将青少年初级保健患者转诊至焦虑和抑郁的单次干预：一项可行性研究方案

Referring Adolescent Primary Care Patients to Single-Session Interventions for Anxiety and Depression: Protocol for a Feasibility Study.

作者信息

Eyllon Mara, Dalal Michelle, Jans Laura, Sotomayor Ian, Peloquin Gabrielle, Yon James, Fritz Rochelle, Schleider Jessica

机构信息

Practice Research Network, Reliant Medical Group, Worcester, MA, United States.

Northeastern University, Northeastern University Health and Counseling Services, Boston, MA, United States.

出版信息

JMIR Res Protoc. 2023 Aug 9;12:e45666. doi: 10.2196/45666.

DOI:10.2196/45666

PMID:37556202

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10448284/

Abstract

BACKGROUND

Despite the growing prevalence of depression and anxiety among adolescents, fewer than half access appropriate mental health care. Single-session interventions (SSIs) for depression and anxiety offered in primary care are a promising approach to bridging the treatment gap.

OBJECTIVE

We aimed to implement a clinical workflow for primary care and behavioral health providers to refer patients aged 13 to 17 years with mild to moderate depression and anxiety symptoms to Project YES (Youth Empowerment and Support), an open-access SSI platform, in a large group medical practice with an integrated behavioral health department.

METHODS

Pediatric primary care and integrated behavioral health providers will be educated on the benefits of Project YES for adolescent anxiety and depression and trained in a workflow integrated within the electronic health record system, Epic, to refer patients during well-child visits and pediatric behavioral health visits. Patients with mild to moderate internalizing symptoms based on the 17-item Pediatric Symptom Checklist or youth Pediatric Symptom Checklist will be invited to try an SSI through Project YES. We will examine provider uptake and perceptions of acceptability, feasibility, and appropriateness over time.

RESULTS

The rollout will take place between November 2022 and May 2023, when outcomes will be evaluated. Data analysis and manuscript writing are anticipated to be completed during the summer of 2023.

CONCLUSIONS

SSIs such as those available through Project YES have the potential to provide low-cost, evidence-based mental health treatment to adolescents with mild to moderate depression and anxiety. If deemed feasible and acceptable, providing SSIs in primary care settings could significantly improve access to mental health care without taxing pediatric primary care and behavioral health providers.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/45666.

摘要

背景

尽管青少年中抑郁症和焦虑症的患病率不断上升，但获得适当心理健康护理的青少年不到一半。在初级保健中提供的针对抑郁症和焦虑症的单节干预措施（SSIs）是缩小治疗差距的一种有前景的方法。

目的

我们旨在为初级保健和行为健康提供者实施一种临床工作流程，以便在一个设有综合行为健康部门的大型团体医疗实践中，将有轻度至中度抑郁和焦虑症状的13至17岁患者转诊至“是计划”（青年赋权与支持），这是一个开放获取的SSI平台。

方法

将对儿科初级保健和综合行为健康提供者进行关于“是计划”对青少年焦虑和抑郁的益处的教育，并对他们进行在电子健康记录系统Epic中整合的工作流程培训，以便在儿童健康检查和儿科行为健康就诊期间转诊患者。根据17项儿科症状清单或青少年儿科症状清单有轻度至中度内化症状的患者将被邀请通过“是计划”尝试单节干预。我们将随着时间推移检查提供者的采用情况以及对可接受性、可行性和适宜性的看法。