasedepressionscreeninginprimarycare AT rinadsbeidas pilotstudyofparticipatoryandrapidimplementationapproachestoincreasedepressionscreeninginprimarycare |
| _version_ |
1718418952689811456 |