Date of Award

Spring 5-22-2021

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice



First Advisor

Pedro Colio, DNP, FNP-C, ENP-C, CCRN


The aim of this evidence-based project is to improve depression screening among adolescents between the ages of 12 and 18 using the PHQ-9 Modified Scale for Teens in a rural pediatric primary care clinic in Southern California. Depression is a cause of considerable morbidity and mortality among the pediatric population. The literature supports the use of depression screening tools in a variety of settings, including pediatric primary care; their use has shown an improvement in detection of depression in adolescents. The American Academy of Pediatrics (AAP) and the U.S. Preventive Services Task Force (USPSTF) both recommend the use of tools to screen for depression in adolescents beginning at the age of 12. Screening tools for depression, specifically PHQ-9 Modified for Teens, help to identify depression in both the adult and pediatric populations. With its use in pediatric primary care, the PHQ-9 scale has been shown to have a sensitivity of 94.7% and a specificity of 86.5%. In a pediatric primary care clinic, four clinicians including physicians and nurse practitioners will be educated about AAP depression screening guidelines, on the use and scoring of PHQ-9 Modified Scale for Teens. The screening tool will be used for every well-child visit with patients between the ages of 12 and 18 for a period of 3 months. Baseline, pre-intervention data will be collected retrospectively comprising of a 3-month period and compared to the 3-month period of post-intervention data obtained from electronic medical record (EMR) charts. The findings will demonstrate whether there is an increase in detection of depression in adolescents seen during a well-child visit post-intervention compared to those same adolescents seen for a previous well-child visit pre-intervention. If successful, this evidenced-based project could be applied in other pediatric primary care clinics to improve screening and care of the adolescent patient with depression.

Included in

Nursing Commons