Improving Mental Health Outcomes in Adolescent Patients With Universal Anxiety Screening in an Outpatient Pediatric Primary Care Office: A Quality Improvement Project.

INTRODUCTION: In the wake of the cultural and mental health consequences that arose since the COVID-19 pandemic, primary care providers must be able to assess and initiate treatment of anxiety disorders in the pediatric population. Only 59% of children with a diagnosable anxiety disorder are identified and receive treatment. This quality improvement project aimed to evaluate the implementation of universal anxiety screening using the General Anxiety Disorder-7 tool in pediatric primary care. METHODS: Screening was performed on adolescents (aged 12-18 years) to evaluate the frequency and acceptability of tool administration and identification of anxiety and referrals to mental health care for treatment. Employing a pretest-posttest design, the effect of universal anxiety screening for adolescents was measured at well-child visits. RESULTS: Anxiety screening and anxiety diagnosis rates were significantly increased post-implementation. DISCUSSION: Universal screening for anxiety was efficacious in the project setting for identifying cases of anxiety.

Developing, Implementing, and Evaluating Personalized Education for Pediatric Patients Diagnosed With Asthma on an Observation Unit.

INTRODUCTION: A quality improvement project was commenced to determine if personalized, patient-specific education can increase parent/guardian knowledge and reduce subsequent emergency department (ED) visits and inpatient admissions secondary to asthma. METHOD: Pre- and post-education survey scores were analyzed for a change in knowledge. A retrospective electronic health record (EHR) chart review was performed one year following the education to determine if the patients had additional ED visits or inpatient admissions. RESULTS: A statistically significant increase in post-education survey scores (p = 0.004) and decrease in post-education inpatient admissions was found (p = 0.005). There was no significant difference between the number of pre- and post-education ED visits. DISCUSSION: Asthma is a chronic medical condition that often requires life-long home management. These results revealed that parent/guardian knowledge regarding asthma can be increased and optimal home management improved by personalized, patient-specific education.

Implementation of intimate partner violence education for adolescents with spina bifida.

OBJECTIVE: Intimate partner violence (IPV) prevention among adolescent patients with disability is needed, yet rarely discussed in the clinical setting. This study evaluated the feasibility of implementing a brief educational training based on an evidence-based IPV intervention in a pediatric spina bifida clinic. Frequency of IPV discussion was assessed through evaluation of patient feedback and provider surveys. METHODS: Adolescent patients with spina bifida aged 12-21 completed after visit surveys before (N= 13) and after the provider training (N= 21). Primary outcomes included frequency of provider discussion about IPV and receipt of patient safety cards. Chi-square tests compared patient feedback prior to and two months following the education session. Provider knowledge and attitude changes were assessed with pre-post surveys. RESULTS: More patients discussed IPV with providers following the education session compared to baseline (p= 0.03). Provider feedback, both immediately and at two months after the education session showed increased awareness of IPV, comfort with assessment, disclosure, and referral to resources. CONCLUSIONS: The educational intervention increased provider comfort with addressing IPV within a specialty clinical setting. The frequency of IPV communication significantly increased as compared to baseline, patients reported the discussions were beneficial, and providers reported greater comfort discussing IPV and referring patients to resources.