Depression Screening in Primary Care: Using HIT for Patients with Limited English

初级保健中的抑郁症筛查：对英语能力有限的患者使用 HIT

• 批准号: 8186411
• 负责人: Dara H. Sorkin
• 金额: $ 37万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-05 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8186411
• 关键词: Address; Affect; Caring; Clinic; Clinical; Communication Barriers; Community Health Centers; Depressed mood; Depression screen; Detection; Diagnosis; Distress; Economics; Electronic Health Record; Electronics; English Language; Financial Support; Funding; Goals; Grant; Health; Health Personnel; Health Resources; Health Services Administration; Home environment; Hospitals; Individual; Information Systems; Intervention; Language; Laws; Life; Medical; Mental Depression; Mental Health; Mental Health Services; Methods; Multimedia; Notification; Online Systems; Outcome; Patients; Post-Traumatic Stress Disorders; Prevalence; Primary Care Physician; Primary Health Care; Process; Provider; Psyche structure; Randomized Controlled Trials; Refugees; Research; Risk; Risk Assessment; Screening procedure; Software Engineering; Specific qualifier value; Stimulus; Stress; System; Technology; Time; Training; Trauma; United States; Visit; health information technology; high risk; improved; indexing; innovation; interactive multimedia; medical specialties; meetings; mental disorder diagnosis; new technology; novel; primary care setting; skills; southeast Asian; tool; treatment as usual; usability

DESCRIPTION (provided by applicant): The prevalence of depression in primary care is high. Primary care physicians serve as the initial point of contact for most patients with depression, yet it is estimated that only about half of the depressed patients who present for care are recognized and treated. Language barriers can further exacerbate this problem. Approximately 54 million people in the United States speak a language other than English at home and over 21 million are limited English-language proficient (LEP). Language barriers may result in less discussion about patients' mental health needs, and fewer referrals to specialty mental health services. Recent advances in health information technology (HIT), however, may facilitate novel ways to screen for mental health problems among limited English proficient patients. The HIT intervention in this study will have four components: 1) web- based training for the providers; 2) multimedia electronic screening of patients for depression and PTSD; 3) immediate electronic notification system for the health care providers and integration with the patients' electronic health records (EHR); and 4) provider clinical decision support. In a randomized, controlled trial in a primary care setting, we will assess the potential of a multi-component health information technology intervention to improve the screening rates, clinical detection, provider initiation of treatment, and patient outcomes for depression and post-traumatic stress disorder among LEP Southeast Asians. We also will examine the usability and acceptability of this technology to patients with limited English skills and their providers. Finally, we will identify and evaluate potential facilitators and barriers to wide spread implementation and dissemination of the HIT intervention. This technology has the potential to be adapted and utilized for any group of limited English-language proficient (LEP) patients, regardless of their native language, and has the potential to be adapted for providers to aid in the recognition, diagnosis, and treatment of mental health problems in diverse primary care settings. PUBLIC HEALTH RELEVANCE: This study assesses the potential of Health Information Technology (HIT) to improve the screening, diagnosis, and treatment of depression and post-traumatic stress among LEP Southeast Asians. Should this intervention be found to be effective, the principles of the HIT technology could be easily adapted for screening in other languages to increase the recognition and treatment of depression and PTSD in primary care settings.

描述（由申请人提供）：初级保健中抑郁症的患病率很高。对于大多数抑郁症患者而言，初级保健医生是最初的接触点，但据估计，只有一半的抑郁症患者被识别和治疗。语言障碍可以进一步加剧这个问题。在美国，大约有5400万人说英语以外的语言，超过2100万人的英语熟练熟练（LEP）。语言障碍可能会导致人们对患者的心理健康需求的讨论更少，而对专业心理健康服务的推荐也很少。但是，健康信息技术（HIT）的最新进展可能有助于筛查有限英国熟练患者的心理健康问题的新方法。这项研究的热门干预将有四个组成部分：1）为提供者提供基于网络的培训； 2）抑郁症和PTSD患者的多媒体电子筛查； 3）卫生保健提供者的即时电子通知系统，并与患者的电子健康记录（EHR）集成； 4）提供商临床决策支持。在初级保健环境中的一项随机对照试验中，我们将评估多组分健康信息技术干预措施的潜力，以提高筛查率，临床检测，提供者的治疗启动以及患者在LEP东南亚人中的抑郁症和创伤后应激障碍。我们还将检查该技术对具有有限英语技能的患者及其提供者的可用性和可接受性。最后，我们将确定并评估潜在的促进者和障碍，以实施广泛的蔓延和传播热门干预措施。该技术有可能适应任何有限的英语熟练（LEP）患者，无论其母语如何，并且有可能适应提供者，以帮助提供者在多样化的初级保健环境中识别，诊断和治疗心理健康问题。 公共卫生相关性：这项研究评估了健康信息技术（HIT）的潜力，以改善LEP东南亚人中抑郁症和创伤后压力的筛查，诊断和治疗。如果发现这种干预措施有效，则可以轻松地适应其他语言的筛查，以增加初级保健环境中对抑郁症和PTSD的识别和治疗。