Date of Award

Spring 5-25-2024

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Joseph Burkard, DNSc, CRNA

Abstract

Increasing patient access to mental health providers: Improving depression and anxiety outcomes for African American women aged 18 years old and older.

Background: Depression and anxiety are growing health problems in the United States. In 2020/2021, there was a 36.4% to 41.5% increase in reported symptoms of depression and anxiety. Evidence has shown that African American women experience disproportionate increased risks and disparities in obtaining mental health care.

Purpose of Project: To improve access to African American or culturally competent mental health providers for adult African American women. Improving access to mental health care will lead to earlier diagnosis and treatment of depression and anxiety. Evidence has shown that early diagnosis can lead to decreased symptoms, ultimately improving patient outcomes.

Framework/ EBP Model: The Iowa Model of evidence-based practice to promote quality care was utilized. The 5 A’s framework was utilized as the foundation for motivational interview techniques.

Evidence-based Intervention/Benchmark: The validated Patient Health Questionnaire - 9 and Generalized Anxiety Disorder - 7 questionnaires were utilized to screen church members for depression and anxiety. The attendees were educated via PowerPoint presentation on the current rate of depression and anxiety among African American women, including signs and symptoms. Once education was complete, questionnaires were scored, and those with a positive score were gathered individually. After explaining the participation requirements and obtaining consent, a list of African American and culturally competent providers was distributed. Follow-up calls and rescreening were conducted at 1, 2, and 3-months post-intervention. The 3-month follow-up questionnaires were utilized to determine intervention effectiveness.

Evaluation of Results: Before the intervention, the PHQ-9 scores of project participants were divided into categories. 29% were non-minimal, 29% were mild, 38% were moderate, 4% were moderately severe, and none were severe. After the intervention, post-intervention PHQ-9 scores were categorized as 94% non-minimal and 6% mild. None of the participants fell under any other category. Similarly, before the intervention, the GAD-7 scores of the project participants were put into different categories. 42% were minimal, 38% were mild, 13% were moderate, and 8% were severe. After the intervention, post-intervention GAD-7 scores were categorized as 88% minimal and 13% mild. None of the participants fell under any other category.

Implications for Clinical Practice: In addition to improving access to African American and culturally competent mental health providers, this project addresses the disparities experienced by the African American population, decreases stigma attached to mental health conditions within the community, and provides early access to care and treatment, which in turn provides direct access to mental health providers and improved patient outcomes compared to current methods.

Conclusions: By implementing early screening and education regarding the growing problem of depression and anxiety and by improving the barrier of locating African American or culturally competent mental health providers, we directly addressed the mental health disparities experienced by African American Women.

Keywords:

Depression, Anxiety, Patient-Health Questionnaire-9, Generalized Anxiety Disorder-7

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