Depression screening perceptions and practices in a primary care clinic: A mixed-methods study.

Abstract

Depression is highly prevalent in primary care (PC) settings. While extensive efforts are directed at optimization of depression screening practices, rates remain suboptimal, and barriers continue to be poorly understood. The present study investigated screening-related practices and beliefs. A concurrent mixed-methods approach was utilized to obtain both quantitative and qualitative data. Participants (N = 36) completed a self-report survey and a brief semistructured interview to assess attitudes toward depression screening, knowledge/beliefs about screening, as well as administration practices and screening-related training. Despite low rates of training (52.8%), participants endorsed understanding of the purpose, scope, and specialty populations targeted for screening. 83.3% of the sample assisted patients with screening completion. Rephrasing and reading the screening items were common and (with exception of reading the paper form) were associated with higher reported screening-related barriers (p < .05). Perceived importance of screening scores was significantly, positively associated with screening-related competence scores (r = .50, n = 35, p < .01). Qualitative data analysis revealed that screening may be conducted on a case-by-case basis or deferred based on perception of clinical relevance and time constraints. Finally, participants endorsed multiple screening-related questions and concerns about administration, psychometrics, and overarching screening goals. To improve implementation of universal depression screening, goals of depression screening need to be clearly explained. Screening workflows require optimization balancing employees' feedback and best practice recommendations. (PsycInfo Database Record (c) 2023 APA, all rights reserved).